Dental Clinics Overlook Teen Substance Risks Despite Regular Visits
A recent national survey reveals a startling gap in U.S. dental practice: fewer than half of dentists report screening adolescent patients for substance use. Despite their potential as front-line healthcare providers who see teens regularly, most dentists do not routinely ask about or counsel on tobacco, alcohol, cannabis, or other drug use.
The study, published ahead of print in the Journal of Adolescent Health, was conducted among 751 practicing dentists affiliated with the National Dental Practice-Based Research Network. It investigated dentists’ knowledge, attitudes, and behaviors regarding substance use screening, counseling, and referrals for adolescents.
Key findings include:
Approximately 40.5% of respondents said they screen for nicotine or tobacco use at least once a year in teen patients.
Only about one-third reported screening annually for alcohol, cannabis, or other drugs.
Of those who did screen, many do not provide follow-up counseling: 48.5% never counsel for alcohol, 52.7% for cannabis, and 55.4% for illicit substances after a positive screen.
Referral rates to specialized care were also low, indicating that even when a risk is identified, many clinicians are not equipped to initiate or direct further care.
Dentists participating in the survey were predominantly male (61%), white (67%), and working in private practice environments (81%). The authors note that while current rates of screening are low, many dentists expressed willingness to adopt screening, counseling, and referral as part of their practice; stigma and perceived relevance were cited as minor barriers.
The authors contextualize these findings against broader public health data, citing that adolescent use of substances like alcohol, vaping, and cannabis remains widespread, though rates dipped after the COVID-19 onset. The fact that many teens engage in experimentation or risk behaviors underscores the missed opportunity for dentist-led intervention.
The survey highlights a critical need for dental education and professional development to emphasize the role dentists can play in early identification of substance use. Incorporating validated screening tools, building confidence in counseling techniques, and establishing referral pathways may enable more dentists to act not just as oral health providers but as part of a broader adolescent health safety net.
In summary: while dentists are uniquely positioned to notice risk behavior in teens, current practice patterns show that many are not leveraging this role. With targeted training and system support, the dental community could expand its impact on adolescent wellness beyond cavities and gum disease.
Original Article Info
‘First national study’ finds few U.S. dentists screen teens for substance use
Oral Health Group, October 9, 2025