Prevention program encourages schoolchildren to be cancer killers too
BY Dee Humphrey, RDH, BS
Are we missing the idea of prevention and starting too late? Dental professionals have direct influence on patients, especially school-age children, for prevention of oral diseases, whether it's in the dental office or the community. But do we actually take a one-day initiative to get inside the school system setting to educate children on prevention of tobacco use at an early age? Are we taking time to ask children under age 18 if they are using tobacco products?
It has been the norm in my dental office or when I am present at community functions to ask all children and adolescents if they brush their teeth on a regular basis while discreetly questioning if they use tobacco products of any kind. Most of the children giggle and say no to tobacco use, while some adolescents get big eyed and quietly shake their heads no.
According to the Clinical Practice of the Dental Hygienist, "thousands of children and adolescents become regular users of tobacco every day."1 Therefore, it should be a priority for all dental professionals to increase the awareness of tobacco prevention among all school-age children due to the alarming rise of oral cancer and other serious health-related problems associated with use later on in life.
Working as a prevention specialist, I was given the opportunity to go to three local schools and educate over 620 children about staying tobacco free. My team distributed a 10-question anonymous survey to find out how many students were using tobacco products and what kind they were using. The children were encouraged to be as honest as possible; it helped that we mentioned no one would get into trouble and no one would know they wrote it. Then the children were educated about the harmful effects of tobacco use, and a video about a man with oral cancer was also presented.
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Upon reevaluating the surveys, there was a tremendous need to raise the tobacco prevention awareness within school-age children. Over 30% of the children from ages 10-14 years old were using tobacco products on a daily basis, and nearly 50% had at least tried it before the age of 12. I was shocked to come across an 11-year-old boy who scribbled, "winter-mint fine cut" [chewing tobacco] next to the question, "What kind of tobacco do you use?" It saddened me to learn that only 7% of the children actually thought they could get cancer or other serious health-related problems from tobacco use. Despite the disappointing results, this information ignited a drive to persevere in finding a different approach to a new tobacco prevention program that would truly impact all school-age children everywhere.
Returning to the clinical setting, my first plan of action was to give the children a glimpse of what dental professionals see on a daily basis within the oral cavity. After proper authorization, I began taking intraoral pictures of the irreversible damage of periodontal disease that tobacco use causes to one's oral cavity. Most of the adults had no idea what was actually going on inside their mouths and were very surprised to see the before-and-after pictures. If the adults were shocked, then the visual images were a must (for this new tobacco prevention program) in attempting to elicit a powerful impact among the children. To further education, our presentation used kid-friendly terms on the prevalence of the harmful drug nicotine, the role addiction plays, and two short videos.
Personal testimonies were told to the children to provide someone who could identify with what they observe, hear, and the peer pressure they possibly experience. Then an oversized cigarette and tobacco can were brought out for a hands-on activity to help children understand what ingredients are actually found within these harmful substances.
The children were encouraged to pull things out from within the cigarette and tobacco can while reading the warning or caution labels for further understanding. Toilet bowl cleaner and rat poisoning were the ultimate jaw-dropping ingredients that totally captured the children's attention. Seeing other harmful ingredients that are in tobacco (pesticides, ammonia, cyanide, benzene, cadmium, sodium, etc.) in the things from the local grocery store brought an all-time awareness to the children's eyes. Children need to be taught that the damage done is immediate and harmful, as is taking 20 seconds for nicotine to affect the brain, and then reach the rest of the body.1
Next, the children were educated on how all tobacco products have the potential to cause serious health-related problems such as: COPD, GERD, emphysema, lung cancer, heart disease, psoriasis, heart attack, tooth decay, oral cancer, stroke, coronary artery disease, osteoporosis, throat cancer, stomach ulcers, discolored fingers, cataracts, Buerger's disease, asthma and other respiratory conditions, cervical cancer, and miscarriages.1
Each child, during the presentation, was given a condition ticket with definitions from the list above to aid in their awareness. The children needed to know that, although they may not get cancer when they grow up, there are other associated problems they could get later on in life, which are just as life threatening. Throughout the crowd, seven random children were given a different condition, in which they later learned if they lived or died before their 20th high school reunion. This factor brought the realization "It could happen to me" to the children, because most people don't actually think it could happen to them. The children were then told about my own father who found out in July 2014 that he had oropharyngeal and colon cancer from a past history of tobacco use 13 years ago.
Throughout the presentation, a soft-sounding bell was ringing in the background every seven to eight seconds, representing someone dying from tobacco use within this time frame. It is powerful in getting the message across in a subtle way.
All participating children were given a treat bag full of goodies such as Colgate toothpaste, Oral-B toothbrushes, Glide floss, Spry gum with xylitol, sugar-free Life Savers, handouts of local tobacco cessation programs, and information from the Oral Cancer Foundation and Centers for Disease Control and Prevention to take home. Children were also encouraged to share all the information with their parents, and if they used tobacco, to advise them to stop. Little "cancer killer" specialists were being created and tobacco prevention was well under way.
In conclusion, walking down the aisle of my local grocery store, a little boy about 10 years old came up to me and said, "Hey, I know you," and then proceeded to tell his mom, "She is a cancer killer." With a gentle smile, I first explained to his mother how I knew her child (because of his participation in the tobacco prevention program that was taught earlier at school that day), and then mentioned that "cancer killer" is a title I wear proudly and what I want to be known for.
The little boy continued to say, "Mom, someone dies every seven seconds [from tobacco use], and there is rat poison in it." Upon walking away, the child continued to tell his mom about all the pictures of diseases of the oral cavity he saw and even mentioned some of the other carcinogenic ingredients found in tobacco products. What a killer impact coming from the mouth of a babe! If one child understands and never uses tobacco products of any
kind, then the impact of this tobacco prevention program is doing its job. We must become like children who are so eager to share the information learned and purposely take the initiative to increase awareness through early prevention instead of doing something after it's too late. Join the "cancer killer" initiative, and fight back today.
For more information on Dee and her Tobacco Prevention Program, contact [email protected]. RDH
Dee Humphrey, RDH, BS, is a prevention specialist who provides quality preventive care and treatment services for many underserved citizens within a tristate area. She received her RDH and Bachelor of Science degree at Missouri Southern State University, Joplin, Missouri. She has worked as a clinical dental hygienist and prevention specialist since 2010 at the Sam Hider Health Clinic, Jay, Oklahoma.
1. Wilkins E. Clinical Practice of the Dental Hygienist, 10th ed. Philadelphia: PA Lippincott Williams & Wilkins. Wolters Kluwer Health. 2009. P. 503-508.