The Oral Health Care Professional Role

A detailed health history is considered a vital tool in the assessment process, providing general medical and dental health patient information. Health history forms are used to gather clues to begin the process of creating a treatment plan, that is geared towards the needs of the patient prior to the initiation of treatment.³¹ It is important to list all forms of tobacco that an individual may use on the health history form, smoking cigarettes, smokeless tobacco, and cannabis usage are not enough, with these new current tobacco and nicotine trends among the young adults. E-cigarettes and oral nicotine pouches usage must now be listed as an option for the patient to check off, to consider all future long-term effects with oral and systemic health.²⁰ This will allow the clinicians and doctors to be able to direct the appointment accordingly with clinical exam findings, construction of treatment plans, elevate and shed light with prognosis for success with treatment plans or procedures and, lastly patient education to help the patient with their oral health outside of the routine visits.

ONPs should also be listed on consent forms prior to oral surgery and post operative care. Nicotine constricts blood vessels, reducing blood flow and oxygen supply to tissues, which can delay wound healing, viability of surgical flaps and increase the risk of infection. Nicotine can stimulate bone resorption, leading to bone loss and impaired bone healing. Additionally, nicotine is a considered a vasoconstrictor, that leads to hypoxia of tissues, which can raise pulse and blood pressure rates, affecting the cardiovascular system.³²

It is the role of the oral health care provider to be knowledgeable of current trends, while providing routine care. Oral health care providers have an ethical obligation and duty to offer and facilitate tobacco and nicotine cessation treatments for their patients as a standard component of care. Having the appropriate screening questions on the healthy history form may allow an individual to inform their provider that they are using these products, without stating it verbally, which some patients struggle or feel uncomfortable with, especially shy young adults.

In addition, these screening questions may initiate crucial conversation between youth and guardians, creating parental involvement. It allows the clinician to freely bring it up and then supply the patient with the current information they need in a professional interaction. Putting the 5A’s of tobacco/nicotine cessation in motion, with educational pamphlets on tobacco and nicotine cessation, caries, periodontal disease, and risks for oral cancer, can all be distributed to the patient at this time. Clinicians can also give parents and guardians resources to assist communication regarding the harm tobacco and nicotine products have on the overall health and oral health with their children.³³ Along, with educational resources, the oral health provider can refer the patient to appropriate local cessation programs, mental health providers and the patients primary care physician. Dental professionals should create a referral system to collaborate with the patient’s health care providers to address both the physical and behavioral aspects of nicotine addiction.