The Effect of Nicotine Lozenge Over Teeth Bleaching During Cigarette's Addiction Treatment

The aim of this study was to evaluate the effect of nicotine lozenge on teeth staining with/without bleaching in animal model study. A total of 15 Wistar rats were exposed in an acrylic container to 10 cigarettes smoke three times a day for 8 minutes per time, and sacrificed after 60 days. A total of 30 incisor teeth were treated (n=10) as the following: Group-1: in-office bleaching, at-home bleaching and immersion in artificial saliva; group-2: in-office bleaching, at - home bleaching and immersion in nicotine lozenge solution and in artificial saliva; group-3: immersion in nicotine lozenge solution and in artificial. The specimens of all groups were photographed using a stereomicroscope at T1) immediately after the extraction and before any treatment; T2) after one month of the treatment; and T3) after two months of the treatment. Four equidistant points of each specimen were analyzed using CMYK shade guide. The data were analyzed one-way ANOVA test followed by Tukey test for multiple comparisons with (a ≤ 0.05). In group-1, there was a significant difference of the color saturation of specimens between T1 and T2, and between T1 and T3 readings (P<0.0001). In group-2, there was a significant difference of the color saturation of specimens between T1 and T2, between T2 and T3 readings (P<0.0001). In group-3, there was a significant difference of the color saturation of specimens between T1 and T2, and between T1 and T3 readings (P<0.0001). The usage of nicotine lozenge promotes teeth lighting with/without bleaching.

El objetivo de este estudio fue evaluar el efecto de comprimidos de nicotina sobre la tinción de los dientes con/sin blanqueamiento en un estudio de modelo animal. Un total de 15 ratas Wistar fueron expuestas en un recipiente acrílico al humo de 10 cigarrillos tres veces al día durante 8 minutos por vez, y sacrificadas después de 60 días. Se trataron un total de 30 dientes incisivos (n=10) de la siguiente manera: Grupo-1: blanqueamiento en consultorio, blanqueamiento en casa e inmersión en saliva artificial; grupo-2: blanqueamiento en consultorio, blanqueamiento en casa e inmersión en solución de comprimidos de nicotina y en saliva artificial; grupo-3: inmersión en solución de nicotina en comprimidos y en artificial. Los especímenes de todos los grupos fueron fotografiados utilizando un microscopio estereoscópico en T1) inmediatamente después de la extracción y antes de cualquier tratamiento; T2) después de un mes del tratamiento; y T3) a los dos meses del tratamiento. Se analizaron cuatro puntos equidistantes de cada espécimen utilizando la guía de colores CMYK. Los datos se analizaron con la prueba ANOVA unidireccional seguida de la prueba de Tukey para comparaciones múltiples con (a ≤ 0,05). En el grupo 1, hubo una diferencia significativa de la saturación de color de las muestras entre T1 y T2, y entre las lecturas T1 y T3 (P<0,0001). En el grupo 2, hubo una diferencia significativa de la saturación de color de las muestras entre T1 y T2, entre las lecturas de T2 y T3 (P<0.0001). En el grupo 3, hubo unadiferencia significativa de la saturación de color de las muestras entre T1 y T2, y entre las lecturas T1 y T3 (P<0,0001). El uso de comprimidos de nicotina promueve la iluminación de los dientes con/sin blanqueamiento.

The Fagerström and AUDIT Tests as Probable Screening Tools in Oral Cancer and Their Correlation with CYP1A1, GSTM1, GSTP1, and GSTT1 Gene Expression.

