It’s not news that smoking causes dental issues and health issues. Global Prevalence of Tobacco Use in Adolescents and Its Adverse Oral Health Consequences by Muhammad Ashraf Nazir, Asim Al-Ansari, et al. studies the effects of smoking on the teeth of adolescents aged thirteen to fifteen in one hundred and thirty-three countries.
Smoking and Oral Health
Smoking has been directly related to dental caries, periodontal disease, hairy tongue, melanosis, and hyperkeratosis. Tobacco use is high among adolescents worldwide. The lowest-income countries had the lowest number of adolescent smokers. Higher-income countries had the highest number of adolescent smokers.
Globally, nine out of ten smokers began smoking before age eighteen. Most smokers who start before eighteen continue into adulthood. Early education about the dangers of smoking and oral health may prevent children and teenagers from trying cigarettes.
A global health initiative is needed to educated and prevent dental and health-related effects of smoking. Oral conditions in juvenile smokers directly affect their quality of life and general health. Harmful long-term and short-term oral conditions caused millions of sick days for children in these countries, and the cost of treatments is over a hundred billion a year.
The researchers’ goal is to raise awareness among dental professionals on the importance of early education for young smokers.
The Study
Adolescent cigarette, oral tobacco, and snuff users that were apart of various studies since 2007 until now are included in the study. The countries with the most recent studies were used. The countries are placed into four categories based on their gross national income: low-income, lower-middle-income, upper-middle-income, and high-income countries.
Twenty-eight low-income, 76 lower-middle-income, 48 upper-middle-income, and 33 high-income countries are represented in the study. Almost a quarter of juveniles have a smoking habit in Madagascar compared to Tajikistan at almost five percent. Four percent of adolescents smoke in Vietnam while close to half of the children in Papua New Guinea use tobacco.
Seven percent of Chinese juveniles smoke, while almost forty percent of kids in Tuvalu used tobacco. Eleven percent of kids in the United States smoke. Just over three percent smoke in Oman. Boys consistently smoked more than girls except for the highest-income group where the percentage was close to even.
Common Oral Conditions
The study shows that juveniles who smoke have an increased risk of many oral conditions:
- gingivitis and bleeding gingiva
- malodor or halitosis
- caries
- periodontal disease
- oral mucosal lesions
- xerostomia and hypersensitivity
- oral pre-cancerous lesions and cancer
Tobacco contains thousands of complex chemicals; some are known to be poisonous while others cause diseases such as cancer. Tobacco also alters the oral microbiome, which promotes bacterial colonization. Smoking also increases antibiotic resistance and suppresses the immune system. The chemicals also disrupt the oral cavity’s pH balance and compromise the healing of any wounds.
The Five A’s and Five R’s
The five A’s and the five R’s were created to help health and dental professionals constructively organize their anti-smoking education.
The five A’s are: ask, advise, assess, assist, and arrange. Ask the patients if they smoke and document their answers. Advise them to quit smoking and try to assess their level of readiness to do so in your conversation.
Assist in their quest to quit by suggesting various healthy alternatives. Arrange a follow-up visit to check specifically for damage caused by their tobacco use, which puts the problem in perspective.
The five R’s are: relevance, risks, rewards, roadblocks, and repetition. Discuss how quitting smoking is relevant in the patient’s life, especially when it comes to their health, looks, and family. Communicated the risks involved with using tobacco and the rewards that come from quitting.
Be honest about barriers, or roadblocks, that the patient may experience during the process and reassure them with the risks and rewards. Keep repeating the information.
For the Record
The study discovered just how high and widespread the use of tobacco among juveniles truly is. In most countries, males smoked more than females, and the economy of their country has a direct relationship to the number of children who smoked. Each juvenile that smoked had an increase in gingivitis, halitosis, and tooth staining.
Health and dental professionals need a plan of attack to help decrease tobacco use in the large percentage of young smokers they see in the dental chair. The five A’s and five R’s are just one option a dental clinic can follow. Dentists and hygienists can become role models, educators, researchers, and collaborators in the process of quitting. The entire goal is always to increase the quality of life of your patients.
