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Cited by 1Forensic Toxicology and Drug AnalysisSubstance Abuse Treatment and OutcomesOpioid Use Disorder Treatment

Dental screening, counseling, and referral to treatment for substance use disorder: Survey of the National Dental Practice-Based Research Network

McCauley, Jenna L., Crawford, Phillip, Leo, Michael C., McBurnie, Mary Ann, Barton, Danyelle, Weidner, Heather A., Rindal, D. Brad, the National Dental PBRN Collaborative Group·2026·Journal of Studies on Alcohol and Drugs
DOI 10.15288/jsad.24-00383PMC PMC12666503
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Abstract

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: = 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.

Integrity signals

Registry

Crossref · 10.15288/jsad.24-00383

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

14 of 23 cited sources checked · 5 supported · 0 flagged · accuracy not yet measured

  • Interpretationown data

    Annual screening rates for tobacco, alcohol, and illicit drugs appear largely unchanged from the prior decade.

    “However, rates of screening at least annually for these substances reported in this study appear to be largely unchanged from the prior decade; tobacco: 58.1%; alcohol: 42.4%; illicit drugs: 39.2%).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites McNeely et al., 2013 source

      The Discussion (page unavailable) reports that 59% of dentists in a 2009 survey conducted routine tobacco screening, a figure close to the citing study’s 58.1%. But routine screening is not the same measure as screening at least annually, and the cited paper provides no comparable prior-decade rates for alcohol or illicit drugs. Its Introduction also says tobacco screening had increased over a longer period. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    The near ubiquity of nicotine screening is likely due to campaigns, awareness of quitline resources, and educational efforts.

    “The near ubiquity of nicotine screening is likely a result of campaigns, awareness of quitline resources where patients can easily be referred, and educational efforts amongst dental professionals that highlight the direct relevance to oral health and promote easy to implement screening programs, such as the 5-As (Gajendra et al., 2023; Marshall et al., 2024).”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites Gajendra et al., 2023 source

      The ‘Role of oral healthcare providers in cessation’ section reports that 73% of dentists and 80% of hygienists ask about and document tobacco use. ‘Brief educational interventions’ describes the 5As model and referral to quitlines, while ‘Behavioral interventions’ says convenient quitline referrals make providers more likely to offer cessation interventions. The review does not attribute the prevalence of screening to campaigns, quitline awareness, or educational efforts. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites Marshall et al., 2024 source

      The National and State Tobacco Control Program section (page not provided) links education, media campaigns, and health-system changes to quitline use and tobacco screening and referrals. It does not establish that nicotine screening is nearly ubiquitous or that these efforts caused its prevalence among dental professionals; it also does not address oral-health education or the 5-As. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Interpretationcitation

    An implementation gap persisted between dentists' screening and counseling practice behaviors.

    “Consistent with previous studies, despite the availability of targeted smoking cessation interventions adapted for delivery in the dental setting, an implementation gap persisted between dentists’ screening and counseling practice behaviors (Chaffee et al., 2020).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Chaffee et al., 2020 source
  • Premisecitation

    Knowledge of patient substance use is relevant to dental practitioners because of oral health impacts and opioid prescribing.

    “Knowledge regarding patient substance use is particularly relevant to dental practitioners given the impact that substance use disorders (e.g., methamphetamine use, alcohol use, tobacco use) and their associated behavioral comorbidities (e.g., poor oral hygiene practices, malnutrition, high sugar diets, etc.) have on oral health, as well as the frequency with which dentists prescribe opioids that”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Baghaie et al., 2017 source

      The Introduction and Discussion describe oral disease associated with substance use, and “For dental practitioners” recommends asking patients about substance use. That section also discusses opioid analgesics and opioid-seeking behavior, but it does not establish how frequently dentists prescribe opioids. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites Dana et al., 2018 source
  • Premisecitation

    Dental practices are an often-overlooked resource for identification and early intervention for problematic substance use.

