Alcohol-related harms result in significant health, social and economic costs to the Scottish population. Dental Professionals (DPs), including general dental practitioners (GDPs) and dental hygienists, are ideally placed to support public health efforts to reduce alcohol-related harm by routinely screening patients and offering alcohol-related health advice. DPs in the UK are encouraged to screen patient’s alcohol consumption and provide advice in the form of alcohol brief interventions (ABIs) (Scottish Government, 2018a; Department of Health & Social Care, 2021). A literature review conducted over 10 years ago highlighted that DPs were reluctant to deliver ABIs (McAuley et al., 2011). There is a need to review more up to date evidence on this topic to understand what progress, if any, has been made regarding the delivery of ABIs and other forms of alcohol-related health advice in dental practice settings. Further, there is a gap in knowledge relating to dental patients’ views on receiving such advice. Gaining this understanding would help to inform future research and policy priorities regarding the delivering of alcohol-related health advice in dental practice settings. 

A scoping review was conducted to systematically explore the current evidence on the delivery of alcohol-related health advice to patients in dental practice settings. The review questions were: 1) what are the range of interventions used to deliver alcohol-related health advice in dental practice settings?; 2) what are the barriers and facilitators to the delivery of alcohol-related health advice?; and 3) what are dental patients’ views on the delivery of alcohol-related health advice? A scoping review methodology was followed to identify relevant literature sources that could provide answers to the review questions. Data were extracted from included articles and presented and analysed according to the review questions.

Only 17 literature sources detailing 12 primary studies that were identified as relevant to this scoping review, demonstrating the limited evidence base on this topic. The only type of intervention used to deliver alcohol-related health advice was the ABI; this was delivered in different formats across three types of dental practice settings and had mixed impact on dental patients’ alcohol consumption. Several barriers and facilitators to delivering this advice in dental practice settings were identified: 

• Limited time: Delivering alcohol-related health advice placed pressure on the already limited time DPs had to spend with patients. This was generally considered to be less of an issue for dental hygienists as they tend to spend more time with patients compared to GDPs.
• Training: A lack of training on how to deliver alcohol-related health advice was linked to DPs’ limited knowledge and confidence to deliver the advice. Conversely, training DPs facilitated the delivery of this advice.
• Perceptions on the roles of DPs: DPs had mixed views on their role in providing general health promotion interventions including alcohol-related health advice.
• Some considered this an important part of their role while others did not view this as relevant. There were also contrasting views regarding the suitability of dental hygienists delivering such advice.
• Perceived patient discomfort and non-compliance to DP’s advice: Some DPs believed that discussions about alcohol would discomfort or embarrass patients, and result in disrupting important dentist-patient relationships. Some also believed that patients would not want to receive such advice from DPs, and that patients would not comply with the advice.
• Lack of funding: Insufficient funding or remuneration for delivering alcohol-related health advice and other general health promotion interventions prevented DPs from delivering such interventions.
• Lack of referral resources and follow-on care: Concern over the lack of appropriate and relevant information and limited knowledge of services to signpost/refer patients to, and the ethical and legal implications of this made some DPs reluctant to deliver alcohol-related health advice.
• The review also found that patients generally were comfortable with receiving alcohol-related health advice from DPs and welcomed such advice if their drinking impacted on their oral health; this contrasts with DPs perceptions that patients would not want to receive such advice during dental visits.

The key recommendations presented are reflective of the findings from our data analysis and discussion. They are:

• More research in the form of robust trials is needed on the feasibility and potential effectiveness of ABIs in dental practice settings.
• More research is needed to explore the utility of innovative approaches including virtual and computer-based screening tools and programmes to provide advice to dental patients on how to reduce their alcohol consumption.
• Collaborative working with DPs, dental patients and policy makers should be encouraged to identify strategic ways to address barriers to the delivery of alcohol-related health advice in dental practice settings.
• Regular and appropriate training should be provided to DPs to boost their confidence and normalise alcohol-related health advice as part of their relationships with patients.
• More research to capture dental patients’ views on the acceptability of receiving alcohol-related health advice to inform training materials and clinical guidance. Public awareness of the public health role of DPs in addressing alcohol-related harm should be promoted