By Danielle 
Fewer than half of U.S. dentists screen adolescents for substance use, according to what authors describe as the first national survey of dentists’ practices on the issue, published online ahead of print in the Journal of Adolescent Health.
The Substance Use Disorders (SUDs) Screening Survey assessed dentists’ knowledge, attitudes and current practice behaviours related to screening for substance use—including tobacco, nicotine, alcohol, cannabis and illicit drugs—along with their provision of brief counselling and referrals for treatment.
“This is the first national study of dentists’ SUD screening, counselling and referral practices among adolescent patients,” the authors wrote, adding that while current rates are low, “a substantial proportion of dentists indicated willingness to screen, counsel and refer adolescents” and reported low stigma and high perceived relevance to practice.
In a cross-sectional, regionally representative electronic survey of 751 practising dentists in the U.S. National Dental Practice-Based Research Network, 40.5 per cent reported screening for nicotine or tobacco use at least once a year in adolescent patients.
About one-third screened annually for alcohol, cannabis or other drugs. Respondents were predominantly male (61 per cent), white (67 per cent) and working in private practice (81 per cent).
Roughly half of dentists who screen said they never provide counselling or education after a positive screen for alcohol (48.5 per cent), cannabis (52.7 per cent) or illicit drugs (55.4 per cent), and referral rates to specialty care were described as low.
Teens and substance use
By way of broader context, the latest Monitoring the Future survey found that in 2023, illicit drug use among adolescents remained under pre-pandemic levels. Specifically, 10.9 per cent of eighth graders, 19.8 per cent of 10th graders and 31.2 per cent of 12th graders reported using any illicit drugs in the past year. National Institute on Drug Abuse Reported use of most substances fell sharply after 2020 with COVID-19-era disruptions, then held relatively steady through 2022 and into 2023 at these lower rates.
Meanwhile, student substance use in Canada has remained largely steady from 2021–22 to 2023–24, according to the latest results from Health Canada’s Canadian Student Tobacco, Alcohol and Drugs Survey. Alcohol remains the most commonly used substance among students in Grades 7–12, with 22 per cent reporting use in the past 30 days, followed by vapes (15 per cent) and cannabis (12 per cent).
Use tended to increase with age, peaking among Grade 12 students, and varied by gender and geography. Gender-diverse students reported higher rates of cigarette, illicit drug and non-prescribed medication use, while students in rural areas reported more vaping, alcohol and polysubstance use than their urban peers.
Alcohol (69 per cent) and cannabis (49 per cent) were viewed as the easiest to obtain, most often through friends and family. Awareness of health risks also differed by grade: younger students were more likely to underestimate the harms of substance use, while older students—especially in Grade 12—were most likely to perceive little or no risk from cannabis use.
When seeking information about the risks of drugs and alcohol, students most often turned to official websites (26 per cent), school classes (21 per cent) and healthcare professionals (14 per cent).