As oral health care professionals, we recognize tobacco use as a significant factor that contributes to both oral cancers and periodontal diseases. Patients who use tobacco experience less successful outcomes from non-surgical and surgical periodontal treatments, as well as with dental implants.1,2,3
Because tobacco use brings oral risk factors, clinics are ideal settings to encourage and assist patients in their attempts to become tobacco free. It is important for all dental offices to record their patients’ tobacco use and their interest in quitting tobacco.4 Clinics have always emphasized tobacco cessation, scheduled patients on a recurring basis for more lengthy appointments, and hired personnel with skills to educate and motivate patients. Patients appreciate this added value when approached in a non-judgmental, caring, and respectful manner. Now a new program exists to help us proactively connect patients to support that can greatly increase their success in quitting tobacco.
The Minnesota Clinic Fax Referral Program offers dental clinics a streamlined approach to referring patients to cessation coaching by phone. The program allows dental office staff to fax a HIPAA-compliant referral form to a single, tobacco cessation phoneline. The fax triggers a call to the patient from the appropriate quitline service. (Individuals who are uninsured or underinsured are referred to QUITPLAN® Services.) During the initial call, the program is described and the patient is invited to enroll. Patients who enroll complete a series of phone coaching sessions, scheduled at their convenience. The patient may also call and talk with a quit coach if more help is needed between or after the scheduled phone sessions. The dental office will also receive a fax from the quitline reporting the results of the initial enrollment.
Prior to this system, a clinician would have to look up a patient’s insurance in order to get patients directed to the correct quitline service offered by their insurer, then identify the corresponding quitline phone number and give it to the patient. The process was time consuming and the patient still had to call to initiate the coaching. Now it is easy for both the clinic and the patient. Plus, it is free and available to all Minnesotans, regardless of the patient’s medical or dental insurance coverage.
Phone coaching can remove barriers and help patients develop a plan for quitting tobacco. Pilot programs completed in several Twin Cities medical clinics have shown that proactively connecting patients to telephone coaching can be a successful strategy to help tobacco users quit.5 Subsequent pilots in dental clinics obtained similar results.
This program is offered through Call it Quits, a collaboration among Minnesota’s health plans (Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, MMSI, Preferred One, UCare) and ClearWay MinnesotaSM. Materials and registration information about the Minnesota Clinic Fax Referral Program were mailed to all MDA members earlier this summer. To learn more about Call it Quits or register your clinic to participate in the Minnesota Clinic Fax Referral Program, call (651) 662.4054 or visit www.preventionminnesota.com and click on the Call It Quits icon on the home page.
Additional cessation support materials such as forms to document tobacco use history, forms to conduct brief or extended interventions, or an office self-help manual on tobacco cessation with pharmacotherapy information, can be obtained through the University of Minnesota’s School of Dentistry Tobacco Use Cessation Program. Visit www.umn.edu/perio/tobacco and click on Office Tobacco Cessation Interventions.
We have a wonderful opportunity in dentistry not only to improve our treatment results and help our patients improve their long-term oral health, but to add years and quality to their lives. Helping our patients quit tobacco can yield these positive outcomes. I encourage each of us in the dentistry field to make it our responsibility.
1. Tomar SL and Asma S. Smoking-attributable periodontitis in the US: Findings from NHANES III. J Perio 71(5): 743-751, 2000.
2. Heasman L, Stacey F, Preshaw PM, McCracken GI, Hepburn S, Heasman PA. The effect of smoking on periodontal treatment response: A review of clinical evidence. J Clin Perio 33:241-253, 2006.
3. Sanchez-Pereza A, Moya-Villaescusa MJ, Caffesse RG. Tobacco as a risk factor for survival of dental implants. J Perio 78(2):351-359. 2007.
4. Stafne EE and Bakdash B. Tobacco cessation program: Resources to help organize a dental office program. NW Dentistry 83(4):31-35, 2004.
5. Manley, Marc W. Collaborating on Statewide Cessation: A Win-Win for Heath Care Professionals and Patients. Metro Doctors 10(1):21-22, 2008.
*Dr. Stafne directs the Tobacco Use Cessation Program at the University of Minnesota’s School of Dentistry. He also serves as advisor to Call It Quits on administering the Minnesota Fax Referral Program in dental clinics. He can be reached at email@example.com.