Tackling alcohol misuse within the dental healthcare setting : how does dentistry deal with such a public health issue and how can we improve on this response?

• Main Author: Roked, Zairah
• Published: Cardiff University 2016
• Subjects: 617.6; H Social Sciences (General)
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.693429

Introduction: Dental professionals have opportunities to advise patients on harms associated with alcohol misuse. However, it is not known how this might be undertaken or whether advice in dental settings is effective. Methods: This thesis complies with the first three stages of the Medical Research Council’s framework for the design of interventions to improve health. The first theoretical stage comprises a systematic literature search. The second Phase I/modelling stage comprises qualitative research, using thematic analysis, to determine barriers to brief alcohol interventions (BAIs) in dental settings. The third stage consists of a Phase II exploratory randomised controlled trial. 106 out of 2300 patients were recruited over eight weeks from a South Wales dental practice and screened for alcohol misuse. 47 patients scored positive for misuse; 26 were randomised to an intervention group, 21 to control conditions. Findings: The literature identified a paucity of research on BAI effectiveness in primary dental care settings. It identified motivational interviewing (MI) as an effective intervention in secondary dental care and the Modified-Single Alcohol Screening Question (M-SASQ) as a reliable screening tool. Qualitative research identified evidence of dissonance between the views of dental professionals and patients. Dental professionals felt alcohol misuse prevention was not relevant to their role, whereas patients felt it should be part of dental care. In the exploratory trial, there was some evidence that there is potential for patients to be screened and treated for alcohol misuse in a primary dental care setting. However, recruitment and retention rates were poor. As a result, there was not enough definite evidence to conclude whether it was truly feasible to screen and treat patients for alcohol misuse in a general dental practice setting. Conclusions Further work is needed before a Phase III definitive trial can be designed. In particular, methods in improving recruitment and retention rates need to be explored.