Enhance-D Study
An update on one of the largest randomised controlled trials in dentistry in the UK.
23 August 2026
Tobacco smoking has severe and direct impacts on oral health, making smoking cessation interventions well-suited to dental settings. Additionally, dental professionals are in unique and opportunistic positions to provide health education and prevention advice to their patients, due to their frequent contact with ‘healthy’ patients and strong rapports. However, there is limited research that measures how effective these interventions in primary dental care could be.
The ENHANCE-D (Enhancing Dental Health Advice) trial is one of the largest randomised controlled trials in dentistry in the UK, involving 1,219 smokers from 54 NHS dental practices across England and Scotland. Some participants also had periodontitis (gum disease). The study looked at how well three different stop-smoking approaches work when offered through dental practices, and whether they are good value for money:
- Electronic cigarettes (E-cigarettes)
- Nicotine Replacement Therapy (NRT) such as patches or gum
- Very Brief Advice, which is short advice from a healthcare professional encouraging people to quit smoking.
The main outcome measured was how many people had successfully stopped smoking after six months, confirmed using a biological test rather than just self-reporting. For participants with gum disease, we also looked at whether their gum health improved by measuring the percentage of areas around the teeth that still had deep gum pockets (5 mm or more) after six months, as these pockets are a sign of more serious gum disease.
Additionally, a qualitative process evaluation explored participants experiences of receiving the study interventions, alongside the views of dental teams, NHS commissioners, service managers, and policymakers. An economic evaluation also measured the cost-effectiveness and cost-benefit analysis. A further sub-study explored the use of dental therapists or hygienists as principal investigator within primary dental care research, which was a novel aspect of this trial.
If you are interested in hearing the results from this trial, please consider attending our results day event on Thursday 14th January 2027 at The Catalyst Building, Newcastle University. The day is verifiable for 6 hours free CPD and will include an expert panel who will discuss the implications of ENHANCE-D in the wider dental context. Speakers will include:
- Dr Jason Wong (England CDO)
- Dr Gillian Leslie (Scotland CDO)
- Mary Foy MP (Chair of the APPGs on Dentistry and Oral Health, and Smoking and Health)
- Hazel Cheeseman (ASH CEO)
- Ailsa Rutter OBE (Director of Fresh and Balance),
- Prof Avijit Banerjee (Faculty Dean of College of General Dentistry, President of BSODR, EIC BDJ Portfolio)
- Professor Linda Bauld (Chief Social Policy Advisor, Scottish Government)
- Dr Shiv Pabary MBE (Chair of the BDA's GDP Committee)
- Prof Jennifer Gallagher MBE (IADR president)
You can register your interest using the link below (see banner). You can also contact us at ENHANCED@newcastle.ac.uk
This study is funded by the National Institute for Health Research (NIHR) [Health Technology Assessment (NIHR129780)].