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Consensus Report of the 1st European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals. C.A. Ramseier / N. Mattheos / I. Needleman / R. Watt / S. Wickholm. Swiss Cancer League National Stop Smoking Program „Smoking is harmful… Let it be“. University of Michigan
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Consensus Report of the 1st European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals C.A. Ramseier / N. Mattheos / I. Needleman / R. Watt / S. Wickholm Swiss Cancer League National Stop Smoking Program „Smoking is harmful… Let it be“ University of Michigan School of Dentistry, Ann Arbor, USA
Detrimental effects of tobacco use on oral health • Oral mucosa • Periodontium
Detrimental effects of tobacco use on oral health • First evidence for ANUG • Cigarette smoking of more than 10 cigarettes per day may increase the risk for the development of the Vincent disease (ANUG) 4 to 7 times. • (Pindborg 1947)
Journal of the American Dental Association (JADA), Dezember 1964
Journal of the American Dental Association (JADA), Dezember 1964
Journal of the American Dental Association (JADA), Dezember 1964
The dentist‘s role in helping patients to stop smoking Arden G. Christen, DDS, MSD, Zaragoza AFB, Spain „Many patients want to quit smoking but simply do not know how. The dentist can help them if he has studied the scientific evidence of the health consequences of smoking and is himself a nonsmoker.“ Christen AG, JADA, 1970
The dentist‘s role in helping patients to stop smoking • Arden G. Christen, DDS, MSD, Zaragoza AFB, Spain • Involvement of the dentist • Formulating an active program • Community responsibility • Resource material for the dentist Christen AG, JADA, 1970
First National Dental Symposium on Smoking Cessation: Helping Dental Patients to Quit Smoking April 1989, Chicago, USA McCann Tobacco Use and Oral Health Barbara Gebert et al. Dentists as smoking cessation counselors Roger H. Secker-Walker et al. A statewide survey of dentists‘ smoking cessation advice Stuart J. Cohen et al. Helping smokers quit: a randomized controlled trial with private practice dentists Michael J Geboy Dentists‘ involvement in smoking cessation counseling: a review and analysis
Special Section: IADR Symposium on Tobacco Use, Prevention, and Cessation March 2002, San Diego, USA John C. Greene Tobacco Use, Prevention, and Cessation: Introduction to the Special Section David M. Burns Reducing Tobacco Use: What Works in the Population? Michael Kotylar Managing Nicotine Addiction Shirley C. Gelskey Impact of a Dental/Dental Hygiene Tobacco-Use Cessation Curriculum on Practice Saman Warnakulasuriya Effectiveness of Tobacco Counseling Stuart A. Gansky et al. Oral Screening and Brief Spit Tobacco Cessation Counseling: A Review and Findings Alice M. Horowitz Where from Here?
European Workshop on Oral Care and General Health Opportunities for the Dental Hygienists in Health Education in the New Century - a meeting for educators April, 2003, Munchenwiler, Switzerland Renvert S Systemic Diseases and Destructive Periodontal Diseases Persson GR Periodontal Risk Management (PRM) Moinyhan P Nutritional Impact on Oral Health Promotion Sicillia A Oral Hygiene Revisited Ramseier CA Smoking Prevention and Cessation
1st European Workshop on Tobacco use Prevention and Cessation for Oral Health Professionals October 2005, Munchenwiler, Switzerland
Participants Rolf Attström (Switzerland, Sweden) Habib Benzian (France, corresponding participant) Viv Binnie (Schottland) Michael Bornstein (Switzerland) Elias Casals Peidró (Spain) Arden Christen (USA) Thomas Dietrich (USA, Germany) Jacquelyn Fried (USA) Angela Fundak (Switzerland) Christine Gafner (Switzerland) Marjolijn Hovius (The Netherlands) Martin Janda (Sweden) Ron Knevel (The Netherlands) Kerstin Knutsson (Sweden) Eva Lädrach (Switzerland) Sabine Ledderhose (Switzerland) Nikos Mattheos (Switzerland, Greece) Bernard McCartan (Ireland) Andy McEwen (United Kingdom) Joan McGowan (USA) Robert Mecklenburg (USA) Luigi Minenna (Italy) Ian Needleman (United Kingdom) Tim Newton (United Kingdom) Kerstin Öhrn (Sweden) Susan Padrutt (Switzerland) Lena Persson (Sweden) Argy Polychronopoulou (Greece) Nicki Radley (United Kingdom) Christoph Ramseier (USA, Switzerland) Ulrich Peter Saxer (Switzerland) Meta Schoonheim-Klein (The Netherlands) Gay Sutherland (United Kingdom) Jeanie Suvan (United Kingdom) Clemens Walter (Switzerland) Saman Warnakulasuriya (United Kingdom) Richard Watt (United Kingdom) Seppo Wickholm (Sweden) October 2005, Munchenwiler, Switzerland
Participants October 2005, Munchenwiler, Switzerland
Working group position papers • Public Health Aspects Watt R. et al. • Evaluation of Tobacco use Needleman I. et al. Cessation Counseling in the Dental Office • Undergraduate Education Ramseier C.A. et al. • Continuing Education Wickholm S. et al. • Evaluation of Education Mattheos N. et al.
