Northern Virginia Health & Life Magazine: January/February 2010
"Where There's Smoke"

When Beverly Fink, RDH, says that “people smoke where we do our work,” she’s not referring to patients lighting up in the waiting room—definitely not. Instead, Fink, the director of dental hygiene for Dental Associates of Northern Virginia and the president and founder of PerioAdvocates, is talking about the fact that she and her colleagues carry out their jobs on patients’ mouths—the point of entry for every type of tobacco habit. “We’re the first line of healthcare workers to see the unhealthy signs of tobacco use,” she says.

In fact, while much attention has been paid to the link between smoking and lung cancer, people tend to overlook the effects of tobacco on the mouth. The American Dental Association reports that smoking increases problems with gum disease, tooth decay, and tooth loss; affects healing after dental procedures; and can complicate the retention of dental implants. Furthermore, the American Cancer Society estimates that more than 35,000 people last year received diagnoses for cancers of the oral cavity, including the tongue, gums, lips, tonsils, salivary glands, hard and soft palates, and linings of the cheeks. In most of these cases, the use of a tobacco product was a significant risk factor.

“Many smoking-related cancers are found first in the mouth,” says Dental Associates’ Gary Greenspan, DDS. “That’s why every patient who comes in for a routine exam gets an intra-oral and extra-oral cancer screening of the palate, tongue, soft tissues, submandibular glands, and the lymph nodes along the neck. It takes just a minute, but because a lot of cancers found in the mouth are quite serious, it’s critical to detect them early. Time is of the essence.”

A dentist who detects red or white patches, lumps, swelling, or other problems likely will swab the area to collect a cell sample, then send the sample to a lab for analysis. “If I suspect more of a problem,” says Greenspan, “I get the patient to an oral surgeon ASAP. They may want to do a tissue biopsy.”

Kick the Habit

Greenspan and Fink are adamant that between exams, if a patient detects a potential problem, he should alert his dentist. “Get into the office immediately if you notice something,” says Fink. And whether they’ve noticed something or not, Greenspan and Fink appeal to every patient to stop using tobacco products.

“They know they shouldn’t be smoking and they know why,” says Fink, “but they don’t want to hear about it. It puts everyone on edge.” Still, Fink wishes that patients would view dental professionals as allies. Dentists can prescribe anti-smoking medications, and both dentists and hygienists can inform, motivate, and recommend other sources of help. “That may mean asking patients how they would like to be supported,” says Fink, “or calling them to track their progress. People don’t realize how much support the dental office can be. We’re willing to help. Our job is to find out whether people smoke or if they are in the process of quitting. Are they considering quitting? Are they wishing they quit? When you’re ready to quit, we’re here for you. Please remember us.”