BACKGROUND: Cancer is currently a major public health problem worldwide, with a marked increase of about 70% in the number of expected diagnosed cases over the next two decades. The amount of tobacco and alcohol consumed is calculated based on the subjective information provided by the user. Tobacco exposure can be assessed using the Fagerström Test for Cigarette Dependence (FTCD) and alcohol consumption by the Alcohol Use Disorder Identification Test (AUDIT). MATERIALS AND METHODS: Forty-eight subjects answered the Fagerström, and AUDIT tests and we studied them as likely screening tools for oral cancer and their correlation with the expression of CYP1A1, GSTM1, GSTP1, and GSTT1 genes by the RT-qPCR method. RESULTS: There were significant differences in the AUDIT score and CYP1A1 expression between cancer and control groups. Participants in advanced stages, whether due to tumor size or regional metastasis, showed significant differences in the duration of tobacco use, FTCD, AUDIT score, and CYP1A1 expression when compared to patients in early stages. Among subjects without cancer, we found a significant correlation between participant age and GSTP1 expression. Furthermore, the expression of GSTP1 was significantly correlated with the number of cigarettes smoked per day, duration of tobacco use, and FTCD. CONCLUSIONS: Questionnaires designed to evaluate the degree of tobacco and alcohol exposure and dependence combined with gene expression tests can be useful to assess the risk of developing oral cancer. Furthermore, raising the awareness of individuals regarding their degree of dependence and encouraging them to participate in cessation programs are important educational measures for the prevention of tobacco-related malignancies.

Influence of nicotine dependence, current smoking status and gender on CYP1A1, CYP1B1 and CYP2A6 expression in oral squamous cell carcinoma / Influência da dependência nicotínica, parâmetros de consumo de tabaco e gênero na expressão de CYP1A1, CYP1B1 e CYP2A6 em carcinoma de células escamosas oral

Objective: Tobacco smoke is composed of cancer-causing chemicals referred to as carcinogens. These carcinogens are metabolized by the enzymes of the cytochrome P450 (CYP) family. Our objective was to evaluate the correlation of tobacco consumption parameters with CYP1A1, CYP1B1 and CYP2A6 expression using qRT-PCR in samples of oral squamous cell carcinoma (OSCC). Material and Methods: The sample was divided into 2 groups: Cancer (36 subjects) and non-Cancer (12 subjects). The smokers' participants (36) were evaluated regarding their Nicotine dependence (ND) was assessed by the Fagerström test for cigarette dependence (FTCD). Questions regarding tobacco consumption like the number of cigarettes/day (CPD), duration of use, and pack-years were also evaluated. The Mann-Whitney and Spearman correlation tests were used at a significance level of 5%. Results: 48 participants were included, 32 men (66.7%), 36 smokers (75%) and 27 smokers with OSCC (56.3%). Samples of OSCC expressed more CYP1A1, CYP1B1, and CYP2A6. Especially, the CYP1B1 gene was significantly expressed in OSCC samples, regardless gender or tobacco use. No women expressed CYP2A6, as well as, non-smokers did not express the CYP1A1 and CYP2A6 genes. CYP1A1 gene was higher among men (P = 0.021). Conclusion: Lack of exposure to tobacco may justify the absence of CYP1A1 and CYP2A6 expression in non-smokers. The CYP1B1 gene was significantly expressed in the cancer presence despite gender or tobacco use. The assessment of ND and quantification of tobacco consumption are important instruments in monitoring smokers with benign oral lesions and, especially, in the presence of cancer.(AU)

Objetivo: A fumaça do tabaco é composta de substâncias químicas cancerígenas conhecidas como carcinógenos. Esses carcinógenos são metabolizados pelas enzimas da família do citocromo P450 (CYP). Nosso objetivo foi avaliar a correlação dos parâmetros do consumo de tabaco com a expressão de CYP1A1, CYP1B1 e CYP2A6 por qRT-PCR em amostras de carcinoma de células escamosas bucal (CCEB). Material e Métodos: A amostra foi dividida em 2 grupos: Câncer (36 indivíduos) e sem Câncer (12 indivíduos). Os participantes fumantes (36) foram avaliados quanto à dependência nicotínica (DN) pelo teste de Fagerström para dependência de cigarro (TFDC). Questões relacionadas ao consumo de tabaco como número de cigarros / dia (CPD), tempo de uso e anos-maço também foram avaliadas. Os testes de correlação de Mann-Whitney e Spearman foram utilizados com nível de significância de 5%. Resultados: foram incluídos 48 participantes, 32 homens (66,7%), 36 fumantes (75%) e 27 fumantes com CCEB (56,3%). Amostras de CCEB expressaram mais CYP1A1, CYP1B1 e CYP2A6. Especialmente, o gene CYP1B1 foi significativamente expresso em amostras de CCEB, apesar do sexo ou uso de tabaco. Nenhuma mulher expressou CYP2A6, assim como, não fumantes não expressaram os genes CYP1A1 e CYP2A6. O gene CYP1A1 foi maior entre os homens (P = 0,021). Conclusão: A falta de exposição pode justificar a ausência da expressão dos genes CYP1A1 e CYP2A6 entre não fumantes. O gene CYP1B1 foi significativamente expresso na presença de câncer, independentemente do sexo ou do uso de tabaco. A avaliação da DN e a quantificação do consumo de tabaco são importantes instrumentos no acompanhamento de fumantes com lesões bucais benignas e, principalmente, na presença de câncer (AU)

