UB's School of Dental Medicine is taking the next step in patient care by providing non-judgmental tobacco counseling for those who agree to quit smoking.
The program is the first of its kind in UB's Dental School, and one of the few that exist in the country, according to founder Othman Shibly, D.D.S., assistant professor of periodontics and endodontics. He said the program sets itself apart from many others because it has the potential to help to both patients who want to quit and those who haven't considered quitting.
"The program was developed because of a need to close the gap between clinical research and clinical practice," he said. "Smoking is a dental problem, just like a cavity is."
Another goal is to provide long term results for patients.
"By adding preventative measures, we can change the short term success of treatments, such as filling a cavity, to long term success and help patients have a healthier life," Shibly said.
In the past, dental students were trained to refer smokers to a quit line. Shibly's program takes dental practice to the next level by making it mandatory for third- and fourth-year dental students to provide full counseling to patients.
"The dental curriculum is filled with education about the effects of tobacco, but that's not enough," he said. "My philosophy is that we as dentists can have a more effective role than referring patients to a quit line."
Students involved in the program agree that dentists should take a more active role in encouraging patients to quit smoking.
"Dentists should be concerned with the patient's overall heath, not just their oral health," said Christopher Parks, a third-year dental medicine student and program counselor.
The program's treatment plan is based on the "5 A's" protocol: ask, advise, assess, assist and arrange.
According to Shibly, the dental student first evaluates the patient's smoking habits. Then, the patient goes through periodontal exams. When the results are shared, the student advises them to quit smoking.
To determine which patients are ready for treatment, they are asked to rate their readiness on a scale of one to ten. If patients rate themselves a seven or higher, they are treated with medications and behavior modification techniques for free. Finally, the day before the patient's quitting deadline, the student makes a follow up call for support.
Students are required to take eight hours of training, Shibly said. The Roswell Park Cancer Institute in Buffalo provides the training lectures.
"Eight hours is sufficient for training," he said. "We'll learn more as we continue to implement the program."
Shibly's survey of the program's success, which included 74 patients, showed that about 50 percent quit smoking during counseling. This amount is higher than most programs in the country, which usually have a success rate of 10 to 20 percent, Shibly said.
Six months later, 22 percent of patients were still smoke-free, bringing the program's results closer to what is seen nationally, Shibly said.
"Right now, we're working on a better follow-up program to maintain the results," he said.
Although the program adds more work to the dental curriculum, students feel it is an important supplement.
"One important figure in a patient's life, like a dentist, can have a lifelong impact on an individual's health," said Erica Scott, a dental medicine student at UB. "Quitting alone is hard to do sometimes, and we can help."
Right now, 60 percent of dental students counsel patients, but Shibly hopes to reach 100 percent participation.
The American Academy of Periodontics is currently trying to make tobacco counseling a part of dental treatment, because smoking is the number one cause of oral diseases, according to Shibly.
"Health professionals have a moral obligation to help patients quit if they know they are a smoker," he said.
