Need Help Quitting Smoking? At Columbia, You Can Ask Your Dentist

November 18, 2021

If you’re a smoker, your dentist may notice the effects.

"We see substantial changes in the mouth from smoking, such as yellow teeth, plaque, and receding gums,” says David Albert, DDS, MPH, associate professor of dental medicine and health policy at Columbia’s College of Dental Medicine and the Mailman School of Public Health.

That’s one reason why the dentist’s office is a good place to help people quit smoking. And New York State’s Department of Education requires dentists to complete a tobacco cessation class before receiving a license to practice dentistry.  

“Patients are used to receiving health education from their dentist and dental hygienist about their oral health,” says Albert. “Adding tobacco cessation advice and assistance is a natural fit for the dental team.”

“The dentist is in a unique position to identify patients who are at risk for serious illnesses related to tobacco use,” Albert says. “A dentist can readily show the patient changes in the oral cavity due to smoking—on the gingiva, teeth, the palate, tongue, or cheeks—and this can be very effective in motivating the patient to quit tobacco use.”   

About 12% to 15% of the U.S. population—and the dental school’s patients—are smokers, and nearly 40% say they want to quit. But of those who try to quit on their own, only about 4% succeed. Brief office-based interventions can increase the quit rate to 15%, though giving patients other tools—including nicotine replacement therapies or prescription medications to help combat cravings—can boost the quit rate to nearly 30%.

Dental treatment often involves multiple visits, allowing the dental team to reinforce the smoking cessation plan and increase the chance of a successful attempt to quit. “Patients are open to interventions in the dental office and are more likely to accept counseling and assistance to help them quit tobacco,” Albert says. 

Dental students at Columbia are taught how to identify the signs of smoking during visits and use motivational interviewing techniques. Students are also trained to offer nicotine replacement therapy and prescription tobacco cessation medications to give the patient the necessary tools to succeed. The College of Dental Medicine also provides tobacco cessation seminars to postdoctoral periodontal students so they can learn to identify signs of smoking and provide counseling and assistance to patients who want to quit. 

A new program was added to provide faculty with tobacco cessation training and promote education within the dental school practices in Vanderbilt Clinic.

The emphasis on tobacco cessation isn’t new to the College of Dental Medicine, which was one of the first dental schools to provide tobacco cessation education to students more than 20 years ago. 

"We are committed to making tobacco cessation clinically relevant by helping our students understand that it is an important part of what they do,” says Roseanna Graham, DDS, PhD, the James Winston Benfield Associate Professor of Operative Dentistry at the College of Dental Medicine. “Helping our patients quit smoking contributes to improving their oral and overall health.”

Tobacco use is associated with a variety of systemic conditions such as lung, esoghageal, and other cancers, lung disease and emphysema, and cardiovascular diseases. Smoking also leads to many oral health problems. More than half of periodontal (gum) disease is caused by smoking, but because smoking reduces blood supply in the gums, there are fewer noticeable signs such as bleeding and inflammation in the gums. Smoking also can contribute to reduced salivation, dental cavities, and bad breath, as well as oral lesions and mouth cancers from the many toxic substances found in tobacco and cigarette smoke.

Students can use the EPIC electronic health record to refer patients who smoke to a tobacco cessation expert for more intensive counseling and treatment.

New opportunities for tobacco cessation counseling are being explored. “The College of Dental Medicine was very successful in using telehealth during the pandemic, and this initiative is now being expanded to include tobacco cessation screening and counseling for patients,” Graham says.