Credentials of Corresponding Author
MPH
Name of Faculty Advisor
Dr. Holly Kramer and Dr. Abigail Silva
Purpose
Among those who use chewing tobacco, how many visits a dentist in a year, in the United States of America?
Background and significance
Smokeless tobacco (SLT) is a tobacco product that is used by means other than smoking. It is commonly known as spit tobacco, chewing tobacco, chew, and dip. Smokeless tobacco is one of the frequently used tobacco products in the United States (US). According to a study, around 6% of high school students and 1.8% of middle school students were current users of smokeless tobacco in 2015. Smokeless tobacco is also a commonly used tobacco product among US adults after cigarettes and cigars. SLT use can lead to many adverse oral health outcomes such as periodontal disease, precancerous oral mucosal lesions, and leukoplakia. It is estimated that the SLT product contains more than 30 cancer-causing agents. SLT users are more prone to develop cancer of the throat, lip & cheek as they regularly keep the tobacco against the soft tissues and/or ingest the tobacco juice. But current warnings on the SLT products do not advise people to visit the dentist. Dental visits can help detect oral cancers earlier and helps prevention Dentists may also provide counseling to help people quit or reduce SLT use. It is vital that the SLT users visit the dentist regularly. The overall goal of our study is to determine the number of times smokeless tobacco users visit the dentist in a year. With the help of this study, the SLT users can be encouraged to visit the dentist frequently which helps in early detection and treatment of cancerous or precancerous lesions.
Theoretical/Conceptual framework
All over the globe, there are around 300 million people in about 70 countries, who use tobacco in smokeless forms. Studies have shown that 60 to 80 % of the SLT users have oral lesions which could be precancerous. Hence, it is imperative for SLT users to see their dentist frequently. Dental visits can help detect oral cancers earlier and helps prevention. Dentists may also provide counseling to help people quit or reduce SLT use. As a general rule, one is required to visit a dentist at least once in 6 months. The American Dental Association (ADA) recommends regular dental visits, the frequency of the visits determined by the dentist depending on oral health. The current warnings on the ST products do not advise people to visit the dentist.
We hypothesize that the SLT users visit the dentist fewer times compared to the non-SLT users in one year. With the help of this study, the SLT users can be encouraged to visit the dentist frequently which helps in early detection and treatment of cancerous or precancerous lesions.
Method
A cross-sectional observational study was conducted using the BRFSS 2018 data. We analyzed the data for participants between 18 - 69 years who responded to the question about tobacco product use. Statistical analyses include Chi-squared test and multivariate logistic regression We also examined the use of SLT for different states of the USA. The statistical analyses accounted for the complex survey design and adjusted for the sampling weights, strata, and cluster statement.
Results
Of the total 437,436 survey participants, 14,230 participants are smokeless tobacco users. Smokeless tobacco (SLT) use was more common among the age group 45-54 years (20.8%). Most of them were non-Hispanic White males. The total number of SLT users who visited the dentist in the last year is 7,238. Among SLT users, 17 % of them did not have any health insurance coverage. SLT users are at 33% lower odds of visiting the dentist in the past 12 months compared to the non- SLT users. Kentucky, Montana, South Dakota, Wyoming, and West Virginia had higher percentages of SLT users.
Conclusions
The findings in this study indicate that SLT users visit the dentist fewer times in a year compared to non-SLT users.
Chewing Tobacco and Importance Of Dental Visits