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Swiss Cancer League National Stop Smoking Program „Smoking is harmful… Let it be“ A. Ramseier / N. Mattheos / I. Needleman / R. Watt / S. Wickh University of Michigan School of Dentistry, Ann Arbor, USA Consensus Report of the 1st European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals

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Swiss Cancer League

National Stop Smoking Program„Smoking is harmful… Let it be“

C.A. Ramseier / N. Mattheos / I. Needleman / R. Watt / S. Wickholm

University of MichiganSchool of Dentistry,Ann Arbor, USA

Consensus Report of the 1st European Workshop on Tobacco Use Prevention and

Cessation for Oral Health Professionals

• 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)

Detrimental effects of tobacco use on oral health

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

Christen AG, JADA, 1970

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.“

The dentist‘s role in helping patients to stop smoking

Christen AG, JADA, 1970

Arden G. Christen, DDS, MSD, Zaragoza AFB, Spain

• Involvement of the dentist

• Formulating an active program

• Community responsibility

• Resource material for the dentist

First National Dental Symposium on Smoking Cessation: Helping Dental Patients to Quit Smoking

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

April 1989, Chicago, USA

Special Section: IADR Symposium on Tobacco Use, Prevention, and Cessation

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?

March 2002, San Diego, USA

European Workshop on Oral Care and General Health

April, 2003, Munchenwiler, Switzerland

Opportunities for the Dental Hygienists in Health Education in the New Century - a meeting for educators

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

October 2005, Munchenwiler, Switzerland

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

• 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.

Working group position papers

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.

Publication

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 CessationUndergraduate 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 CessationContinuing 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 CessationEvaluation 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

Christoph A. Ramseier

[email protected]

Thank you very much!

Swiss Cancer League

National Stop Smoking Program„Smoking is harmful… Let it be“

University of MichiganSchool of Dentistry,Ann Arbor, USA