Smokers are significantly less likely to seek dental care than nonsmokers

Smokers are significantly less likely to seek dental care than nonsmokers, according to data from a nationally representative sample of 15,250 American adults. The finding holds true regardless of age, gender, race, ethnicity, socioeconomic status, location and insurance coverage.

Because smokers face increased risk of gum disease, tooth loss and oral cancers, “they’re the very population that should be seeking more dental care,” says Susan K. Drilea, lead author of the study, which was sponsored by the National Institutes of Health and the Centers for Disease Control.

The study, reported in the latest American Journal of Health Behavior, analyzed data gathered during a government health care survey in 2000. “We found that 33 percent of current smokers reported having at least one dental visit that year compared to 45 percent of nonsmokers,” says Drilea.

The finding highlights an “opportunity for intervention,” according to the report. “Efforts to decrease the rates of serious oral diseases may be enhanced by targeting educational campaigns to smokers, emphasizing the need for regular dental visits.”

Dental professionals could play a key role in delivering these messages, says the report. Many practices have already adopted the “Ask, Advise, Refer” approach recommended by the American Dental Hygienists’ Association to help their patients quit smoking.

Drilea says support from other health advocates could augment the efforts of dental professionals. “Tobacco awareness campaigns are beginning to incorporate more recognition that oral health is affected by the use of tobacco. Lung cancer has traditionally been the focus of attention, but increasingly they are acknowledging that every system in the body is affected.”

Further research might improve such educational efforts by asking smokers why they don’t visit the dentist more often. “Determining whether this is a matter of personal choice, a lack of awareness, a financial issue, or whether there are obstacles as part of the dental visit itself” could be helpful, says Drilea.

Dan Peterson, a Nebraska dentist who places special emphasis on working with patients who smoke, offers insight into what such research might find. Smokers, he says, fear that their dentist will “condemn them for smoking and try to get them to quit, when most of my patients don’t want to quit.”

Peterson offers this advice to colleagues interested in promoting oral health among patients who smoke: “Don’t judge them, come across as caring and concerned. Be direct with the effects of smoking to their oral health and provide them with options of care. For our patients who insist on smoking, we provide a special program of more regular dental care. We educate, educate, educate and care.”