Substance UseSubstance-use screening and interventions in dental practices: Survey of practice-based research network dentists regarding current practices, policies and barriers
Section snippets
Study design and population
We administered the survey to dentists who were members of the Practitioners Engaged in Applied Research and Learning (PEARL) network. The PEARL Network was one of three dental practice-based research networks (PBRNs) established in 2005 with a seven-year grant from the National Institute of Dental and Craniofacial Research, National Institutes of Health. PEARL Network members are practicing dentists who have expressed an interest in conducting research in their own clinical practices. PEARL
RESULTS
Of the 210 eligible dentists, 143 participated in the survey (68 percent response rate). Table 1 shows characteristics of respondents and their primary dental practices. We compared the member profiles of survey respondents with those of the entire PEARL Network and found no substantial differences between the two groups with regard to age, sex, race/ethnicity or practice setting. Most participants were in general practice settings, including four public health and two dental medicine clinics.
DISCUSSION
Our survey findings indicate that dentists in the PEARL PBRN approve of screening for substance use, and most reported that they conducted screening in their practices. As PBRN members, these practitioners already had expressed a strong interest in research, and they may be more likely to adopt newer practices such as screening and interventions for substance use. However, even among this group, reported rates of follow-up counseling and referrals for patients with positive screening results
CONCLUSIONS
The results of this study show that dentists in the PEARL Network recognized the importance of screening for substance use, but they did not consistently follow up screening results with effective interventions, and they perceived significant barriers to doing so. The most frequently cited barrier was a lack of knowledge/ training about substance-use assistance, and we could expect educational interventions (such as focused training in office-based brief counseling) to have a favorable impact
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Underreported drug use among dental patients: A call for dental care professionals to improve drug use screening
2023, Journal of the American Dental AssociationDental practitioners’ use of health risk assessments for a variety of health conditions: Results from the South Atlantic region of The National Dental Practice-Based Research Network
2021, Journal of the American Dental AssociationCitation Excerpt :Our study has 3 main strengths. Compared with similar studies,54,55 our respondent sample size (n = 475) is large, thereby enabling increased confidence in the robustness of the results and conducting regression analyses with multiple variables. In addition, we assessed HRA practices as a continuum, allowing us to identify the referral step as a key limitation.
Assessment and Management of the High-Risk Dental Patient with Active Substance Use Disorder
2020, Dental Clinics of North AmericaCitation Excerpt :Common oral symptoms associated with substance use are listed in Table 1. McNeely and associates21 discuss various factors related to dentists recognizing an SUD. The implementation of screens and the referral to treatment services were limited, however, to alcohol and tobacco and not evenly distributed among dentists, depending on their geographic region.
Patient Interviewing Strategies to Recognize Substance Use, Misuse, and Abuse in the Dental Setting
2020, Dental Clinics of North AmericaCitation Excerpt :Like other health care providers, dentists are often pressed for time30,31 and may fear that engaging in open-ended patient dialogue regarding emotionally sensitive issues such as substance use will become too labor-intensive or time-intensive. Many clinicians perceive time constraints as a major barrier to the assessment of substance use, and this theme of insufficient time is well documented in the dental literature.32–34 A provider in a recent qualitative study35 stated, “So, I heard all this stuff that I’m supposed to be doing, taking a complete history, complete addiction history. . . But I don’t have time to do what I am supposed to do in terms of proper treatment, opioid treatment, so I cut corners a bit” (p. 378).
Opioid prescribing and risk mitigation implementation in the management of acute pain: Results from The National Dental Practice-Based Research Network
2018, Journal of the American Dental AssociationIntimate partner violence screening in the dental setting: Results of a nationally representative survey
2018, Journal of the American Dental AssociationCitation Excerpt :It is concerning that, in our study conducted 15 years later, an even greater percentage of participants (55%) did not have a list of referrals for IPV survivors. Lack of awareness of a referral source for patients has frequently been cited as a barrier toward dentists’ acceptance of medical screenings,25,26,64,65 and in this case it was also an influential factor in dentists’ attitudes about their professional role to screen for IPV. Uncertainty about where to refer IPV survivors for services has been a noted barrier and source of low self-efficacy to IPV screening among a variety of health care practitioners.66
Disclosure. None of the authors reported any disclosures.
This research was supported by grants 5U10DA013046 and U10 DA13035 from the National Institutes of Health (NIH)/National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN), Bethesda, Md., and by grant U01 DE016755 from the National Institute of Dental and Craniofacial Research, NIH. Dr. McNeely received support from NIH/NIDA grant K23DA030395 and from grant KL2RR029891 from the NIH/New York University Clinical and Translational Science Institute, New York City.
The authors thank Damon Collie and Don Vena, The EMMES Corp., Rockville, Md., and George E. Bigelow, National Institute on Drug Abuse/Clinical Trials Network Publications Committee.
The authors thank Nora Volkow, MD, director of National Institute on Drug Abuse, National Institutes of Health, and colleagues at the Clinical Trials Network for support and encouragement in exploring acceptability and sustainability of innovation in approaches to tobacco-use cessation.
- 1
Dr. McNeely is an assistant professor, Department of Population Health and Department of Medicine, Division of General Internal Medicine, New York University School of Medicine, 227 E. 30th St., Room 623, New York, N.Y. 10016
- 2
Ms. Wright is an assistant research scientist, Department of Psychiatry and Department of Population Health, New York University School of Medicine, New York City.
- 3
Dr. Matthews is a biostatistician, The EMMES Corp., Rockville, Md.
- 4
Dr. Rotrosen is a professor, Department of Psychiatry, New York University School of Medicine, and associate chief of staff for mental health research, Veterans Affairs New York Harbor Healthcare System, New York City.
- 5
Dr. Shelley is director, Research Development, and an associate professor, Department of Population Health, Division of Comparative Effectiveness and Decision Science, New York University School of Medicine, New York City.
- 6
Mr. Buchholz is a senior clinical research associate, PEARL Network, New York University College of Dentistry, New York City.
- 7
Dr. Curro is director of clinical operations, PEARL Network, and director of regulatory affairs, Bluestone Center for Clinical Research, New York University College of Dentistry, New York City. Address reprint requests to Dr. McNeely.