Quality of life in a smoking cessation program: lifestyle, anxiety, and depression / Qualidade de vida em um programa de cessação do tabagismo: estilo de vida, ansiedade e depressão

Objective: Tobacco dependence is quite variable among individuals because it includes many aspects such as psychological, emotional, behavioral, and cultural perspectives. This study aimed to evaluate the social and emotional issues of patients in a smoking cessation program through the generic and specific quality of life questionnaires. Material and Methods: Two generic questionnaires (SF36 and Fantastic Lifestyle) and two specific (SRQ-20 for depression and STAI s/t for levels of state and anxiety trait) were applied at the first meeting and after three months of treatment. Data were statistically analyzed by the Pearson correlation coefficient (significance level of 5%). Results: In total, 15 participants (10 men, 5 women), with mean age of 60 and 56, respectively. The mean of the smoking intake was 65.88±34.37 for men and 35.66±11.17 for women. SRQ20 and STAI s/t indicated that poor improvement in depression and anxiety was related to relapse; SF36 questionnaire indicated improvement in the domains of physical aspect limit, pain, social and emotional aspects; Fantastic Lifestyle indicated improvement according to its scale, being in a first moment "Regular" (53 points), and later, "Good" (55.67 points). Conclusion: In conclusion, smoking cessation treatment is correlated to the decrease in anxiety and depression levels and improvement of the general quality of life (AU)

Objetivo: A dependência do tabaco é bastante variável entre os indivíduos porque inclui muitos aspectos, como perspectivas psicológicas, emocionais, comportamentais e culturais. Este estudo teve como objetivo avaliar as questões sociais e emocionais de pacientes em um programa de cessação tabagágica por meio de questionários genéricos e específicos de qualidade de vida. Material e Métodos: Dois questionários genéricos (SF36 e Estilo de Vida Fantástico) e dois específicos (SRQ-20 para depressão e IDATE s/t para níveis de estado e traço de ansiedade) foram aplicados no primeiro encontro e após três meses de tratamento. Os dados foram analisados estatisticamente pelo coeficiente de correlação de Pearson (nível de significância de 5%). Resultados: No total, 15 participantes (10 homens, 5 mulheres), com média de idade de 60 e 56 anos, respectivamente. A média do consumo tabágico foi de 65,88 ± 34,37 para homens e 35,66 ± 11,17 para mulheres. SRQ20 e IDATE s/t indicaram que a fraca melhora na depressão e ansiedade estava relacionada à recaída; o questionário SF36 indicou melhora nos domínios limite do aspecto físico, dor, aspectos sociais e emocionais; Estilo de Vida Fantástico indicou melhora de acordo com sua escala, sendo em um primeiro momento "Regular" (53 pontos), e posteriormente, "Bom" (55.67 pontos). Conclusão: Em conclusão, o tratamento para cessação do tabagismo está correlacionado à diminuição dos níveis de ansiedade e depressão e à melhora da qualidade de vida geral (AU)

Update on the approach to smoking in patients with respiratory diseases.

Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with "healthy" smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.

Update on the approach to smoking in patients with respiratory diseases / Atualização na abordagem do tabagismo em pacientes com doenças respiratórias

ABSTRACT Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with "healthy" smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.