Publication Consensus report: First European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals. Care pathway Ramseier CA, Mattheos N, Needleman I, Watt R, Wickholm S. Oral Health Prev Dent. 2006;4(1):7-18.
www.tobacco-oralhealth.net www.tobacco-oralhealth.net/workshop2005
www.tobacco-oralhealth.net www.tobacco-oralhealth.net/workshop2005
Public Health Aspects of Tobacco Control in Dental Practices • FDI - WHO Framework Convention on Tobacco Control (FCTC) • Oral health professionals have a unique role to play in Tobacco control • Policies, organisational, and educational initiatives need to be implemented • Compensation systems, cessation procedure code need to be used Ramseier CA et al., Oral Health Prev Dent. 2006;4(1):7-18.
Evaluation of Tobacco Use Cessation (TUC) in the Dental Office • Available evidence for behavioural change support combined with pharmacotherapy • Feasibility of such interventions in dental settings needs to be established • TUC should be embedded in standard care in dental practice • Team approach in the dental setting is essential for effective TUC • Funding for further research: • Outcomes of TUC in dental settings • Implementation and feasibility of different TUC models • Barriers to TUC in dental settings • Effect of TUC on oral health outcomes Ramseier CA et al., Oral Health Prev Dent. 2006;4(1):7-18.
Education of Tobacco Use Prevention and Cessation Undergraduate education • Implementation of TUC in undergraduate dental and dental hygiene curriculum needs to be promoted • Curriculum content should be interdisciplinary, including: • Biological effects of tobacco use • Tobacco culture and psychosocial aspects of tobacco use • Prevention and treatment of tobacco use and dependence • Clinical skills training for TUC • Supportive environment for TUC should be created with: • Tobacco-free policies • Encouraging staff, faculty, and students to enter individual tobacco cessation programs Ramseier CA et al., Oral Health Prev Dent. 2006;4(1):7-18.
Education of Tobacco Use Prevention and Cessation Continuing education (CE) • The majority of dental personnel currently practicing without education of TUC • CE courses that specifically address practitioners and the entire dental team must be designed and offered regularly • CE courses should be multi-disciplinary • Strategies to implement tobacco use prevention and cessation into practice: • Tobacco interventions is an ethical and professional responsibility • Best interests of the dental practice Ramseier CA et al., Oral Health Prev Dent. 2006;4(1):7-18.
Education of Tobacco Use Prevention and Cessation Evaluation of undergraduate and continuing education • Competent TUC skills should be evaluated at undergraduate, graduate, and continuing education level • Assessment of knowledge base: • Multidisciplinary • Comprehensive • Assessment of clinical skills: • Throughout the entire curriculum • In CE courses: • Assessment of pre-course knowledge and skills • Evaluation of the entire CE course by the participants • Assessment of the clinical practice implementation process Ramseier CA et al., Oral Health Prev Dent. 2006;4(1):7-18.
Oral Health Network on Tobacco use Prevention and Cessation (OHTPC) www.tobacco-oralhealth.net
Oral Health Network on Tobacco use Prevention and Cessation (OHTPC) www.tobacco-oralhealth.net
Acknowledgements Swiss Cancer League National Stop Smoking Program „Smoking is harmful… Let it be“ Oral B Laboratories Pfizer Inc. Quintessence Publishing group
Thank you very much! Christoph A. Ramseier ramseier@umich.edu Swiss Cancer League National Stop Smoking Program „Smoking is harmful… Let it be“ University of Michigan School of Dentistry, Ann Arbor, USA