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December 03, 2008  
DENTAL NEWS: Feature Story

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  • Smokers Not Getting in to See Dentists

    Smokers Not Getting in to See Dentists


    December 12, 2005

    By: Jean Johnson for Dental1

    Even though people that use tobacco are more susceptible to oral disease, a recent study published in American Journal of Health Behavior says that nicotine users do not go to the dentist as often as non smokers. The study was sponsored by the National Institutes of Health and the U.S. Centers for Disease Control and Prevention.
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    Learn more about smoking and oral health:

    The American Dental Association recommends an exam and cleaning every six months or at least once a year.

    Since blood supply to smoker’s mouths is reduced, it’s even more important for tobacco users to brush two minutes twice a day and floss before bed.

    Smokers are at increased risk for:
    Gum disease
    Tooth loss
    Oral cancers


    Based on data from a government health survey taken in 2000 from 1,500 Americans, the study “found that 33 percent of current smokers reported having at least one dental visit that year compared to 45 percent of nonsmokers,” said lead author, Susan Drilea, Ph.D.

    "Given the higher risk of oral diseases among smokers and the critical role played by dental care in preventing, diagnosing and treating oral diseases," the authors wrote, "finding that current smokers are less likely to visit a dentist than are non smokers identifies an opportunity for intervention."
    Drilea said the study did not reveal information about why smokers visit their dentists less often than others, but she speculated that a number of issues might rest at the bottom of the behavior.
    "My hunch is that it has to do with maybe some of the reasons they choose to smoke to begin with," Drilea said. "It has to do with health consciousness and health-seeking behaviors. Still, determining whether this is a matter of personal choice, a lack of awareness, a financial issues, or whether there are obstacles as part of the dental visit itself could be helpful in addressing the overall problem.”
    Sue Golame and her husband of Park City, Utah both smoked when they were first married. “It was bad enough smoking in Mormon country,” said Golame. “But if my memory serves correct, the study is true. Neither my husband nor myself went in for cleanings too often. In fact, about the only time we did go was when a tooth hurt so badly we had no choice. Back then we thought we’d live forever and were impervious I guess – that is if we even thought about it.”

    Forty-year-old Golame goes on to explain that the medical and dental world has always been anathema to herself and her husband.

    “Yes, that might be one of the bigger reasons,” she said. “We just always hated the whole vibe. The officious receptionists and the fluorescent lights and the clinical feel to the scene. Being treated like a bag of bones and such. It all has such an inhumane feel to it. At least it always has to us. We’re better now, but we still dislike going into the dentist and the physician. People are nice enough, but they maintain this distant, impersonal tone. It’s so weird confiding your personal issues to a science-based organization that think of you as just another miserable case. I suppose we should be grateful for science, but we really don’t like how the medical world conducts itself.”

    Portland dental hygienist Nina Lieblich hopes that the offices she works in aren’t as bad as the ones Golame and her husband have encountered. More, Lieblich thinks there is something to the health consciousness issue that Drilea raises.

    “It’s true that the majority of people we see probably are non smokers, but that might have to do with the idea that people who smoke tend to be the ones that don’t take care of the rest of their bodies,” said Lieblich. Something to the effect of their lungs are already a mess, “so why would they worry about their mouths.”

    That said, Lieblich points out that both herself and the dentists in whose offices she practices make concerted efforts to work with smokers. “Because smoking reduces the blood supply to the teeth and gums, we try to get patients that are involved in extensive dental procedures like periodontal therapy or dental implants to quit smoking if they can,” said Lieblich. “Those kinds of treatments are time consuming and costly, and the chances of them succeeding are much better if people will stop smoking.”

    “One thing we can do is recommend that patients see their medical doctor for medications like Zyban. There is also Wellbutrin, which even though it is an antidepressant has been shown to help smokers stop,” said Lieblich. “Also we try to tell patients why smoking is bad. But that’s hard to do since a lot of times people don’t want to hear that if they are addicted.”

    Last updated: 12-Dec-05

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