Attitudes on Screening for Medical Conditions by Oral Healthcare Professionals

Objectives: We previously demonstrated that chairside screening by oral health care professionals (OHCP) can identify patients at increased risk for cardiovascular disease, suggesting a role for OHCP in early detection/prevention directed at important medical conditions. Gaining insight from practicing OHCP on the acceptability and perceived barriers of conducting routine medical screening among their patients will help guide health care delivery recommendations and policy development.

Methods: A 5- point Likert-scale (1=very important/willing, 5=very unimportant/unwilling) survey was administered to practicing dentists attending the 2008 ADA Health Screening Program. The Friedman nonparametric analysis-of-variance was used to compare responses regarding “willingness to collect specific types of specimens” and “importance of issues when considering incorporation of medical screening into your practice”. Post-hoc comparisons were conducted following Siegel and Castellan (1988).

Results: Of 427 respondents, 76% were male and 60% were 40-60 years old. The majority felt it was “very important” for dentists to conduct screening for cardiovascular disease (53%), hypertension (64%), diabetes mellitus (51%) HIV infection (53%), and hepatitis (54%). Respondents were “very willing” to conduct medical screening that yields immediate results (59%), refer a patient to a physician (82%), collect saliva specimens (70%) and collect finger stick blood (38%).

Post-hoc comparisons showed respondents were significantly more willing (p<0.001) to collect saliva than finger stick blood or measure height and weight (mean ranks 1.39, 2.08, 1.94, respectively). Respondents felt insurance was significantly less important (p<0.001) than time, cost, liability, or patient willingness when considering incorporation of medical screening into their practice (mean ranks: 3.59, 2.84, 2.95, 2.93, 2.68, respectively).

Conclusions: OHCP considered medical screening important and were willing to incorporate it into their practice. Additional education and practical implementation strategies are necessary to help overcome the expressed reluctance to collect all types of specimens and address perceived barriers.