Yesterday, more than 750,000 people were expected to â€˜take the leap' and get ready to quit smoking as part of No Smoking Day. But the campaign remains as much about the profession as it does about those attempting to quit. No Smoking Day gives the profession the opportunity to recommend tips on how to maintain a healthy mouth and although most patients know that smoking is hazardous to their health, they may not be aware of the many dangers caused by tobacco, such as gum and periodontal disease, or know it is linked to mouth cancer.
As a Hygienist I see my role in smoking cessation as crucial. My experience over the last 40 years has given me a good insight into the damage smoking causes to the mouth and its surrounding structures.
When I started my career in the 70s at least 50 per cent of my patients smoked and so did I. Although difficult to admit, to my shame if I had an awkward patient with lots of tobacco stain, I would sneak off afterwards to the staff room for a ciggy.
I stopped when I was 30 thank goodness, but I believe I lost 3 of my molar teeth through smoke damage.
When I say smoke damage, that's exactly what I mean. Obviously the chemicals and nicotine are harmful and carcinogenic. But what occurred to me was that I was essentially barbequing my gums and soft tissues with hot smoke which I sucked in with the power of a Henry Hoover forcing the smoke into the tissue.
As we know smoke rises, so the palate becomes like a kipper - pale and devoid of a blood supply. The intensity of the smoke will hit the upper back molars as it is sucked up. Hygienists will have noticed that the gingival palatal tissue surrounding the 6's and 7's in smoker has receded by at least 4-5mm, but not so much the buccal aspect. Perhaps the cheek tissue prevents the infusion of the smoke!
As far as I know there has not been any scientific research into this theory, but one only has to look at the crinkled lined lips of smokers and dehydrated facial skin to acknowledge there is something more to this than just nicotine.
People of my generation grew up with smoking. It was the norm. Indeed for us ladies it was seen as sophisticated - remember the iconic photo with Audrey Hepburn?
What really concerns me is the amount of young people I see smoking. Rising costs to stave people off the habit means more youngsters have turned to rolling their own. Guys, it's not sophisticated and it's not a good look. How does this relate to tailor-made cigarettes? Is the tobacco stronger in roll ups? Is there less protection from the filters? Do they inhale more or less smoke? Again I can't find any research relating to this.
When broaching the subject of smoking with my patients I take a very holistic approach. They don't want to be nagged yet again by another health care professional. They KNOW smoking is bad for them. I am honest about my experience of smoking. I take on board all the other daily stress of their lives. These are people not just mouths with teeth and gums. All I want for them is to keep their health teeth and sanity.
I hope I can help them to understand what the consequences are so they can then make informed decisions. That's all I ask and all I can expect.
When I finish treatment I ask patients not to smoke for at least one hour to give the enamel a chance to re-mineralize. I hope to plant the seeds of awareness so they may think about stopping. It's a start.
Like weight loss and many other addictive problems, patients have to want to stop. We mustn't tell them off or the shutters will come down and they probably won't return.
As for me I wouldn't even dare have one again. It might seem such a good idea at a party with a glass of merlot, but two weeks later you're standing in the corner shop saying "Twenty Bensons Please".
The term "smoking gun" was originally, and is still primarily, a reference to an object or fact that serves as conclusive evidence of a crime or similar act. How apt!
Michele Trewhella EDH , cert FE