RESUMO O tabagismo é o maior responsável pelas doenças respiratórias (DR). Os efeitos nocivos do tabaco sobre o aparelho respiratório se iniciam ainda intraútero e influenciam as respostas imunológicas ao longo da infância e vida adulta. Os tabagistas com DR possuem peculiaridades que podem dificultar a cessação tabágica, tais como maior grau de dependência e de abstinência de nicotina; níveis mais elevados de monóxido de carbono exalado; motivação e autoeficácia baixas; maior preocupação com ganho ponderal; e elevada prevalência de ansiedade e depressão. Além disso, requerem tratamento mais intensivo e prolongado. É necessário esclarecer sempre o paciente sobre o fato de que parar de fumar será a única medida que irá reduzir a progressão das DR e melhorar sua qualidade de vida, independentemente do tempo e da gravidade da doença. Os médicos devem sempre oferecer o tratamento de cessação tabágica. O tratamento ambulatorial ou hospitalar deve ser multidisciplinar, baseado em intervenções comportamentais e farmacoterapia, sendo eficaz e custo-efetivo, dobrando as chances de sucesso.

Tobacco influence in heavy metals levels in head and neck cancer cases.

Heavy metals intoxication is known to be risk factors for various diseases, including cancer. These metals may be presented in food and soil as well as in leaf and tobacco smoke. The aim of this study was to correlate the exposure to heavy metals stemming from tobacco and head and neck squamous cell carcinoma carcinogenesis. Analysis of lead, copper, manganese, arsenic, chromium, and cadmium by atomic absorption spectrophotometry was performed in whole blood samples from 91 patients: 68 smokers with oral cavity, pharynx, or laryngeal cancer; 8 non-smokers with oral or larynx cancer; and 15 non-cancer smokers with tobacco-related diseases (control group). No differences were found in metals quantifications, except a significant difference was observed (p = 0.0223) with higher mean in copper levels for non-smokers with cancer. The present study concluded, for the groups evaluated, it was not possible to prove the relationship between the studied metals in the development of the neoplasm. On the other hand, the results of copper demonstrated a correlation with smokers with cancer and lower levels of circulating copper.

Expressão dos genes CYP1A1, CYP1B1, CYP2A6 e CYP2E1 em fumantes com câncer bucal / Expression of CYP1A1, CYP1B1, CYP2A6 and CYP2E1 in smokers with oral cancer

Os carcinógenos do tabaco estão relacionados a diversos tipos de câncer incluindo o carcinoma de células escamosas (CCE) bucal. Aliado ao álcool, o tabaco contribui para o desfecho desfavorável destes casos. A susceptibilidade individual ao câncer pode estar relacionada a expressão das enzimas que metabolizam tais carcinógenos. O objetivo deste trabalho é avaliar a expressão dos genes CYP1A1, CYP1B1, CYP2A6 e CYP2E1 no CCE bucal por meio de qPCR. Foram coletadas amostras de 32 indivíduos com CCE e de 15 controles submetidos a cirurgias bucais por lesões benignas. Foram constituídos quatro grupos: Grupo CCE fumante (n=26), Grupo CCE não fumante (n=6), Grupo controle fumante (n=9) e Grupo controle não fumante (n=6). O Teste de Fagerström para Dependência a Cigarros (TFDC) foi usado para avaliar a DN (DN) e AUDIT para avaliação do consumo de etílicos. Houve diminuição da expressão do gene CYP1B1 nos casos de CCE comparados aos controles. Foram encontradas diferenças estaticamente significativas de expressão gênica de CYP1B1 entre os Grupos CCE fumante e controle fumante (p=0,0018), Grupo CCE não fumante e controle não fumante (p=0,0079) e CCE fumante com CCE não fumante (p=0,0385) e entre os quatro grupos (p<0,0001). Houve diminuição da expressão do CYP2A6 no Grupo CCE fumante em relação ao Grupo controle, mas apenas um paciente do Grupo controle expressou este gene. Houve aumento da expressão de CYP2E1 entre os Grupos CCE fumante e controle fumante (p=0,0424). Concluindo, foi encontrada grande variabilidade interindividual no estudo da expressão dos genes estudados. Houve maior expressão de CYP1A1 e CYP2E1 em amostras de indivíduos fumantes com CCE. Os genes CYP1B1 e CYP2A6 estavam menos expressos no Grupo CCE fumante em relação ao Grupo controle. Para os genes CYP1B1 e CYP2E1 foram encontrados valores significativos na correlação entre a expressão gênica e parâmetros demográficos e de perfil tabágico no Grupo controle fumante, e do AUDIT no Grupo CCE não fumante. O gene CYP2E1, além de estar relacionado ao metabolismo do álcool, também deve ser considerado importante marcador do metabolismo dos carcinógenos derivados do tabaco

