In this joint Share & Learn session with local oral health programs (LOHPs) and local lead agencies (LLAs) in tobacco prevention, we explored shared tobacco cessation goals and objectives and heard more about the intersection between tobacco use and oral health. You heard from two tobacco researchers from the Department of Preventive and Restorative Sciences at the UCSF School of Dentistry, Benjamin Chaffee, Professor, and Liz Couch, Project Policy Analyst, along with Rachel Colorafi, Program Consultant with the California Tobacco Prevention Program (CTPP) in the California Department of Public Health. Our presenters  shared the latest research on tobacco use and its impact on oral health along with tobacco cessation resources. We ended the Share & Learn with questions and discussion on how LOHPs and LLAs are implementing their tobacco cessation objectives. Our goal for this session was to bring everyone up to speed on current tobacco and oral health research and resources and provide opportunities to collaborate across programs locally.

Learning objectives:

1. Learn about CTPP and the shared tobacco goals and objectives of LOHPs and LLAs.
2. Understand how tobacco use impacts oral health.
3. Share resources to support tobacco cessation efforts locally and statewide.
4. Discuss implementation of tobacco cessation objectives.

Speaker bios

Slides

Recording (1:30:24)

Resources shared: 

• Kick it California (KIC): app, for health professionals (including referral info), materials/resources, education/training
• CTPP youth cessation resource flyer
• UCSF Smoking Cessation Leadership Program
• Tobacco Cessation Toolkit for California Dental Providers, CE course for California dental providers, and new flyer to promote the CE opportunity

Q & A:

1. Are there any materials that directly speak to oral health and tobacco? The Tobacco Education Clearinghouse of California (TECC) has a few social media messages: https://www.tecc.org/social-media-message-library/smml-32/, https://www.tecc.org/social-media-message-library/smml-31/, https://www.tecc.org/social-media-message-library/smml-30/, https://www.tecc.org/social-media-message-library/smml-29/. CDC’s Tips From Former Smokers also has a few campaign resources related to oral health, such as this one. The ADA also has a brochure; unfortunately, it's not free currently. There are a few other webinars that may be of interest: KIC's "Tobacco Use and Oral Health: The Critical Role of Dental Professionals" and the UCSF Smoking Cessation Leadership Center's "Empowering Change: Using Brief Motivational Interviewing for Tobacco Cessation in Oral Cancer Prevention Webinar, co-hosted by the American Dental Hygienists’ Association."
2. Can LOHPs and local dental providers use the Medi-Cal Dental Care Coordination Referral Form for linking Medi-Cal patients to tobacco cessation resources? And also, can dental providers bill for both the encounter fee and tobacco cessation at the same time? Can a county-employed RDH bill for tobacco cessation alone if properly documented? The referral form is really to get Medi-Cal members into dental care specifically, not tobacco cessation. Look into the KIC referral platform instead. And yes - Medi-Cal covers tobacco cessation services (using code D1320) along with exam codes. $10 maximum allowance. See Medi-Cal provider handbook, MOC, and SMA here: https://www.dental.dhcs.ca.gov/Dental_Providers/Medi-Cal_Dental/Provider_Handbook/. Code D1320 (tobacco cessation counseling) is reimbursable via the Medi-Cal Dental program but must be delivered by the same provider on the same day as an oral examination (D0150 or D0120): https://dental.dhcs.ca.gov/MCD_documents/providers/provider_handbook/PHB_section_07_codes.pdf. Really, we believe providers should deliver tobacco cessation counseling at any relevant opportunity, not only at 6-month check-ups. However, D1320 is only reimbursable from Medi-Cal Dental when delivered along with an oral evaluation.
3. Tell us more about the CE course - when is it available? Is there a flyer? How do dental providers register? It's an on-demand course on YouTube (and there's a link to a form at the end to receive their CE certificate): https://www.youtube.com/watch?v=PE7X1F-D-Wk. COHTAC is the CE provider, so we can tell you more about how many dental providers in your county earn CE credits by taking this course! See the new promotional flyer here. 
4. For youth patients, do dental providers need a consent from parents/guardians to provide cessation counseling? Especially if parents/guardian are not aware of their child tobacco use. Any patient ages 13yrs+ can be referred to KIC without parent permission. In California, dental providers are allowed to have conversations with youth over the age of 12 with or without parents – it is up to the discretion of the dental provider (see here and here). We encourage dental providers to try to engage parents in this conversation, but you may get a more honest response from youth if parents aren’t in the room. This resource flyer from CTPP may be a helpful place to start the conversation with younger patients.