Substance-use screening and interventions in dental practices: Survey of practice-based research network dentists regarding current practices, policies, and barriers.

Dental visits represent an opportunity to identify and assist patients with unhealthy substance use, but little is known about how dentists are addressing patients’ use of tobacco, alcohol, and illicit drugs. This study, funded in part by the National Drug Abuse Treatment Clinical Trials Network, surveyed dentists to learn about the role their practices might play in providing substance use screening and interventions. A 41-item web-based survey was sent to all 210 dentists active in the Practitioners Engaged in Applied Research and Learning Network, a practice-based research network. The questionnaire assessed dental practices’ policies and current practices, attitudes and perceived barriers to providing services for tobacco, alcohol, and illicit drug use.

One hundred forty-three dentists completed the survey (68% response rate). Although screening was common, fewer dentists reported that they were providing follow-up counseling or referrals for substance use. Insufficient knowledge or training was the most frequently cited barrier to intervention. Many dentists reported they were offer assistance for use of tobacco (67%) or alcohol or illicit drugs (52%) if reimbursed; respondents who treated publicly insured patients were more likely to reply that they would offer this assistance.

Conclusions: Dentists recognize the importance of screening for substance use, but lack the clinical training and practice-based systems focused on substance use that could facilitate intervention. The results of this study indicate that dentists may be willing to address substance use among patients, including use of alcohol and illicit drugs in addition to tobacco, if barriers are reduced through changes in reimbursement, education, and systems-level support.