Tobacco carcinogens are related to various types of cancer, including oral squamous cell carcinoma (OSCC). Allied to alcohol, tobacco contributes to the unfavorable outcome of the cases. Individual cancer susceptibility may be related to an expression of the enzymes that metabolize such carcinogens. The aim of this work is to evaluate the expression of the genes CYP1A1, CYP1B1, CYP2A6 and CYP2E1 on OSCC by qPCR. Samples were collected from 32 individuals with OSCC and 15 controls submitted to oral surgeries due to benign lesions. There were four groups: Smoker SCC group (n = 26), nonsmoker SCC group (n = 6), Smoker control group (n = 9) and nonsmoker control group (n = 6). The Fagerström Test for Cigarette Dependence (TFCD) was used to evaluate nicotinic dependence (ND) and AUDIT for the evaluation of alcohol consumption. There was a decrease in CYP1B1 gene expression in cases of SCC compared to controls. (P = 0.0018); smoker CCE and non-smoker control (p = 0.0079); smoker SCC with nonsmoker SCC (p = 0.0385) and between the four groups (p <0.0001). There was a decreased expression in CYP2A6 in the smoker SCC Group compared to the control group, but only one control group patient expressed this gene. There was an increased expression of CYP2E1 between the smoking and nonsmoking SCC groups (p = 0.0424). In conclusion, large interindividual variability was found in the study of the expression of the genes studied. There was greater expression of CYP1A1 and CYP2E1 in samples from smokers with SCC. The CYP1B1 and CYP2A6 genes were less expressed in the smoker SCC Group. Significant values were found for the CYP1B1 and CYP2E1 genes in the correlation between a gene expression and a parameter and a non-smoker control group, non-smoker control group and AUDIT. The CYP2E1 gene, besides being related to alcohol metabolism, should also be considered an important marker of the metabolism of the carcinogens derived from tobacco

How to improve the early diagnosis of oral cancer? / Como melhorar o diagnóstico precoce do câncer bucal?

Objective: Oral squamous cell carcinoma (OSCC) is one of the most common malignant neoplasms, with 300,000 new cases annually diagnosed in the world. Although it appears in the fifth position among men in Brazil, late diagnosis continues to be a leading cause of poor prognosis. We reviewed the literature to evaluate factors that contribute to diagnostic delay in oral cancer considering aspects related to the patient, health team and public health system. Material and Methods: The Medline (PubMed), Scopus, Web of Science and Embase databases were searched in the last 5 years using the following MeSH descriptors: carcinoma, squamous cell; mouth neoplasms; delayed diagnosis. The articles should contain in their objectives factors contributing to the delayed diagnosis of OSCC related to the patient, healthcare professionals and public health system in general. Results: One hundred twenty articles were retrieved and 27 on the delayed diagnosis of oral cancer were eligible. Conclusion: The literature showed that the delay in the diagnosis and treatment of patients with oral cancer could be minimized by providing health information, particularly about risk factors, by improving the training and retraining of physicians and dentists and by improving access to the health system. The communication technologies such as telemedicine, can play a key role in the early diagnosis of oral cancer. (AU)

Objetivo: o carcinoma de células escamosas de cavidade bucal (CCECB) é uma das neoplasias malignas mais comuns, com cerca de 300 mil novos casos diagnosticados anualmente no mundo. Embora esteja na quinta posição entre os mais frequentes em homens no Brasil, o diagnóstico tardio continua a ser a principal causa de mau prognóstico. Revisamos a literatura para avaliar fatores que possam contribuir para o atraso de diagnóstico no câncer bucal considerando aspectos relacionados ao paciente, equipe de saúde e o Sistema de Saúde Pública. Material e Métodos: Foram pesquisados os bancos de dados Medline (PubMed), Scopus, Web of Science e Embase nos últimos 5 anos utilizando os seguintes descritores MeSH: carcinoma de células escamosas, neoplasias de boca e atraso diagnóstico. Os artigos deveriam conter em seus objetivos fatores que possam ter contribuído para o diagnóstico tardio do CCECB relacionado ao paciente, aos profissionais de saúde e ao Sistema de Saúde Pública em geral. Resultados: Cento e vinte artigos foram recuperados, sendo elegíveis, vinte e sete relacionados ao diagnóstico tardio de câncer bucal. Conclusão: a literatura mostrou que o atraso no diagnóstico e tratamento de pacientes com câncer bucal poderia ser minimizado, fornecendo informações sobre saúde, particularmente sobre fatores de risco a população, melhorando o treinamento e reciclagem de médicos e dentistas e melhorando o acesso ao sistema de saúde. As tecnologias de comunicação, dentre elas a telemedicina, pode desempenhar um papel fundamental no diagnóstico precoce de câncer bucal. (AU)

