Periodontal disease and oral health-related quality of life : smoking cessation adventures in primary dental care

Much of the workload of primary dental care teams in remote-rural Scotland consists of treating periodontal disease, an inflammatory condition for which smoking is a proven risk factor.<br/><br/>This thesis sought to ascertain the effectiveness of a smoking cessation intervention applied in a primary care dental setting and employed a narrative literature review to explore periodontal disease, smoking and smoking cessation interventions. This literature review informed the design of a randomised controlled trial which failed due to lack of recruitment.<br/><br/>The Medical Research Council Framework for the Development and Evaluation of Complex Interventions was employed to provide structure to the modelling of a feasibility trial likely to succeed in evaluating the benefit of smoking cessation provision in rural dental settings.<br/><br/>A systematic literature review was undertaken to evaluate evidence regarding prevalence of periodontal disease, tobacco use and the effectiveness of tobacco cessation interventions applied in remote-rural areas. This identified a dearth of robust evidence particularly in relation to smoked tobacco. In order to model a feasibility study better adapted to the current study population, a prevalence study exploring the smoking attitudes and behaviours, the oral health-related quality of life and periodontal status of 398 dental patients was undertaken at the two study locations.<br/><br/>Twenty three percent of the participants were found to be smokers and periodontal health was significantly poorer in those who smoked. Both smokers and non-smokers strongly agreed that dentists should be involved in provision of smoking cessation activities.<br/><br/>The willingness of smokers to quit was not related to the degree of periodontal disease they experienced, suggesting that periodontal health is not valued sufficiently to factor into a decision to stop smoking. However periodontal health and smoking status both impacted greatly on oral health-related quality of life.<br/><br/>It is recommended that a feasibility trial be undertaken in remote-rural primary dental care of a smoking cessation intervention which forms an integral part of periodontal care and focuses on improving quality of life parameters rather than periodontal measures.

Name dc:type.qualificationname

Doctor of Philosophy

Level dc:type.qualificationlevel

Doctoral Thesis

Grantor dc:publisher.institution

University of Dundee

Year dc:date.issued

2014

Author dc:creator

• Emslie, Karen

Advisors dc:contributor.advisor

• Freeman, Ruth
• Hall, Andrew

Language dc:language

eng

Identifier

oai:discovery.dundee.ac.uk:studenttheses/073d9a66-18e8-49ea-b048-71c3298e02cc

OAI identifier oai:identifier

oai:discovery.dundee.ac.uk:studenttheses/073d9a66-18e8-49ea-b048-71c3298e02cc