Maryland dental hygienists' assessment of patients' risk behaviors for oral cancer.

PURPOSE: This study examined Maryland dental hygienists' knowledge of tobacco and alcohol use as oral cancer risk behaviors; the practice of obtaining comprehensive medical histories regarding patients' current, past, and type/amount of alcohol and tobacco used; and their opinions about the adequacy of their tobacco and alcohol cessation educational preparation in a state that ranks unusually high for oral cancer mortality rates.

METHODS: The data source was the Maryland Oral Cancer Survey of Dental Hygienists conducted in November 1997 (MDOCSDH, 1997) with a simple random sample of 700 dental hygienists selected from a registry of 2,677 licensed dental hygienists in Maryland. Data were collected with a 40-item self-administered mailed questionnaire. Unweighted data from 331 returned surveys (response rate = 60%) were analyzed using SAS and SUDAAN Software. Stratified and logistic data analysis techniques were utilized, and the results were evaluated statistically using a .05 level of significance.

RESULTS: Nearly all of the responding dental hygienists knew that tobacco is an oral cancer risk factor. Most probed their patients' present use of tobacco in medical histories; however, fewer assessed patients' past use and type/amount of tobacco used. Very few believed that they were adequately prepared to provide tobacco cessation education, although the majority agreed that dental hygienists should be prepared to provide this type of information. The majority of respondents also knew that alcohol use is an oral cancer risk factor; however, less probed their patients' present use of alcohol in medical histories compared to assessing present tobacco use. Even fewer assessed patients' past use and type/amount of alcohol used. A very small minority believed that they were adequately prepared to provide alcohol cessation education. Yet, in contrast to tobacco cessation counseling preparation, few respondents believed that dental hygienists should be prepared to provide alcohol cessation education. There was a significant relationship (p < .05) between screening for all three aspects of tobacco use and agreement of dental hygienists that they were adequately prepared to provide tobacco cessation education. Of seven background characteristics, practice setting was the only one found to be positively associated (p < .05) with even one of three complete medical history screening indices--the practice of assessing all three tobacco screening items.

CONCLUSION: There is a need to provide more complete and accurate information in tobacco and alcohol educational programs for Maryland dental hygienists. Additional research is needed to explore sources of noninterest or discomfort in assessing patients' use of these substances, since a substantial number of Maryland dental hygienists do not assess all aspects of patients' tobacco and alcohol usage and do not agree that dental hygienists should be prepared to provide tobacco and alcohol cessation education for their patients. Maryland dental hygienists' opinions regarding the adequacy of their tobacco and alcohol cessation education appear to accurately reflect their practice of obtaining comprehensive medical histories regarding these substances.