Objective: The objective of this study was to conduct a national survey of practicing dentists to assess their current knowledge, attitudes, and practice behaviors related to substance use screening among their adult patients. The secondary objective was to identify practitioner- and practice-level facilitators and barriers to substance use screening.
Method: This cross-sectional study consisted of an electronic survey disseminated to practicing dentists who were active members of the National Dental Practice-Based Research Network (n = 790; 61% male).
Results: The majority of dentists reported some level of screening for nicotine (95.7%), alcohol (87.2%), cannabis (83.9%), and illicit drug (87.7%) use among their adult patients. More than 2 in 5 dentists reported never counseling patients regarding problematic use of alcohol, cannabis, and illicit drugs. Higher screening frequency was associated with higher counseling frequency and lower endorsement of two barrier factors: beliefs regarding responsibility, relevance, and effectiveness, and lack of training and/or resources. Higher frequency of counseling was associated with higher frequency of referral behavior and lower endorsement of three barrier factors: concerns regarding patient truthfulness/discomfort; beliefs regarding responsibility, relevance, and effectiveness; and lack of training and/or resources.
Conclusions: Results indicate a high level of willingness to screen, counsel, and refer patients for substance use among a majority of dentists, although current practice behaviors lag willingness. Findings regarding barriers and facilitators can guide efforts to develop, disseminate, and implement screening, brief intervention, and referral to treatment training, initiatives, and tools that are inclusive of or specifically target dental providers.