ABSTRACT
Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.
Subject(s)
Humans , Male , Female , Adult , Smoking/adverse effects , Smoking/therapy , Smoking Cessation/statistics & numerical data , Chronic Periodontitis/etiology , Socioeconomic Factors , Time Factors , Brazil , Carbon Monoxide/analysis , Logistic Models , Prospective Studies , Surveys and Questionnaires , Risk Factors , Age Factors , Treatment Outcome , Smoking Cessation/psychology , Chronic Periodontitis/therapy , Middle AgedABSTRACT
O objetivo deste estudo foi avaliar o efeito de um programa antitabágico e do tratamento periodontal não-cirúrgico na perda dentária em fumantes portadores de periodontite crônica. Fumantes que desejavam parar de fumar se inscreveram no serviço oferecido pelo Programa de Cessação de Tabagismo do Hospital Universitário em São Paulo. Eles se submeteram a tratamento periodontal não cirúrgico concomitantemente à terapia de cessação de tabagismo. Manutenção periodontal foi realizada a cada três meses até 24 meses de acompanhamento. Um examinador calibrado e cego para o hábito de fumar realizou exame periodontal completo na inclusão dos pacientes e após 3, 6, 12 e 24 meses após o término do tratamento periodontal. Este examinador verificou a perda dentária durante o período de acompanhamento. Durante os 24 meses no estudo, a decisão da extração dentária era tomada por um consenso de três periodontistas do grupo de pesquisa. Dos 1.214 pacientes inscritos, 306 foram examinados, 112 foram incluídos e 59 continuaram no estudo por dois anos. Destes, 18 (31%) pararam de fumar e 41 (69%) continuaram fumando ou oscilaram. A média geral do número de dentes perdidos foi 0,63 (±1,4). Após ajustar para as extrações realizadas durante a fase de tratamento periodontal, a média diminuiu para 0,42 (± 1,2), sendo 0,39 ± 0,8 no grupo dos que pararam de fumar e 0,44 ± 1,3 no grupo que continuou fumando (p = 0.88). Apesar de a extensão cumulativa e a média dos dentes ausentes terem sido semelhantes nos dois grupos durante o acompanhamento, houve uma tendência de maior perda dentária no grupo fumante no primeiro ano de acompanhamento. Com estes resultados, verificou-se que a cessação to tabagismo não promoveu um benefício adicional na perda dentária em fumantes 24 meses após parar de fumar.
The aim of this study was to evaluate the effect of a smoking cessation program and non surgical periodontal treatment on tooth loss in smokers with chronic periodontitis. Smokers willing to quit smoking enrolled in the service offered by the Smoking Cessation Program at the University Hospital in São Paulo. They have undergone non surgical periodontal treatment concomitantly to smoking cessation therapy. Periodontal maintenance was performed every 3 months until 24 months of followup. A calibrated examiner, blinded to smoking status, performed complete periodontal examination on baseline and after 3, 6, 12 and 24 months after periodontal treatment. The examiner assessed tooth loss during follow-up. During the 24 months of follow-up, the decision to extract a tooth was taken by a consensus of 3 periodontists of the study group. Of the 1,214 enrolled patients, 306 were examined, 112 were included and 59 remained in the study for two years. Of these, 18 (31%) quit smoking and 41 (69%) continued to smoke or oscillated. The mean number of tooth lost was 0.63 (±1.4). After adjusting for the extractions performed during the treatment phase, the mean number decreased to 0.42 (±1.2), being 0.39 ± 0.8 in the quitters group and 0.44 ± 1.3 in the group the continued to smoke (p=0.88). Even though the cumulative extent and mean number of missing teeth were similar in both groups during follow-up, there was a tendency for a higher tooth loss in the smokers group in the first year of follow-up. It was concluded that smoking cessation did not promote an additional benefit on tooth loss in smokers 24 months after smoking cessation.
Subject(s)
Humans , Male , Female , Chronic Periodontitis , Periodontal Diseases/complications , Tooth Loss , Nicotiana/adverse effects , Tobacco Use Disorder/adverse effectsABSTRACT
O tabagismo é o mais importante fator de risco de diversas doenças crônicas, incluindo a periodontite. Embora cirurgiões-dentistas apresentem potencial para ajudar seus pacientes fumantes a abandonar o vicio, o papel do dentista na cessação do tabagismo ainda não está totalmente esclarecido. O objetivo deste estudo prospectivo de 12 meses foi verificar o efeito de um programa antitabágico multidisciplinar na cessação de tabagismo em fumantes com periodontite. Duzentos e um (201) sujeitos foram triados e 93 foram incluídos e receberam tratamento periodontal não-cirúrgico e terapia antitabágica. Durante o tratamento periodontal, os dentistas motivaram ativamente os participantes a pararem de fumar, usando técnicas de entrevista motivacional. Aconselhamento e suporte adicionais foram fornecidos durante as visitas de manutenção após 3, 6 e 12 meses do término do tratamento periodontal. A condição de tabagista foi avaliada por meio de um questionário estruturado e foi validada pela mensuração de monóxido de carbono expirado (CO). Dentre os 52 indivíduos que permaneceram até o exame de 12 meses, 22 (42,31%), 17 (32,69%) e 17 (32,69%) não estavam fumando após 3, 6 e 12 meses, respectivamente. Concluiu-se que a terapia antitabágica realizada por uma equipe multidisciplinar que inclui dentistas resultou em alta taxa de cessação de tabagismo
Smoking is the leading risk factor of several chronic diseases, including periodontitis. Although it is acknowledged that dentists have potential to help smoking patients to quit, their role in tobacco control is not completely defined. The aim of this prospective 12-month study was to evaluate the effect of a multidisciplinary smoking cessation program in quitting smoking in subjects with periodontal disease. Two-hundred and one (201) subjects were screened, and 93 were included and received non-surgical periodontal treatment and smoking cessation therapy. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6 and 12 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Among the 52 individuals that remained up to the 12-months examination, 22 (42.31%), 17 (32.69%) and 17 (32.69%) were not smoking at 3, 6 and 12 months, respectively. It is concluded that smoking cessation therapy performed by a multidisciplinary team including dentists resulted in high quit rates