The Oral Effects of Tobacco Use- Recognition and Patient Management
|9232||September 10, 2012||1|
Tobacco use is a primary cause of preventable morbidity and mortality worldwide. In the U.S. alone, tobacco - related diseases kill approximately 500,000 people per year. Tobacco exerts its affects on numerous body systems in a dose-dependent manner. The initial interaction of tobacco with the human body occurs in the mouth. Because of the oral cavity’s natural environment (rapid cell turnover, bacterial load etc.) and its vascularity, it is not unexpected that the reaction to tobacco is quite active here and that resulting exposure to tobacco can be most intense. Both the soft tissues and hard tissues of the oral and maxillofacial complex are affected by the use of smoking tobacco and smokeless (spit) tobacco. Therefore, it is important for health care practitioners to understand the effects of tobacco on the oral and maxillofacial complex in order to identify and manage such oral adverse effects. This teaching module includes a complete set of lecture slides with instructor notes, along with 30 assessment items for students to assess their comprehension of the content subsequent to engaging the presentation.
Romito L, Christen A, Coan L. The Oral Effects of Tobacco Use- Recognition and Patient Management. MedEdPORTAL Publications; 2012. Available from: https://www.mededportal.org/adea/publication/9232 http://dx.doi.org/10.15766/mep_2374-8265.9232
Contains time-sensitive information that will likely be inaccurate, obsolete, or irrelevant by August 22, 2015
Contains Information Suitable for Patient Education
- To describe the relationship of tobacco use and periodontal health.
- To describe the relationship of tobacco use and dental caries.
- To identify and describe soft and hard tissue lesions of the oral and maxillofacial complex associated with tobacco use.
- To describe communication techniques, utilizing the 5As tobacco intervention to address tobacco use in their patients, particularly in whom oral manifestations of tobacco use are identified.
- Tobacco Use Cessation (MeSH), Caries, Smoking, Nicotine, Cigarette, Building Oral Health Capacity (BOHC) Collection
- Family Medicine
Assessment, Diagnosis & Treatment
Establishment & Maintenance of Oral Health
Oral and Maxillofacial Pathology
- Assessment, Diagnosis & Treatment
Interpersonal & Communication Skills
Knowledge for Practice
- Clinical Exam
- Dental Student
Authors & Co-Authors
Sponsorship or Funding Source
This project is sponsored in part by funding from the Health Resources and Services Administration/Maternal Child Health Bureau grant #U44MC20223.
Effectiveness and Significance
The module has been utilized as a lecture for several oral health professions audiences and student evaluations have deemed it to be an effective presentation due to the use of images of the lesions being discussed and the accompanying explanations. The content is significant for learners about to enter the clinical setting, or already involved in patient care because they can readily apply the material to a clinical encounter. After completion of the module, the student is better prepared to detect and manage oral tobacco–related lesions. In addition, they have a stronger appreciation of the complexity and broad scope of consequences from tobacco use that can be found in the oral and maxillofacial complex. As such, it is anticipated that they may be more likely to engage their tobacco-using patients in education and cessation counseling.
Special Implementation Guidelines or Requirements
The module will require students to have computer access, with adequate connectivity speed for viewing the presentation.
Prerequisites for this module include a basic understanding of head and neck anatomy and pathology. Typically, the module precedes more detailed information on nicotine addiction, and tobacco dependence treatment strategies. This module has been successfully deployed in two primary ways: as an in-person presentation and in an online program of self-study. As a lecture of 60-90 minutes, the module has been given to oral health professions students during regular class sessions and to private dental/medical practitioners as a continuing education course. In both teaching formats we have found the module to be quite self-contained, that is, students grasp the material easily and require little if any additional support for comprehensive understanding. However, even in the online program which students complete on their own, and at their convenience, the instructor is available via email should questions arise. Last year, one student asked additional questions which went beyond the depth of the material presented and the student was referred to several specific resources from the References list which fulfilled the desire for greater detail on the particular subtopic of interest. Therefore, it is recommended that instructors consider their learners when utilizing this teaching module, and make adjustments if needed, to best suit their intended audience.
We have used Adobe Presenter as a vehicle for delivering this module, as well as in-person lectures and both have been well received. However, we learned that students preferred to have access to both the slides and the verbatim notes. The Adobe Presenter format did not allow for easy printing of slides and notes, so we posted slides and notes separately for the students that preferred to print all materials. In addition, some students also preferred an audio narration in the form of a podcast. Software for lecture capture has been used for this purpose and allows the lecture to be reviewed by students via podcast as many times as they want at their convenience. In our experience, students also expressed a desire to see the oral pathology content paired with the behavioral educational component of tobacco cessation counseling. For example, in a patient for whom a lesion such as those described is found, how exactly would a learner provide education about the oral consequences of tobacco use, advise the patient about quitting, or assess their willingness to quit? Therefore, a component we included in this module is the 5As steps of tobacco dependence treatment (Ask, Advise, Assess, Assist, and Arrange) and a short explanation of how each step of this brief intervention could be applied with a patient. In this manner, a learner who completes this teaching module would not only be able to better understand and recognize some of the oral consequences of tobacco use in their patients, but they could then apply that knowledge to provide an evidence-based approach to educate and counsel patients regarding their oral findings and tobacco cessation and /or refer them to an appropriate resource for further evaluation and treatment. A lecture is limited in that it is teacher-driven, limits student engagement, and promotes a passive learning situation. Fostering active learning can be challenging but useful to enhance the breadth and depth of student comprehension and retention of the concepts being taught. Therefore, we encourage instructors to consider incorporating active learning strategies with this presentation. Suggestions for utilizing active learning strategies with this presentation include:
- Brief role play activity of patient/clinician communication (Implementing the 5 As; Patient Interviewing to obtain a tobacco history).
- Gaming ( Jeopardy-style; In-class audience response system or “clickers”).
- Strategic questioning /discussion throughout the lecture (purposefully inserting questions and answers within the PowerPoint; “Think Pair Share”: This classroom assessment technique (Angelo and Cross, 1993) allows the instructor to pose a specific question or general topic to the learners. After considering a response on their own, students pair up with a peer and share their insights. After collaboration, each (or selected) pairs then share responses with the entire class.).
- Lecture based assignments and quizzes (Pre-class reading assignment followed by an online quiz; Post-class additional reading assignments based on lecture content.)
This information is made available under the Creative Commons license.
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