General dental practitioners' knowledge, attitudes and practice towards psychoactive substance use screening: A systematic review

Abstract

Issues

Dentists can play a key role in screening for psychoactive substances use. This systematic review aimed to identify the knowledge, attitudes and practices of dentists related to screening for use of psychoactive substances and the facilitating factors and barriers.

Approach

According to Preferred Reporting Items for Systematic reviews and Meta-Analyses, four databases were searched until July 2024 to identify reports relating to screening for substance use by dentists. Search terms used key words relating to knowledge, attitudes or practices concerning the screening of tobacco, alcohol or any other substance use.

Key Findings

Twenty reports met the inclusion criteria for this review. In practice, dentists were more likely to identify tobacco use than alcohol or other substance use. Although the screening for tobacco was widely performed by dentists, the proposal of interventions was less frequent. Despite the opinion of many dentists that screening is part of their professional role, particularly tobacco, their knowledge of how to identify and intervene seemed low. Lack of knowledge or training were identified as barriers.

Implications

Identification of these factors should encourage greater diffusion of recommended tools for screening and development of initial and continuing training for dentists. These factors should convince decision-makers to help dentists to identify referral solutions, in particular coordinated care pathways, and to consider the acceptability and feasibility of the screening tools available to dentists.

Conclusion

Tobacco use was more frequently identified than was other substances, screening was always more frequent than interventions, and lack of training proved to be the main barriers to screening. Education and training in the screening of psychoactive substance use is a key factor in encouraging improved practices, particularly on intervention following detection and on substances other than tobacco.