    “Dental practices are an often-overlooked resource for identification and early intervention regarding problematic substance use behaviors.”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Pollack et al., 2014 source

      The Abstract describes dental settings as a way to identify at-risk people who may not access other health services, and the Discussion describes their potential for early HIV detection and treatment. The paper does not establish that dental practices identify or provide early intervention for problematic substance use; its evidence concerns HIV screening. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites Strauss et al., 2012 source
  • May combine two claims. 18
  • Classified as probably not a substantial claim. 8

  • May combine two claims.

    Premisecitation

    Brief screening questionnaires are feasible, but implementation rates in primary care are largely disappointing.

    “Ample evidence suggests that use of brief screening questionnaires is feasible; however, general implementation rates in frontline healthcare settings like primary care are largely disappointing (Mertens et al., 2015; Agley et al., 2018; Thoele et al., 2021).”
    Quote in the paperSubstantial claim2 of 3 sources checked
    • cites Mertens et al., 2015 source
    • cites Agley et al., 2018 source
    • cites Thoele et al., 2021 source

      The Results (Study characteristics; no page available) report low screening rates in some primary-care groups, including 9% for physicians and 3.5% for usual care in the Mertens study. But the review also reports increases in screening across many implementation studies (Results, Implementation outcomes); it does not establish that general primary-care implementation rates are largely disappointing or directly assess the feasibility of brief questionnaires. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    PEARL respondents endorsed routine screening for tobacco (78%), alcohol (44%), and illicit drug use (33%).

    “Most PEARL respondents endorsed routine screening for tobacco use disorders (78%), whereas less than half endorsed routine screening for alcohol use disorders (44%) and illicit drug use disorders (33%).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites McNeely et al., 2013 source

      The Results section, “Screening and assistance for users of tobacco, alcohol and other drugs” (page unavailable), says verbal screening was conducted more often for tobacco than for alcohol or illicit drugs, supporting the claimed pattern. It does not give the cited 78%, 44%, and 33% figures in the available passage; its figures for respondents who considered screening important are instead 99%, 92%, and 93%. The Methods section also distinguishes attitudes toward screening from reports of routine verbal screening, so the claim's wording ‘endorsed routine screening’ is not established. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A recent scoping review concluded that oral health providers are a largely untapped resource in screening and addressing SUDs.

    “A recent scoping review of screening, brief intervention, and referral to treatment in oral health settings, concluded that oral health providers were a largely untapped resource in screening and addressing substance use disorders (Zerden et al., 2024).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Zerden et al., 2024 source

  • May combine two claims.

    Premisecitation

    Many dental practitioners have long-term patient relationships and regularly care for patients who may not present in other healthcare settings or who endorse substance misuse.

    “Many dental practitioners establish long-term patient relationships that provide frequent opportunities for screening and intervention and regularly provide care to patients who may not present in other healthcare settings, as well as patients who endorse misuse of substances (Pollack et al., 2014; Strauss et al., 2012).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Pollack et al., 2014 source

      The Abstract says dental care can reach at-risk people who may not otherwise access medical and public health systems, and the Discussion describes dental care as an opportunity for HIV screening. The passages do not establish long-term patient relationships or specifically say that dentists regularly care for patients who endorse substance misuse. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites Strauss et al., 2012 source

  • May combine two claims.

    Findingown data

    The relevance of screening to dental practice items formed a single scale with Cronbach's alpha .81 and mean 3.91 (SD 0.81).

    “Thus, these items were considered to be tapping a single construct and scored as a scale, Cronbach’s alpha=.81. The mean of the “relevance of screening to dental practice” scale among this adult-serving sample was 3.91 (SD=0.81; min-max=1–5), where higher scores represent higher relevance of screening to dental practice.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Rates of screening at least annually in this study were tobacco 58.1%, alcohol 42.4%, and illicit drugs 39.2%.