Challenges to be overcome: Current situation involving smoking cessation in Dental setting / Desafios a serem superados: situação atual envolvendo cessação do tabagismo no cenário odontológico

Objetivo: O uso do tabaco é a principal causa de doenças evitáveis no mundo. A consulta odontológica representa uma oportunidade de abordar os fumantes no controle do uso do tabaco. Embora esta conclusão seja bem conhecida, a intervenção para cessação tabágica entre dentistas permanece menos explorada do que o esperado. Este estudo avaliou artigos publicados sobre intervenções entre dentistas e profissionais de saúde dentária na cessação do tabagismo e discute as barreiras a serem superadas para atingir esse objetivo. Material e Métodos: As bases de dados Medline (PubMed), Scopus, Web of Science, Cochrane Reviews, LILACS e Google Scholar foram pesquisadas por artigos publicados em inglês entre janeiro de 2010 e dezembro de 2016 usando os seguintes termos MeSH: tobacco use cessation, smoking cessation, tobacco use disorder and dentistry. A busca manual complementar para potenciais artigos foi feita verificando-se referências bibliográficas. Resultados: setenta e duas publicações foram elegíveis e os resultados foram divididos em oito categorias: 1) o papel dos dentistas no controle do uso do tabaco; 2) conhecimento sobre tratamento e intervenções sobre uso do tabaco; 3) características da abordagem do dentista aos fumantes; 4) barreiras e facilitadores; 5) intervenções futuras para cessação do tabagismo, 6) reembolso de intervenções de tabaco, 7) pesquisas e 8) revisões sistemáticas e diretrizes. Conclusão: Os dentistas desempenham um papel importante na prevenção e controle do tabagismo. O treinamento na cessação do uso do tabaco tem aumentado nas últimas décadas. Ensinar a lidar com o tabagismo em cursos de graduação deve ser uma prioridade para os próximos anos, de modo que uma nova geração de dentistas incorpore em suas atividades habituais uma abordagem natural e eficiente para os fumantes.(AU)

Objective: Tobacco use is the leading cause of preventable illness in the world. The dental office represents an opportunity to smokers approach tobacco use control. Despite this well-known statement tobacco use cessation intervention delivered by dentists remain less explored than expected. This study evaluated published articles about interventions delivered by dentists and dental healthcare professionals on smoking cessation and discusses the barriers to be overcome to achieve this goal. Material and Methods: The Medline (PubMed), Scopus, Web of Science, Cochrane Reviews, LILACS and Google Scholar databases were searched for articles published in English between January 2010 and December 2016 using the following MeSH terms keywords: tobacco use cessation, smoking cessation, tobacco use disorder and dentistry. Complementary hand searching was done checking bibliographic references for potentially articles. Results: Seventy-two publications were eligible and the results were divided into eight categories: 1) the role of dentists in tobacco use control; 2) knowledge about tobacco use treatment and interventions; 3) characteristics of the dentist's approach to smokers; 4) barriers and facilitators; 5) future interventions for smoking cessation, 6) reimbursement for tobacco interventions, 7) surveys and 8) systematic reviews or guidelines Conclusion: Dentists play an important role in the prevention and control of smoking. Training in tobacco use cessation has been increased in the past few decades. Teaching how to deal with smoking in undergraduate courses should be a priority for the next few years, so that a new generation of dentists will incorporate into their habitual activities a natural and efficient approach to smokers.(AU)

Genetic polymorphisms in the Cytochrome P450 family and squamous cell carcinoma of the oral cavity, pharynx and larynx.

