Chairside Screening
Dentists' attitudes toward chairside screening for medical conditions

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ABSTRACT

Background

Results of previous studies demonstrated the effectiveness of chairside medical screening by dentists to identify patients at increased risk of experiencing cardiovascular-associated events. In this study, the authors assessed dentists' attitudes, willingness and perceived barriers regarding chairside medical screening in the dental office.

Methods

A national, random sample of U.S. general dentists was surveyed by mail by means of an anonymous questionnaire that involved a five-point Likert scale (1 = very important/very willing; 5 = very unimportant/very unwilling). Friedman nonparametric analysis of variance was used to compare response items within each question.

Results

Of 1,945 respondents, most were male (82.3 percent), white (85.7 percent) and 40 to 60 years old (59.4 percent) and had practiced for more than 10 years (84.5 percent). The majority thought it was important for dentists to conduct screening for hypertension (85.8 percent), cardiovascular disease (76.8 percent), diabetes mellitus (76.6 percent), hepatitis (71.5 percent) and human immunodeficiency virus infection (68.8 percent). Respondents were willing to refer patients for consultation with physicians (96.4 percent), collect oral fluids for salivary diagnostics (87.7 percent), conduct medical screenings that yield immediate results (83.4 percent) and collect blood via finger stick (55.9 percent). Respondents were significantly more willing (P < .001) to collect saliva than height and weight measurements or blood via finger stick (mean ranks: 2.05, 2.96 and 3.05, respectively). Insurance was significantly less important (P < .001) than time, cost, liability or patients' willingness (mean ranks: 3.51, 2.96, 2.94, 2.83 and 2.77, respectively).

Conclusions

Dentists considered medical screening important and were willing to incorporate it into their practices. Additional education and practical implementation strategies are necessary to address perceived barriers.

Clinical Implications

The findings of this study regarding chairside medical screening may lead to changes in our approach to dental education and may help define the practice of dentistry in the future.

Section snippets

MATERIALS, METHODS AND PARTICIPANTS

We mailed a self-administered questionnaire to 7,400 U.S.-based practicing dentists. The questionnaire included five Likert scale questions, each consisting of a series of items that addressed dentists' attitudes toward, acceptance of and perceived barriers regarding screening for medical conditions in a dental setting. The five-point response scale was as follows: 1 = very important/very willing, 2 = somewhat important/somewhat willing, 3 = not sure, 4 = somewhat unimportant/somewhat unwilling

Analysis: entire study sample

A total of 1,945 respondents returned the completed questionnaires, for a response rate of 26 percent and a margin of error of ± 2.22 percent. Table 1 shows the demographics of the study sample. Among those who responded to the particular question, 82.3 percent were male; 85.7 percent were white; 84.5 percent had practiced more than 10 years; 56.1 percent were practicing in suburban areas and 28.6 percent in urban areas; and 6.2 percent attended the HSP program at the 2007 ADA annual session.

DISCUSSION

This study is the first nationwide survey of practicing general dentists in the United States to assess attitudes toward, acceptance of and perceived barriers regarding screening for medical conditions in a dental setting. The overwhelming majority of respondents thought it was important and were willing to conduct chairside screening for the specified medical conditions (68.8–85.8 percent)—including CVD, DM, hypertension, HIV and hepatitis infection—in a dental setting. The majority of

CONCLUSION

The data from our study showed that dentists are willing to incorporate chairside medical screening into their practices, thus offering an opportunity for integrated disease prevention and control activities across disciplines. Primary disease prevention and control activities are meant to delay disease onset and control disease severity.52 The first step is identifying people with an increased likelihood of developing disease or experiencing escalating disease severity. This is particularly

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    Disclosure. None of the authors reported any disclosures.

    The authors thank the staff of the American Dental Association Survey Center, Chicago, for assistance in preparing the mailing list for this study. They also thank Nelida Laracuente, Sue Jiang, Zulma Glover and Inez White of the New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, for their assistance in preparing the mailing packets and entering the data.

    1

    Dr. Greenberg is an associate professor, Department of Diagnostic Sciences, and the acting associate dean for research, Office of Research, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark. She also is the statistical analyst for The Journal of the American Dental Association.

    2

    When this article was written, Dr. Glick was a professor of oral medicine, Arizona School of Dentistry and Oral Health, and the associate dean for oral-medical sciences, School of Osteopathic Medicine, A.T. Still University, Mesa, Ariz. He now is the dean of dental medicine, School of Dental Medicine, University at Buffalo, The State University of New York. He also is editor of The Journal of the American Dental Association.

    3

    Dr. Frantsve-Hawley is the director, Research Institute and Center for Evidence-Based Dentistry, Division of Science, American Dental Association, Chicago.

    4

    Dr. Kantor is a professor, Department of Diagnostic Sciences, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, and a professor, Department of Epidemiology, School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway. He also is a member of the editorial board of The Journal of the American Dental Association.

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