    “However, rates of screening at least annually for these substances reported in this study appear to be largely unchanged from the prior decade; tobacco: 58.1%; alcohol: 42.4%; illicit drugs: 39.2%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Frequency of screening, counseling, and referral items each showed unidimensionality, accounting for 65%, 70%, and 78% of variance, with Cronbach's alphas .88, .90, and .93.

    “The frequency of screening, counseling, and referral items exhibited strong evidence for unidimensionality, each accounting for 65%, 70%, and 78%, respectively, of the variance in their respective items. Cronbach’s alpha for frequency of screening, counseling, and referral were .88, .90, and .93, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    More than half of dentists reported no awareness of each of the ORT, DAST, AUDIT, and CAGE screening instruments.

    “More than half of dentists reported no awareness of additional evidence-based instruments designed for healthcare settings, including Opioid Risk Tool (ORT; n=480; 60.8%), Drug Abuse Screening Test (DAST; n=507; 64.2%), Alcohol Use Disorder Identification Test (AUDIT; n=535; 67.7%), and the CAGE (n=628; 79.5%; McNeely et al., 2016; Webster & Webster, 2005; Skinner, 1982; Saunders et al., 1993; May”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The four barrier factors were lack of knowledge and tangible resources; beliefs regarding relevance, responsibility, and effectiveness; concerns regarding patient truthfulness and patient/staff discomfort; and lack of time.

    “The four factors revolved around themes of (1) Lack of knowledge and tangible resources; (2) Beliefs regarding relevance, responsibility, and effectiveness; (3) Concerns regarding patient truthfulness and patient/staff discomfort; and (4) Lack of time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Stigmatizing beliefs regarding SUD were relatively low in prevalence and stigma was not associated with frequency of screening, counseling, and referral behaviors.

    “Stigmatizing beliefs regarding SUD factor was relatively low in prevalence among this sample and stigma was not associated with frequency of screening, counseling, and referral behaviors.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The sample may reflect bias from differences between dentists choosing to participate in a practice-based research network and the broader population of practicing dentists.

    “However, the sample may reflect bias resulting from differences between dentists choosing to participate in a practice-based research network when compared with the broader population of practicing dentists.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Dentists regularly encounter patients with problematic substance use and recognize the importance of screening, but have limited addictions training, lack systems, and under-document substance use.

    “Dentists regularly encounter patients with problematic substance use and recognize the importance of screening for substance use disorder; however, they have limited exposure to addictions training and generally lack systems to aid in screening, intervention, and referral to addictions treatment and often under-document patients’ substance use in their medical records (Le et al., 2022).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Le et al., 2022

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Demand characteristics and social desirability may have impacted self-report.

    “Though the survey responses were anonymized, demand characteristics and social desirability may have impacted self-report.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The survey instrument was developed iteratively, framed within the IMB model, informed by practicing dentists, psychometrics experts, SUD research experts, a scoping review, and feedback from committees.

    “As no gold-standard survey instrument existed specific to the aims of this study, the study team undertook an iterative development process of a survey framed within the Information-Motivation-Behavior Skills model (IMB; Fisher & Fisher, 1992), informed heavily by practicing dentists, experts in psychometrics, and substance use disorder research experts.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fisher & Fisher, 1992 source

  • May combine two claims.

    Study design and conductown data

    All data are self-reported, and analyses are descriptive and correlative.

    “All data are self-reported, and analyses are descriptive and correlative in nature.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Dentists and dental practices represent a vast healthcare resource to aid in the identification of problematic substance use.

    “Dentists and dental practices represent a vast healthcare resource to aid in the identification of problematic substance use.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Except for recent opioid screening studies, most work in this area is dated by nearly a decade.

    “Except for recent studies specific to opioid screening, most work in this area is dated by nearly a decade.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The survey response rate was capped at less than 30% despite meeting recruitment goals.

    “Further, this study had a predetermined sample size based on funds available for remuneration and, as a result of this, the survey response rate was capped at less than 30% despite the study meeting recruitment goals.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisenone given

    Most prior work focused on tobacco, alcohol, and opioid screening, with little on other substance misuse, particularly cannabis and stimulants.

