introduction C D A J O U R N A L , V O L 4 9 , Nº 8
Helping Dental Patients Quit Tobacco: What Can We Do and Why Should We Do It? Benjamin W. Chaffee, DDS, MPH, PhD
GUEST EDITOR Benjamin W. Chaffee, DDS, MPH, PhD, is an associate professor of oral epidemiology and dental public health at the University of California, San Francisco, School of Dentistry. His research interests include tobaccorelated behaviors, caries management and oral health disparities. Conflict of Interest Disclosure: None reported.
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or a number of years, I had the privilege of teaching first-year dental students about tobacco, oral health and supporting dental patients with tobacco cessation. Through a mix of lectures, assignments, role playing and small group activities, we detailed how tobacco ravages the oral cavity. We lamented decades of avoidable death brought on by an industry that peddles addiction to poison. We memorized the 5 A’s, made a run at motivational interviewing and were mindful of the psychological and physiological aspects of nicotine addiction. Mostly, we challenged unspoken assumptions that this would be easy, that patients would quit using tobacco the instant an authoritative voice with a mouth mirror told them they should, as if they were just waiting to be informed that smoking is bad. We grappled with the reality that many, if not most, nicotinedependent dental patients would not be willing or ready to quit, despite our willingness and readiness to help. We never donned a gown, lifted a waxer or examined a single ridge, groove or tubercle. Yet, one of my greatest compliments received on a course
evaluation stated, “This is the first class in dental school that I felt like I was becoming a dentist.” What we did practice was being knowledgeable, empathetic communicators who connect with their patients, not with a warning and empty advice but with tangible, evidence-based resources to reach a healthier state. Essentially — the practice of health care. Students challenged me occasionally. We debated the relative harms, possible merits and professional obligations around electronic cigarettes and cannabis. We pondered whether it was better to be stern or humorous (hint: be yourself). No question came more unexpectedly than when a student asked, “But, what if I just don’t care?” The comment was not so much about apathy for this line of work but about a line between the teeth and the human vessels who carry them from the waiting room to the dental chair. Deep breath. I proposed that all of us in that room, likely all of us in this profession, at some point along our journey had said we’ve chosen this career to help people, to restore lost confidence behind a smile, to extract pain from a throbbing jaw. What AUGUST 2 0 2 1
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