OBJECTIVE: To analyze the genetic polymorphisms of the cytochrome P450 family and their relationship with squamous cell carcinoma of the oral cavity, pharynx and larynx. METHODS: We present a narrative literature review, conducted in PubMed, Lilacs and Cochrane Databases of articles published in the last five years correlating genetic polymorphisms of the cytochrome P450 family and cancer risk in different populations worldwide. RESULTS: We initially found 65 articles and, after selection criteria, 20 case-control studies with various populations worldwide were eligible. The most studied polymorphisms were those of CYP2E1 and CYP1A1 subfamilies. There is little about the other subfamilies. The association found between polymorphisms and cancer risk amounted to a countless number of variables, amongst them: population, selection methods, racial factors and different modes of exposure to carcinogens, genotyping methods, and nomenclature of the polymorphisms. CONCLUSION: so far, there is no proven link between genetic polymorphisms of cytochrome P450 family and squamous cell carcinoma of the oral cavity, pharynx and larynx relationship.

Genetic polymorphisms in the Cytochrome P450 family and squamous cell carcinoma of the oral cavity, pharynx and larynx / Polimorfismos genéticos da família Citocromo P450 e carcinoma de células escamosas de cavidade oral, faringe e laringe

Objective: To analyze the genetic polymorphisms of the cytochrome P450 family and their relationship with squamous cell carcinoma of the oral cavity, pharynx and larynx. Methods: We present a narrative literature review, conducted in Pubmed, Lilacs and Cochrane Databases of articles published in the last five years correlating genetic polymorphisms of the cytochrome P450 family and cancer risk in different populations worldwide. Results: We initially found 65 articles and, after selection criteria, 20 case-control studies with various populations worldwide were eligible. The most studied polymorphisms were those of CYP2E1 and CYP1A1 subfamilies. There is little about the other subfamilies. The association found between polymorphisms and cancer risk amounted to a countless number of variables, amongst them: population, selection methods, racial factors and different modes of exposure to carcinogens, genotyping methods, and nomenclature of the polymorphisms. Conclusion: so far, there is no proven link between genetic polymorphisms of cytochrome P450 family and squamous cell carcinoma of the oral cavity, pharynx and larynx relationship. .

Objetivo: analisar os polimorfismos genéticos da família Citocromo P450 e sua relação com o carcinoma de células escamosas de cavidade oral, faringe e laringe. Métodos: por meio de uma Revisão Narrativa de literatura, realizada nas principais bases de dados Pubmed, Lilacs, e Cochrane Database, de artigos publicados nos últimos cinco anos, correlacionando polimorfismos genéticos da família citocromo P450 e risco de câncer nas diversas populações mundiais. Resultados: foram encontrados inicialmente 65 artigos, que, após critérios de seleção, tornaram elegíveis 20 artigos do tipo caso-controle em diversas populações mundiais. Os polimorfismos mais estudados foram os das subfamílias CYP1A1 e CYP2E1. Pouco existe sobre as demais subfamílias. A associação entre os polimorfismos encontrados e risco de câncer sofreu um incontável número de variáveis, entre elas, população estudada, métodos de seleção, fatores raciais e diferentes modos de exposição aos carcinógenos, métodos de genotipagem, e nomenclatura dos polimorfismos. Conclusão: até o momento, não existe relação comprovada entre os polimorfismos genéticos da família Citocromo P450 e o carcinoma de células escamosas de cavidade oral, faringe e laringe. .

Nicotine dependence and smoking habits in patients with head and neck cancer.

