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Understanding the Dangers and Health Consequences of Spit Tobacco Use (AGD 130)

Presenter: Original Author: Susan C. Dodd, RDH, BA; Revised by Susan Morgan, DDS, MAGD, CTTS; M. Susann Gaydos, RDH, MSDH, CTTS; Amy Funk, RDH, MSDH, TTS; and Ashlee Sowards, RDH, BSDH, MSDH, TTS


Spit (smokeless) tobacco is a public health issue that gets limited attention. Unfortunately, there are segments of the United States population where use rates are high. While many health history questionnaires raise questions concerning smoking, many do not address other forms of tobacco use. Patients using this product should be identified, urged to quit and provided counseling and cessation interventions. Like cigarette smoking, chewing tobacco, snuff, or moist snuff produces an addiction to nicotine. This product is associated with both oral health and systemic health risks. Dental providers are in a situation to show patients the damaging impact this this product has on oral health, and assist patients in quitting.

Note:  This course was adapted from an original course developed by Susan C. Dodd, RDH, BA.

Authors' Note:  The term spit and smokeless tobacco will be used interchangeably throughout this course and refer to tobacco that is not burned, but chewed or placed in the mouth. Smokeless tobacco users, usually, chew or suck (dip) the tobacco and spit out the tobacco juices that form. However, "spitless" tobacco has also been developed, and more recently smokeless cigarettes are being marketed.


Susan C. Dodd, RDH, BA is the president of SCD Healthcare Consulting, LLC. Prior to starting her consulting company, Sue worked with Oral Health America as Director of the National Spit Tobacco Education Program and as Director of Programs overseeing implantation of programmatic and operational needs for OHA programs, sponsorships and cooperative agreements. She developed and supported state and community oral health coalitions and collaborations and assisted in strategic planning to integrate and coordinate OHA programs and development.

Oral Health America’s NSTEP program was a nationally recognized public awareness campaign that in collaboration with the Robert Wood Johnson Foundation worked with public and private sectors to provide tobacco use prevention material and cessation resources, trainings, educational programs and awareness campaigns while working with community partners, baseball organizations, Little League International, professional medical and dental organizations, educators, coaches, parents and children.

Susan Morgan, DDS, MAGD, CTTS received her dental hygiene and dental degree from West Virginia University. For approximately 10 years she treated low-income children, many of whom were already addicted to tobacco products. In 2000, as a faculty member in the Department of Periodontics, she implemented a tobacco cessation program in the WVU School of Dentistry.  She has trained over 700 dental students to provide tobacco treatment strategies, and she has published the initial results of the progress of this program in the Journal of Dental Education.  In 2010 she received her Tobacco Treatment Certification at the Mayo Clinic. She is currently a professor in the WVU School of Dentistry, and she has presented courses on tobacco cessation both locally and nationally. 


M. Suann Gaydos, RDH, MSDH, CTTS, is a master's level trained dental hygienist and Tobacco Treatment Specialist who teaches tobacco treatment strategies to future health care providers. Suann was trained as a Tobacco Treatment Specialist in 2010 and has been involved in presenting tobacco treatment continuing education programs both locally and nationally. As a dental hygiene clinical supervisor, she provides students with the skills necessary to provide effective tobacco cessation counseling and support. She is currently a dental hygiene faculty member at West Virginia University’s School of Dentistry.


Amy Funk, RDH, MSDH, TTS, is a master's level trained dental hygienist.  Amy was trained as a Tobacco Treatment Specialist in 2010 and has been involved in presenting tobacco treatment continuing education programs both locally and nationally. She also directs the Dental Hygiene program at WVU School of Dentistry.


Ashlee Sowards, RDH, BSDH, MSDH, TTS received her master's in Dental Hygiene from West Virginia University, with her master’s thesis title being, "Oral Cancer Screening Techniques Utilized by West Virginia Dental Hygienists."  In April, 2013 she completed her Tobacco Treatment Specialist training at the University of New Jersey School of Medicine and Dentistry.  As a dental hygiene clinical supervisor, she provides students with the skills necessary to talk with their patients about tobacco dependence and offer cessation support. She is currently on the dental hygiene faculty at WVU School of Dentistry.


After completing this course, the dental professional should be able to:

• Describe the types and forms of spit tobacco.
• Highlight the demographics of spit tobacco use.
• Discuss marketing and advertising techniques used by the tobacco industry.
• List the negative health effects of spit tobacco.
• Identify the role of nicotine in the addiction process.
• Discuss the role of the dental clinician in helping patients become tobacco-free.


The ADAA has an obligation to disseminate knowledge in the field of dentistry.  Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.

The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.

Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.


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