    “Most prior work in this area has focused on implementation of tobacco, alcohol, and – more recently – opioid screening, with very little work addressing dentists’ implementation of screening for other substance misuse/use disorder, particularly cannabis and stimulants.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Many dental providers are already engaged in some degree of SUD screening, and to a lesser extent counseling, among their adult patients.

    “Findings suggest that many dental providers are already engaged in some degree of substance use disorder screening, and to a lesser extent, counseling, among their adult patients.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Items assessed barriers to screening and counseling together, so findings cannot disentangle the two practice behaviors.

    “For the purpose of limiting survey length, items assessed barriers to “screening and counseling” together and findings related to barriers cannot disentangle the two practice behaviors.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Compared with non-respondents, participants were more likely to be general practitioners, slightly younger, saw fewer patients per week, less likely to work in managed care, and more likely to work in government.

    “Compared with sampled non-respondents, survey participants (N=821) were more likely to be a general practitioner (27% v. 17%, p<.001), slightly younger (mean age of 51 years v 53 years, p<.001), saw slightly fewer patients per week (average 50 per week v 56 per week, p<.001), and were less likely to work in a managed care setting (5% v. 10%) and more likely to work in a government setting (10% v.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The analysis plan did not include corrections for multiple testing.

    “Also, given the exploratory nature of the study and its intent to spur rigorous follow-up and intervention development, the analysis plan did not include corrections for multiple testing.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The US Preventive Services Task Force recommends screening all adults for unhealthy use of alcohol, tobacco, and other drugs in primary care settings.

    “Given the prevalence and dire health consequences associated with SUDs, the US Preventive Services Task Force has recommended that all adults be screened for unhealthy use of alcohol, tobacco, and other drugs in primary care settings (Curry et al., 2018; Krist et al., 2020).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Curry et al., 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Krist et al., 2020

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

24 of 24

  • The paper relies on this without support.

    Dentists' self-reported screening, counseling, and referral frequencies accurately reflect their actual practice behaviors.

    “All data are self-reported, and analyses are descriptive and correlative in nature.”
    “Though the survey responses were anonymized, demand characteristics and social desirability may have impacted self-report.”
1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Screening is linked to two barrier factors in the abstract but three in the results

    Minor

    The abstract counts two barrier factors associated with screening frequency, while the results identify three, including concerns about patient truthfulness and discomfort.

  • General-practitioner percentage conflicts with the reported count

    Minor

    The paper says 27% of all 821 survey participants were general practitioners, yet reports 672 general practitioners among the 790 respondents to adult-patient items. Those 672 alone constitute more than 27% of the full survey sample.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Holliday R., 2021, Cochrane Database of Systematic Reviews, 2021

Cited by

Sorted by citations

Related

Authors
McCauley, J. L., Crawford, P., Leo, M. C., McBurnie, M. A., Barton, D., Weidner, H. A., Rindal, D. B., & the National Dental PBRN Collaborative Group
Affiliations
  • Medical University of South Carolina (US)
  • Kaiser Permanente Center for Health Research (US)
  • HealthPartners (US)
Corresponding author
McCauley, Jenna L.
ORCID
Venue
Journal of Studies on Alcohol and Drugs
Publisher
Alcohol Research Documentation, Inc.
Published
2026-01
Volume
87
Issue
1
Pages
54-63
ISSN
  • 1937-1888 (ISSN-L)
  • 1938-4114
DOI
10.15288/jsad.24-00383
PMC
PMC12666503
OpenAlex
W4410527431
Cited by
1
References
30
Citations by year
2026: 1
FWCI
0.55
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Studies on Alcohol and Drugs (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
substance use screening, dentists, dental practice-based research network, SBIRT, nicotine use, alcohol consumption, cannabis use, illicit drug use
MeSH terms
Adult, Attitude of Health Personnel, Counseling, Cross-Sectional Studies, Dentists, Female

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

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