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New role for dentists in drug screening

14 August 2015

New role for dentists in drug screening

New research from Columbia University’s Mailman School of Public Health has highlighted the key role dentists have in screening patients for drug misuse. Their study, published in the journal Addiction, found that 77% of dentists ask patients about illicit drug use, and 54% of dentists believe that such screenings should be their responsibility.

Associate research scientist, Carrigan Parish, said: “There are a sizeable number of people whose visit to a dentist represents their sole interaction with the healthcare system, highlighting the significance of the dental visit as a key opportunity to identify substance use disorders. However, our findings underscore a significant barrier in dentists’ attitudes that may limit the potential of the dental venue to play a role in screening for substance misuse.”

Using the results of a survey which received a very high response rate of 71%, the research team sampled 1,802 dentists in the US in general practice. Lead investigator, Lisa Metsch said: “There is an increasing recognition about the need to better integrate oral and systemic health. Questions remain about the feasibility of offering preventive screening and testing alongside dental care – many of which are being answered in this study.”

Several disparities were found in the proportion of dentists who would screen patients for illicit drug use. Those who saw it as their responsibility usually would screen (86%) while those who did not accept it as their responsibility were less likely (68%). Similarly, older dentists were less likely to report that their health history form included questions about substance misuse than those who were younger. Furthermore, more female dentists (61%) than their male counterparts (52%) agreed that screening for illicit drug use was part of their role.

The effects of drugs such as methamphetamine can be catastrophic on oral health giving dentists the opportunity to talk to their patients about such drug use when they come to try fix up their teeth.

Parish added: “Because dental care routinely involves treating pain and emergencies, dentists may encounter substance-seeking patients who complain of pain more severe than anticipated based on the nature of their dental condition, who report lost prescriptions of opioid pain medications, or only seek dental treatment sporadically.

“In order for substance misuse screening to be compatible with the dental setting, two-way communication between patient and dentists needs to occur more openly. While surveys have shown that patients are amenable to receiving medical screenings by dentists ‘chair-side’ for such conditions as HIV, heart disease, and diabetes, further studies directly addressing patient attitudes on substance misuse screening are key in determining patients’ acceptance of such services.”

Dentists may also need additional education to increase their awareness, comfort, and knowledge of substance misuse, given that “dentists are well situated to make appropriate referrals to treatment centres if instilled with the proper training and supports.”

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