'Do you take a drink?' Barriers to alcohol enquiry in dental practice in Scotland

Background Hazardous drinking has detrimental consequences for oral health and is involved in the causation of oral cancer. Drinking over safe limits can lead to a range of medical problems including liver disease that can affect dental treatment. Knowledge of a patient's alcohol status is therefore of relevance to dentists yet few dentists ask patients about their drinking and fewer still provide brief intervention for hazardous drinkers.

Methods The study determined the knowledge and training of Scottish dentists about alcohol using a postal questionnaire and focus groups. We also assessed barriers to the provision of an alcohol screening and brief intervention service in dental practice.

Results Five hundred and fifty eight practices (55.2%) responded to the postal survey. Themes emerging from the postal survey and the focus groups were similar. While the general level of role legitimacy among dentists in relation to alcohol enquiry was high, role adequacy was poor; dentists had significant gaps in knowledge due to a lack of training. Both patients and dentists felt that alcohol enquiry in dental practice would be more acceptable if a clearer link could be made between alcohol and oral health. Lack of time and remuneration were also cited as barriers.

Conclusion Alcohol screening should form part of any oral health assessment. Increasing patient knowledge about the effect of alcohol on the oral tissues may help change patient expectations. Several barriers need to be overcome before alcohol enquiry can become routine in dentistry, these include lack of time, funding, training, and knowledge.