OBJECTIVE: To assess smoking habits and nicotine dependence (ND) in patients with head and neck cancer Methods: This study involved 71 smokers or former smokers with squamous cell carcinoma in the oral cavity, pharynx, or larynx who were treated at a university hospital in the city of São Paulo between January and May of 2010. We used the Fagerström Test for Nicotine Dependence to evaluate smoking habits and ND in the sample. Data regarding cancer treatment were collected from medical records. Depending on the variables studied, we used the chi-square test, Fisher's exact test, Student's t-test, or Spearman's correlation test. RESULTS: Of the 71 patients, 47 (66.2%) presented with high or very high ND, 40 (56.3%) smoked more than 20 cigarettes/day, and 32 (45.1%) smoked their first cigarette within 5 min of awakening. Advanced disease stage correlated significantly with the number of cigarettes smoked per day (p = 0.011) and with smoking history (p = 0.047). We found that ND did not correlate significantly with gender, disease stage, smoking cessation, or number of smoking cessation attempts, nor did the number of cigarettes smoked per day correlate with smoking cessation or gender. Treatment for smoking cessation was not routinely offered. CONCLUSIONS: In most of the patients studied, the level of ND was high or very high. The prevalence of heavy smoking for long periods was high in our sample. A diagnosis of cancer is a motivating factor for smoking cessation. However, intensive smoking cessation treatment is not routinely offered to smoking patients diagnosed with cancer.

Nicotine dependence and smoking habits in patients with head and neck cancer / Dependência nicotínica e perfil tabágico em pacientes com câncer de cabeça e pescoço

Objective: To assess smoking habits and nicotine dependence (ND) in patients with head and neck cancer Methods: This study involved 71 smokers or former smokers with squamous cell carcinoma in the oral cavity, pharynx, or larynx who were treated at a university hospital in the city of São Paulo between January and May of 2010. We used the Fagerström Test for Nicotine Dependence to evaluate smoking habits and ND in the sample. Data regarding cancer treatment were collected from medical records. Depending on the variables studied, we used the chi-square test, Fisher's exact test, Student's t-test, or Spearman's correlation test. Results: Of the 71 patients, 47 (66.2%) presented with high or very high ND, 40 (56.3%) smoked more than 20 cigarettes/day, and 32 (45.1%) smoked their first cigarette within 5 min of awakening. Advanced disease stage correlated significantly with the number of cigarettes smoked per day (p = 0.011) and with smoking history (p = 0.047). We found that ND did not correlate significantly with gender, disease stage, smoking cessation, or number of smoking cessation attempts, nor did the number of cigarettes smoked per day correlate with smoking cessation or gender. Treatment for smoking cessation was not routinely offered. Conclusions: In most of the patients studied, the level of ND was high or very high. The prevalence of heavy smoking for long periods was high in our sample. A diagnosis of cancer is a motivating factor for smoking cessation. However, intensive smoking cessation treatment is not routinely offered to smoking patients diagnosed with cancer. .

Objetivo: Avaliar o perfil tabágico (PT) e a dependência nicotínica (DN) em pacientes com câncer de cabeça e pescoço. Métodos: Estudo realizado com 71 pacientes portadores de carcinoma epidermoide de cavidade oral, faringe e laringe, tabagistas ou ex-tabagistas, atendidos em um hospital universitário da cidade de São Paulo entre janeiro e maio de 2010. Utilizou-se o Teste de Fagerström para Dependência de Nicotina para avaliar PT e DN na amostra. Informações sobre o tratamento oncológico foram coletadas dos prontuários. Foram utilizados os testes do qui-quadrado, exato de Fisher ou t de Student, assim como o teste de correlação de Spearman conforme as variáveis estudadas. Resultados: Dos 71 pacientes, 47 (66,2%) apresentavam DN elevada ou muito elevada, 40 (56,3%) fumavam mais de 20 cigarros/dia, e 32 (45,1%) fumavam seu primeiro cigarro até 5 min após acordar. Houve associações significativas do estádio avançado da doença com a quantidade de cigarros fumados por dia (p = 0,011) e a carga tabágica (p = 0,047). Não houve diferenças significativas da DN em relação a sexo, estádio da doença, cessação tabágica ou tentativas anteriores de cessação, nem como do número de cigarros fumados ao dia em relação a cessação ou sexo. O tratamento do tabagismo não foi rotineiramente oferecido. Conclusões: A DN foi elevada ou muito elevada na maioria dos pacientes estudados. A prevalência de grandes fumantes por longos períodos foi alta em nossa amostra. O diagnóstico de câncer é um fator motivador para a cessação tabágica; entretanto, o tratamento intensivo do tabagismo ainda não é rotineiramente oferecido a fumantes diagnosticados com câncer. .