Tracking Dental Patient Tobacco Use and Intervention in the Academic Clinical Setting

Navigating the dual burden of dental and periodontal care in individuals who also smoke: an expert review

OBJECTIVES

Smoking poses a significant challenge to oral health, particularly in individuals with dental and periodontal disease. This expert review explores the dual burden of managing periodontal and dental care in smokers, emphasizing the impact of chronic tobacco exposure on disease progression and treatment outcomes.

STUDY SELECTION, DATA, AND SOURCES

Clinical trials, systematic reviews, and international guidelines were consulted where available. Search terms specific to the topic were entered into PubMed, Scopus, and Google Scholar to identify the most relevant literature.

RESULTS

Chronic smoking accelerates biofilm re-accumulation and periodontal tissue destruction, complicating treatment outcomes. Smoking cessation remains the most effective strategy for mitigating these risks, improving healing, reducing inflammation, and restoring microbiota balance. Dental professionals play a crucial role in integrating smoking cessation support into periodontal care through evidence-based interventions such as behavioral counseling, pharmacotherapy, and harm reduction strategies. Emerging technologies, including mobile health applications and remote monitoring, enhance patient engagement in smoking cessation efforts. Alternative nicotine products, such as e-cigarettes and heated tobacco products, may serve as harm reduction tools for smokers unwilling to quit, though their long-term effects on oral health remain unclear.

CONCLUSIONS

A multidisciplinary approach that combines periodontal therapy with tailored smoking cessation interventions is essential for improving oral health outcomes in smokers. Future research should prioritize longitudinal studies to assess the effectiveness of integrated smoking cessation and periodontal treatment strategies.

CLINICAL RELEVANCE

The integration of smoking cessation into routine dental care is essential to improve treatment outcomes and long-term oral health. This review emphasizes the need for evidence-based strategies to manage smokers in dental settings and highlights the importance of further research to refine clinical guidelines.

Reusing electronic patient data for dental clinical research: a review of current status

OBJECTIVES

The reuse of electronic patient data collected during clinical care has received increased attention as a way to increase our evidence base. The purpose of this paper was to review studies reusing electronic patient data for dental research.

DATA SOURCES

1527 citations obtained by searching MEDLINE and Embase databases, hand-searching seven dental and informatics journals, and snowball sampling.

STUDY SELECTION

We included studies reusing electronic patient data for research on dental and craniofacial topics, alone or in combination with medical conditions, medications and outcomes. Studies using administrative or research databases and systematic reviews were excluded. Three reviewers extracted data independently and performed analysis jointly

RESULTS

The 60 studies reviewed covered epidemiological (32 studies), outcomes (16), health services research (10) and other (2) topics; were primarily retrospective (58 studies); varied significantly in sample size (9-153,619 patients) and follow-up period (1-12 years); often drew on other data sources in addition to electronic ones (25); but rarely tapped electronic dental record (EDR) data in private practices (3). Type of research was not associated with data sources used, but research topics/questions were. The most commonly reported advantages of reusing electronic data were being able to study large samples and saving time, while data quality and the inability to capture study-specific data were identified as major limitations.

CONCLUSIONS

Dental research reusing electronic patient data is nascent but accelerating. Future EDR design should focus on enhancing data quality, begin to integrate research data collection and implement interoperability with electronic medical records to facilitate oral-systemic investigations.

CLINICAL SIGNIFICANCE

Measuring and improving the quality of dental care requires that we begin to reuse electronic patient data collected in practice for clinical research. Practice data can potentially serve as a useful complement to data collected in traditional research studies.