Application in the dental office of a practical method of clinical-behavioural treatment for smoking cessation: a case report

  • Leonardo Essado Rios Oral Health Coordination, Inhumas Campus, Federal Institute of Goiás, Brazil
  • Maria do Carmo Matias Freire Department of Oral Health, School of Dentistry, Federal University of Goiás, Brazil
  • Nádia Lago Costa Department of Stomatology, School of Dentistry, Federal University of Goiás, Brazil
Keywords: dentistry, dental care, smoking cessation, nicotine, behaviour.


INTRODUCTION: Smoking causes harmful effects to the oral cavity, therefore dentists play an important role in helping their patients to quit. OBJECTIVE: In this article, we aimed to report the application of a practical method of clinicalbehavioural treatment for smoking cessation which was performed by a Dental Surgeon in a male patient who wanted to stop smoking. CASE DESCRIPTION: Behavioural support was based on the Standard Treatment Program (STP) recommended by an English institution specialized in preparing health professionals to promote smoking cessation. Drug support involved Nicotine Replacement Therapy (NRT) by the combination of transdermal patches and chewing gums in different stages and dosages. The Fagerström Test was used to assess the patient’s level of nicotine dependence. Abstinence was monitored by assessing the patient’s level of expired carbon monoxide using a monoximeter. Success in promoting patient’s abstinence was observed during 40 days of treatment and one year of follow-up. Conclusion: The STP behavioural support methodology combined with NRT proved to be quite feasible and promising to be used by dentists in order to treat smoking in the dental office.


Agnihotri R, Gaur S. Implications of tobacco smoking on the oral health of

older adults. Geriatr gerontol int. 2009; 14:526-40.

Reibel J. Tobacco and Oral Diseases: Update on the Evidence, with Recommendations. Med Princ Pract. 2003;12(suppl 1):22-32. http://doi.


Albert D, Ward A. Tobacco cessation in the dental office. Dent clin North

Am. 2012;56:747-70.

Chaffee BW, Couch ET, Ryder MI. The tobacco-using periodontal patient:

role of the dental practitioner in tobacco cessation and periodontal disease management. Periodontol. 2000. 2016;71:52-64. http://doi.


Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral oncol. 2009;45:309-16.


Fiore MC, Jaen CR, Baker T, Bailey WC, Benowitz N L, Curry SEEA et al..

Treating tobacco use and dependence: 2008 update. Rockville, MD: US Department of Health and Human Services, 2008.

Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane database syst. rev. [online]. 2016;3.

Gordon JS, Lichtenstein E, Severson HH, Andrews JA. Tobacco cessation in dental settings: research findings and future directions. Drug alcohol rev. 2006; 25:27-37.

Petersen PE. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century–the approach of the WHO Global Oral Health Programme. Community dent. oral epidemiol.

;31(suppl 1): 3-24.

Rosseel JP, Jacobs JE, Hilberink SR, Maassen IM, Allard RHB, Plasschaert

AJM et al. What determines the provision of smoking cessation advice and

counselling by dental care teams? Br. dent. j. 2009;206:E13-E13. http://

Patel AM, Blanchard SB, Christen AG, Bandy RW, Romito LM. A survey of United States periodontists' knowledge, attitudes, and behaviours related to tobacco-cessation interventions. J. periodontol. 2011;82: 367-76.

Needleman IG, Binnie VI, Ainamo A, Carr AB, Fundak A, Koeber A et al.

Improving the effectiveness of tobacco use cessation (TUC). Int. dent. j.

; 60:50-9.

Davis JM, Ramseier CA, Mattheos N, Schoonheim-Klein M, Compton S, Al-Hazmi N et al. Education of tobacco use prevention and cessation for dental professionals – a paradigm shift. Int. dent. j. 2010;60:60-72.

McEwen A. Standard Treatment Program: A guide to behavioural support

for smoking cessation. 2nd ed. UK: Department of Health, National Centre for Smoking Cessation and Training; 2014.

West R, McEwen A, Lorencato F, Michie S, Churchill S, Willis N. NCSCT Training Standards: Learning outcomes for training stop smoking specialists. 2nd ed. UK: Department of Health, National Centre for Smoking Cessation and Training; 2013.

Aveyard P, Begh R, Parsons A, West R. Brief opportunistic smoking cessation interventions: a systematic review and meta-analysis to compare advice to quit and offer of assistance. Addiction. 2012;107: 1066-73.

Brothwell DJ. Should the use of smoking cessation products be promoted

by dental offices? An evidence-based report. J. Can. Dent. Assoc. 2001;67:149-52.

Lindson-Hawley N, Hartmann-Boyce J, Fanshawe TR, Begh R, Farley A, Lancaster T. Gradual Versus Abrupt Smoking Cessation. A Randomized, Controlled Noninferiority Trial. Ann Intern Med. 2016;164:585-92. http://

Binnie VI. Addressing the topic of smoking cessation in a dental setting.

Periodontol. 2000. 2008;48:170-8.

Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane database syst. rev. [online]. 2012;11. CD000146.pub4

Shiffman S, West R, Gilbert DG. Recommendation for the assessment of tobacco craving and withdrawal in smoking cessation trials. Nicotine Tob Res. 2004;6:599-614.

Warnakulasuriya S, Dietrich T, Bornstein MM, Peidró EC, Preshaw PM, Walter C et al. Oral health risks of tobacco use and effects of cessation. Int. dent. j. 2010;60:7-30.

Watt RG, Daly B, Kay EJ. Prevention. Part 1: smoking cessation advice within the general dental practice. Br. dent. j. 2003;194:665-8.

Chandwani BP, Perry B, Scrivani S, Kulich RK. Smoking cessation in the

dental setting: a practical approach. Gen. dent. 2010;58:318-23.

Hanioka T, Ojima M, Tanaka H, Naito M, Hamajima N, Matsuse R.

Intensive smoking-cessation intervention in the dental setting. J. dent.

res. 2010;89:66-70.

Case Report