Tobacco Dependence Education in Accredited U.S. Dental Assisting Program Curricula

Indianapolis, IN

Tobacco use remains the leading cause of preventable morbidity and mortality in the United States producing numerous adverse oral effects. Thus, tobacco dependence education (TDE) should be an integral part of every oral healthcare professional's education. This study assessed the level of TDE in the curricula of accredited U.S. dental assisting (DA) programs and then compared the findings to those from a similar assessment of dental hygiene (DH) curricula. A previously validated and published 51-item survey was sent to directors of all 298 accredited DA programs. Assessed were curricular TDE content, time spent on each topic, expected levels of clinical competence and resources used. Responses from completed surveys were reviewed, coded and entered into an Excel spreadsheet. Eighty-nine programs returned completed surveys for a 30% response rate. Of the 13 TDE-related content areas, those most often covered were "tobacco-related oral disease" (100%) and "general diseases related to tobacco use" (93%); those least often covered included "stages of (behavior) change" (29%), "how to develop a comprehensive tobacco intervention program in a private office setting" (23%) and "strategies for community-based tobacco control" (22%). In indicating the level of tobacco cessation intervention (Brief, Moderate or Intensive) students should be able to demonstrate competence in upon graduation. 44% of program directors reported Brief, 54% reported Moderate while 8% replied Intensive. Less than half of reporting programs conducted a formal assessment of clinical competence in any of the seven TDE-related skills; however, skills in "assessing patient tobacco use" and "associating head and neck findings to tobacco use" were formally or informally assessed by 64% and 61% of respondents, respectively. When compared to DH program survey results, only one of the 13 TDE content areas, "oral diseases related to tobacco use," was covered more often by DA programs. DA programs reported less curricular time for each of the other content areas save "addressing students' own use of tobacco." TDE appears to play a much smaller role in the curricula of accredited U.S. DS programs, when compared to DH programs. DA programs were also less likely to formally assess clinical competence in TDE skills. Approval was obtained from the IU Institutional Review Board (IRB # 1201007832).