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Dentists can partake in Great American Smokeout Nov. 19

November 02, 2015

By Michelle Manchir

ACS Smokeout poster 

Nov. 19 is the American Cancer Society’s Great American Smokeout observance, and dentists can use the day to talk with their patients about the dangers of tobacco to oral health.

Dentists can be certain that at least some of their patients are smokers.

About 42 million Americans smoke cigarettes, according to the American Cancer Society. As of 2013, there were also 12.4 million cigar smokers in the U.S., and more than 2.3 million who smoke tobacco in pipes — other dangerous and addictive forms of tobacco, according to the American Cancer Society.

Dentists can offer patients resources, including quit line information or guidance toward local tobacco cessation classes.

One way University of Florida dental students are taught to broach the topic of tobacco cessation with patients, Dr. Tomar said, is with an approach called “motivational interviewing.”

Motivational interviewing is a “patient-centered method for talking to individuals about health behavior change. The goal is to help patients make fully-informed decisions while hopefully guiding them toward healthier choices,” according to Lisa Merlo, Ph.D., an assistant professor in the Department of Psychiatry at the University of Florida College of Medicine.

Having a conversation with a patient, guiding them to reflect on and answer questions about him or herself and then identifying possible solutions with the dentist, can be more effective than a traditional approach of just listing healthy behaviors and telling the patient to do them, said Dr. Tomar.

“If we just lecture (patients) about changing behaviors, whether it’s tobacco use, or flossing or drinking five cans of Coke a day, it is generally ineffective because it immediately puts people on the defensive,” Dr. Tomar said.

Dr. Lynn Carlisle, who has written a book called “Motivational Interviewing in Dentistry: Helping People Become Healthier,” said he learned firsthand, as a young dentist freshly graduated from dental school in the 1960s, how ineffective just telling patients what to do can be. “Most patients wouldn’t do what I told them to do,” he said.

Dr. Carlisle, now retired from clinical work, said he spent time studying humanistic psychology, which led him to be a cheerleader for motivational interviewing, especially as it relates to preventive dentistry. This approach “can help people discover their own inherent reasons to make healthy changes,” Dr. Carlisle said.

Asking open-ended questions — or questions that can’t be answered with a simple “yes” or “no,” actively listening to a patient’s concerns and goals, affirming them for any steps they’ve taken to move toward healthy behaviors and developing with them a feasible pathway to reach their goals are some steps to take during motivational discussion, Dr. Tomar said.

“Let them guide the conversation,” said Dr. Tomar. “The whole goal is to put both of us on the same side of the fight. I’m here to help you.”

This interview approach typically requires significant training to achieve true competence, said Dr. Merlo, but dentists can see examples of motivational interviewing online at YouTube.com/user/Merlolab by searching for “the effective dentist” video.

For more information about the Great American Smokeout or to find tools and resources related to tobacco cessation, visit Cancer.org/Smokeout.

The ADA’s consumer website, MouthHealthy.org, also features several videos on the dangers of tobacco use, dental health implications and more.

The ADA also has brochures that can support the efforts of patients who are actively trying to quit smoking or are just starting to think about it. “Quit Smoking: Better Health, Better Life, Better You” is available at ADAcatalog.org by searching for product number DAB071. Use promo code 15126 by Dec. 31 to receive a 15 percent discount on all ADA Catalog products.