If you haven’t seen this commercial, you should watch it now. Courtesy of the Food and Drug Administration, it emphasizes the consequences smoking can have on your teeth, gums and mouth. When this guy doesn’t have enough money to buy his cigarettes, he removes pliers from his pocket and extracts his own tooth.
We’ve all seen it. A patient sits down in the chair, opens their mouth, and we find all sorts of staining, calculus, pockets, recession, attachment loss, bone loss, inflamed and angry gingival, and overall very poor oral health. We ask if they smoke or use tobacco, and they say yes. What I’ve been pleasantly surprised about is the education these patients have already received. They are on board with the consequences tobacco use has had on their teeth, and they admit they already thought it is a major contributing factor. I always ask if they have thought of quitting and ask what I can do to help. I’m happy to say I’ve even gotten a few to quit and have enjoyed being their cheerleader in the process at our dental appointments.
Now, let me turn to a different announcement I’ve read recently regarding periodontal disease and the risk factor of smoking. Delta Dental’s new plan for employees’ limits their cleanings for ‘healthy adults’ to one per year. Employees in Michigan, Indiana and Ohio can complete an online risk assessment survey and may qualify for additional cleanings if they have certain risk factors and/or a history of periodontal disease. The issue that the American Dental Association and American Academy of Periodontology have with the risk assessment is that it “does not include several known risk factors that would possibly warrant additional cleaning benefits, especially smoking.” Delta sent a letter to network dentists announcing the change and recognizing smoking as a risk factor, but “excluded smoking as a risk factor because it did not want to reward employees for ‘bad behaviors.’” Needless to say, dentists and patients are upset by this change.
Another interesting approach by Delta is the option to include a genetic test looking for the Interleukin-1 gene. A positive test would make employees eligible for additional cleanings in the year. Dr. Vorrasi, chair of ADA Council on Dental Benefit Programs, questions this move by saying, “If Delta honestly wanted to assess risk of periodontal disease, why would they exclude the most recognized factors in favor of a genetic test that is unproven?”
Katie Divine, DDS