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SMOKING AND ORAL HEALTH

SMOKING AND ORAL HEALTH. FOR MEDICAL STUDENTS. WHO:. SMOKING IS THE MOST IMPORTANT SINGLE PREVENTABLE RISIK FACTOR FOR HIGH LEVEL OF MORBIDITY and PREMATURE MORTALIRY. MORTALITY. 50 % OF SMOKERS WILL DIE DUE TO SMOKING HALF OF THEM PREMATURERLY THEY LOST 20-25YEARS OF THE LIFE

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SMOKING AND ORAL HEALTH

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  1. SMOKING AND ORAL HEALTH FOR MEDICAL STUDENTS

  2. WHO: • SMOKING IS THE MOST IMPORTANT • SINGLE • PREVENTABLE • RISIK FACTOR • FOR HIGH LEVEL OF MORBIDITY and PREMATURE MORTALIRY

  3. MORTALITY • 50 % OF SMOKERS WILL DIE DUE TO SMOKING • HALF OF THEM PREMATURERLY • THEY LOST 20-25YEARS OF THE LIFE • DIFFERENCES ARE SIGNIFICANT AFTER 20 YEARS OF SMOKING

  4. CASES OF SMOKERS ´ DEATH • SMOKING ATTRIBUTES TO • 25 DIFFERENT DISEASES; • ANUALLY DIE DUE TO SMOKING • CVD …………………. 1,7 mil • CHOPD …… ………...970 tis • LUNG CANCER …… 850 tis

  5. SMOKING AND CANCER • HEAD and NECK – RR 10 – 12 + ALCOHOL - RR 40 - 135 • URINARY ORGANS CANCER • CERVICAL CANCER • STOMACH, COLORECTAL CANCER • HEPATAL, PANCREATIC CANCER • LEUKEMIE (MYELOID)

  6. IN CIGARETTE SMOKE • Cca 5.000 CHEMICALS • 67 HUMÁN CARCINOGENS • 33 TOXIC CONTAMINANTS OF AMBIENT AIR • 47 CHEMICALS REGISTERED AS TOXIC WASTE

  7. OTHER FORMS of TOBACCO • SMOKELESS • PIPES. CIGARS • ARE THE IMPORTANT CAUSES OF HEAD AND NECK CANCERS

  8. RISK FOR REPRODUCTION • IMPOTENCE, INFERTILITY • HORMONAL DYSBALANCE • COMPLICATION DURING PREGNANCY • ABORTS • PREMATURE DELIVERY • CONGENITAL MALFORMATIONS

  9. INTRAUTERINE EXPOSURE • FETAL TOBACCO SYNDROME => • PROGRAMMING • CONGENITAL MALFORMATIONS • NEUROPSYCHICAL DYSORDERS (ADHD,conduct dysorders, addiction, criminality) • GENOTOXICITY =>CANCER

  10. SMOKING and ORAL HEALTH • THE MAIN CAUSES OF TEETH LOST ARE CARIES and PARODONTITIS • SMOKING CONTRIBUTES TO BOTH OF THESE DISEASES

  11. ORAL HYGIENE • IS WORSE AMON SMOKERS, EVEN AMONG SMOKING DENTISTRY STUDENTS • NO-SMOKERS DECLARED 9 times HIGHER FREQUENCY OF DAILY TTETH BRUSH compared with SMOKERS

  12. NIKOTINOVÁ STOMATITIS

  13. KUŘÁCKÁ MELANÓZA

  14. TABÁKOVÉ SKVRNY

  15. ABRASE ZUBŮ

  16. CHLUPATÝ JAZYK

  17. PRENATAL RISKS OF CARIES • MOTHER´S OBESITY …………1,21 • MOTHER´S SMOKING..………..1,33 • LOW BIRTHWEIGHT • PREMATURE DELIVERY

  18. POSTNATAL RISK FACTORS • PARENTAL LOW EDUCATION….1,38 • LOW SOCIAL POSITION.………...1,35 • MATERNAL AGE UNDER 23 Y... 1,27 • IMIGRANTS…………………….1,7-1,8

