JADA’s new CSA Corner highlights ACE Panel survey results on HPV vaccine

Dentists' comfort levels and perceived roles in discussing and administering the human papillomavirus vaccine appear to vary, according to the results of an American Dental Association Clinical Evaluators Panel survey published in The Journal of the American Dental Association.

The ACE Panel report appears in the journal's CSA Corner, which debuted in the April issue. JADA will publish the results of ACE Panel surveys quarterly in the new feature.

The latest survey includes responses from 329 ACE Panel member dentists in the U.S. on various questions related to the HPV vaccine.

Photo of Dr. Sarah Kha
Dr. Sarah Khan. Photo courtesy of Bilal Asif, M.D.
"Overall, the results of the ACE Panel align with the direction I see dentistry going in the future — aligned with the larger health care system," said Dr. Sarah Khan, one of the dentists who responded to the survey. "It appears that a lot of hesitation regarding vaccine education and administration can be navigated through continuing education courses. As a profession, we are working towards creating a comprehensive protocol and script to allow dentists to be a part of this essential public health effort."

One in four respondents said they or a member of their dental team discuss the vaccine with eligible patients or their parents or guardians, and out of those discussions, two out of three are led by the dentist.

Dentists' most common reasons for not discussing the vaccine include that the topic is best left to other health care professionals, they do not know how to address the topic, they are uncomfortable discussing HPV as a sexually transmitted infection and they lack an appropriate location in their office to have the discussion.

Regarding when the discussion should occur, 63% of respondents said during the dentist's examination, while 20% said during the hygienist's examination, 5% said during the assistant's seating of the patient and 12% said at another time.

Graphic from ACE Panel report
Time to talk: These percentages reflect the responses of 329 ACE Panel member dentists on when to discuss the human papillomavirus vaccine with eligible patients or their parents or guardians.

Most dentists responded that a parent or guardian was in the room during the discussion. For patients 9 to 13 years old, 63% of respondents said they spoke to the parent or guardian and the patient and 35% said they spoke to the parent or guardian alone. For patients 14 to 17 years old, 77% said they spoke to the parent or guardian and the patient, 18% said they spoke to the parent or guardian alone and 4% said they spoke to the patient alone.

Most of the dentists who participated in the survey indicated that if the scope of dental practice in their state were expanded to include administration of the HPV vaccine, they would be likely to administer the vaccine and would feel comfortable doing so or they had neutral feelings about administering the vaccine. Thirty-eight percent said they were unlikely and would feel uncomfortable. The most common barriers listed included reimbursement and vaccine preservation, with more than 65% of respondents reporting these potential barriers.

The ADA adopted a policy in 2018 that urges dentists to support the use and administration of the HPV vaccine, recognizing it as a way to help prevent infection of the types of HPV associated with oropharyngeal cancer. The policy encourages dentists to promote the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices' recommendations for the vaccine.

"Since graduating dental school in 2016, I have seen the paradigm shift to including dentists in the larger health care system," said Dr. Khan, who has a master's degree in public health from Stony Brook University in Stony Brook, New York, and works as a pediatric dentistry resident at Maimonides Medical Center in Brooklyn. "I encourage all dentists to collaborate with their nondental health professionals on issues that are on the crossroads of both fields. Even if as a community we do not physically administer the vaccination, we are poised to educate our patients and provide them referrals to receive this protective vaccination."

Dentists can view the entire ACE Panel report online and download the PDF at JADA.ADA.org.

ACE Panel reports feature data from ADA member dentists who have signed up to participate in short surveys related to dental products, prescribing habits and other clinical topics. The ACE Panel Oversight Subcommittee of the ADA Council on Scientific Affairs, along with ADA Science & Research Institute staff, write the reports.

The reports aim to offer ADA members a way to understand their peers' opinions on various dental products and practices, offering insight and awareness on new products and techniques that can benefit patients and the profession.

 Members are invited to join the ACE Panel and contribute to upcoming surveys, which occur no more than once every few months and usually take five to 10 minutes to complete.

To learn more or join the ACE Panel, visit ADA.org/ACE