1. Assess vital signs at every appointment because of cardiovascular side effects.

2. Chewing the nicotine polacrilex dose form may aggravate TMJ. Client/Family Teaching

1. Review the importance of good oral hygiene in order to prevent per-iodontal inflammation.

2. Review the proper use of oral hygiene aids in order to prevent injury.

3. Daily home fluoride treatments for persistent dry mouth.

4. Avoid alcohol-containing mouth rinses.

5. Dry mouth can be treated with tart, sugarless gum or candy, water, or with saliva substitutes if dry mouth persists.

When used in conjunction with a smoking cessation program in the dental office:

1. Must want to stop smoking and should do so immediately.

2. Use gum only as directed. When client has the urge to smoke, chew one piece slowly for about 30 min. If a slight tingling becomes evident, stop chewing until sensation subsides.

3. Acidic beverages, such as coffee, juices, soft drinks, and wine, interfere with buccal absorption of nicotine from the gum; thus, avoid eating and drinking 15 min before and during chewing as effects may be diminished.

4. Gum will not stick to dentures or appliances.

5. Identify individuals and local support groups that can help with smoking cessation and provide emotional and psychologic support throughout the endeavor. Participate in a formal smoking cessation program.

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