  19. SMOKING and CARIES • SMOKERS HAVE: • HIGHER SCORE kpe • HIGHER SCORE KPE • In DOSE-RESPONSE ASSOCIATIONS (salivary cotinine, years of smoking, number cig/day)

  20. SMOKERS HAVE WORSE: • NUTRITION • ORAL HYGIENE • SECONDARY PREVENTION • HIGHER BACTERY COLONISATION LAKTOBACILY a Str.MUTANS • PROTEKTIVE SALIVARY ROLE (lower pH, lower production)

  21. PASIVE SMOKING: • PRENATALY: DEVELOPMENTAL DYSORDERS • INFECTIONS BY MOTHERS in 1st year of the life • IMMUNOSUPRESION : respiratory inf. • = > breathing by mouth => higher risk of inf. In oral cavity • MODIFIKATION of IMUNITY Th1 / Th2

  22. PARODONTAL DISEASES • G neg., anaerob and mikro-aerofil bakteries = > • ENHANCES PRO-INFLAMMATORY PROSTAGLANDINS A CYTOKINES => • DESTRUKCION OF TISSUE

  23. VASOCONSTRICTION • LOWER GUMS OXYGENATION • BETTER CONDITION FOR ANAEROBES

  24. AMONG SMOKERS • 3x – 4x MORE OFTEN SERIOUS PARODONTITIS: • DEEP LOBES, • HIGHER BONE LOST • MORE SUBGINGIVAL DEPOSITS of CALCULUS

  25. PARODONTAL DISEASES • ARE MORE OFTEN ALSO AMONG YOUNG SMOKERS • IZRAEL STUDY • CARDIFF DENTAL STUDY • WORSE EFFECTIVENESS OF TREATMENT

  26. TEETH LOST • MORE THAN 8 TEETH HAVE NOT (45-69letí): • 30%NON-SMOKERS • 29% EX-SMOKERS (abstinence >31 y) • 33% EX-SMOKERS (abstinence 21-30 y) • 42% EX-SMOKERS (abstinence 11-20 y) • 49% EX-SMOKERS (abstinence < 10 y) • 50% SMOKERS

  27. LEUKOPLAKIE • OCCURES 6 times MORE OFTEN AMONG SMOKERS • SIDES: • BUCAL – cigarettes smoking • PALATE – pipes/cigars smoking • LIPS, BUCAL – smokeless tobacco

  28. Homogenní leukoplakie

  29. Verukózní leukoplakie

  30. Nodulární leukoplakie

  31. ORAL CANCER • RELATIVE RISK 2 – 18 • WITH ALCOHOL 100 • WITH OTHER RISKS: Malnutrition, chr. Candidosis, viral infections (human papiloma v., herpes simplex)

  32. CANCER EPIDEMIOLOGY • Male:female rate 6:1, now 2:1 • More often among patients aged 45 + • Among young smokeless tobacco users • TONGUE – 20% • GUMS – 18% • LOWER ORAL CAVITY + SALIVARY GLANDS – 20% • LIPS – 11%

  33. Nádor jazyka

  34. SMOKING IS A DISEASE • DEPENDENCE – dg F 17 • FYSICAL PART – NIKOTIN • BEHAVIORAL PART – AUTOMATIC BEHAVIOR

  35. LEVEL OF DEPENDENCE • FAGERSTROM QUESTIONNAIRE: • QUESTIONS • „PENALTY“ POINTS 4 LEVELS OF DEPENDENCE

  36. SMOKING CESSATION– 4 A / 4P • ASK • ADVICE TO STOP • ASSIST WITH WITHDRAWAL SYMPTOMES • ARRANGE FOLLOW UP

  37. TERAPEUTIC HELP • NICOTINE REPLACEMENT THERAPY chewing gums, sticks, inhalator, tablets • Antidepresivum BUPROPION: Zyban, Wellbutrin • Nicotine Agonis VARENICLIN: Champix • VAKCINATION

  38. CONCLUSION • SMOKING IS AN IMPORTANT HEALTH RISK • SMOKING DAMAGES ORAL HEALTH • PROFESSIONAL DENTISTS ARE ACTIVE IN TOBACCO CONTROL IN MANY COUNTRIES

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