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National Institute on Drug Abuse highlights substance abuse screening tips

January 30, 2019
Photo of Dr. Kessler
Dr. Kessler
In a continuing effort to spotlight dentistry's role in helping prevent substance abuse, the National Institute on Drug Abuse has created a new webpage, Screening for Substance Use in the Dental Setting.

The webpage is designed to help dentists and other dental professionals recognize the signs of risky substance use and addiction. Dr. Brett Kessler, a Colorado-based general dentist and member of the ADA Dental Wellness Advisory Committee, and Stephanie Botts, a registered dental hygienist, provided the tips.

When discussing substance abuse with patients, Dr. Kessler recommends starting the conversation when taking their health history or during the oral cancer screening. When doing this, he urges providers to address unhealthy substance use "in an open and nonjudgmental manner."

Because patients with untreated addiction "could have adverse reactions during dental treatment," he suggested referring such patients to a local behavioral health provider to work toward recovery. In emergency situations, he recommends the doctor refer the patient to an oral and maxillofacial surgeon or a local emergency room.

He also recommends providers:

  • Explain the research on opioids versus over-the-counter pain medications, in particular that the ADA recommends the use of nonopioid medications as a first line of defense.
  • Reassure patients who are in addiction recovery that their dental-related pain will be managed.
  • Check their state's prescription drug monitoring program and screen for opioid misuse risk if prescribing opioids is necessary.
  • Stay up-to-date by familiarizing yourself with the latest guidelines and continuing education on opioid use disorder and other substance use disorders.

The ADA continues to raise professional awareness on medication alternatives to opioids, encouraging dentists to complete Continuing Education Provider Recognition training in model opioid prescribing and urging them to register with their state prescription drug monitoring programs. The ADA also offers free online continuing education courses on safe and effective analgesic prescribing for dental pain.

As a public service, the ADA Center for Professional Success website is now offering free access to information on safe prescribing, online continuing education and other tools for managing dental pain, especially for patients who are at risk for drug overdose or addiction.

The 2019 Health and Well-Being Conference will take place on Aug. 16. The council's ADA Dental Wellness Advisory Committee will host the conference, at ADA Headquarters in Chicago, and focus on continuing education on career burnout and stress management. For more information, contact Alison Bramhall at or 1-202-898-2410.