New York State Oral Health Care Providers' Readiness to Adopt Oral Cancer Examinations and Tobacco Cessation Practice Guidelines

Objectives: The aims of this study were: 1) to assess the oral cancer examinations and tobacco cessation counseling practices of oral health care providers in New York State and 2) to assess their readiness to adopt established practice guidelines. Methods: A comprehensive survey which included validated items based on the Transtheoretical Model of Behavior Change was mailed to a stratified random sample of practicing dentists and dental hygienists in the state. The facilitators and barriers for adoption of these practices were also evaluated. The sample size consisted of 1,025 dentists and 1,025 hygienists. Descriptive statistics were used to characterize the sample as to their examination and counseling practices as well as to their readiness to change their behavior. Results: The surveys effective response rates were as follows: 53% for the dentists and 65% for the dental hygienists. A relatively high number of the oral health care providers (dentists=84%; dental hygienists=74%) reported performing annual oral cancer examinations to most of their patients aged 40 years or older. Nine percent of the dentists and 13% of the dental hygienists were in the early stages of precontemplation and contemplation. A much lower percentage of oral health care providers(dentists=18%; dental hygienists=26%) reported assisting their tobacco user patients to quit. Furthermore, 77% of the dentists and 65% of the dental hygienists were in the early stages of precontemplation and contemplation.Barriers for adopting the guidelines were similar for both groups of providers. Conclusions: Although oral cancer examinations seem to have been adopted as a standard of care by the majority of the oral health care providers in the state, innovative approaches are needed to motivate them to offer tobacco cessation counseling. The identification of the providers' stage of change may permit the tailoring of the interventions to match their needs. Supported by NIH/NIDCR grant no R21DE1442502.