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Use of AUDIT-C alcohol screening tool in NHS general dental practices in North London

British Dental Journal (2021)Cite this article

Abstract

Background The numerous health risks of excessive alcohol consumption are well documented. Individuals at risk of harm from alcohol consumption can be identified through alcohol screening tools; however, there is limited research regarding their use in general dental practices.

Methods Data were collected as part of a feasibility trial evaluating delivery of brief alcohol advice in general dental practices in North London. Patient demographics and health-related behaviours were collected, and the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) tool was used to assess alcohol consumption patterns.

Results The analytical sample comprised 552 dental patients, of whom approximately half (46%) were drinking alcohol at hazardous levels. Males, younger adults, those who consumed red meat weekly and smokers all had significantly increased risks of excessive alcohol consumption. Smokers were more likely to consume excessive levels of alcohol irrespective of smoking frequency. Notable sex differences in alcohol consumption were identified, with males being more likely to consume alcohol frequently and in larger quantities than females.

Conclusion The AUDIT-C tool can be used in general dental practice to screen for harmful levels of alcohol consumption. Clear associations exist between patient demographics, health behaviours and excessive alcohol consumption.

Key points

  • This study illustrates that brief alcohol screening tools can be successfully used in general dental practice to identify patients at risk of harm from excessive alcohol consumption.

  • Harmful levels of alcohol consumption were identified in nearly half of the patients screened.

  • Males, younger adults, smokers and those who consumed red meat weekly were more likely to consume levels of alcohol above the recommended limits.

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References

  1. World Health Organisation. Global status report on alcohol and health 2018. 2018. Available at https://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf (accessed April 2021).

  2. Public Health England. The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies: An evidence review. 2016. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/733108/alcohol_public_health_burden_evidence_review_update_2018.pdf (accessed April 2021).

  3. World Health Organisation. Global status report on alcohol and health 2014. 2014. Available at https://apps.who.int/iris/bitstream/handle/10665/112736/9789240692763_eng.pdf (accessed April 2021).

  4. Griswold M G, Fullman N, Hawley C et al. Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet 2018; 392: 1015-1035.

  5. Shield K D, Parry C, Rehm J. Chronic diseases and conditions related to alcohol use. Alcohol Res Curr Rev 2014; 35: 155-171.

  6. NHS Digital. Part 1: Alcohol-related hospital admissions. 2019. Available at https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-alcohol/2019/part-1 (accessed March 2020).

  7. NHS Digital. Part 2: Alcohol-specific deaths. 2020. Available at https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-alcohol/2020/part-2 (accessed March 2020).

  8. Turati F, Garavello W, Tramacere I et al. A Meta-analysis of Alcohol Drinking and Oral and Pharyngeal Cancers: Results from Subgroup Analyses. Alcohol Alcohol 2013; 48: 107-118.

  9. Hutchison I L, Magennis P, Shepherd J P, Brown A E. The BAOMS United Kingdom survey of facial injuries part 1: aetiology and the association with alcohol consumption. British Association of Oral and Maxillofacial Surgeons. Br J Oral Maxillofac Surg 1998; 36: 3-13.

  10. da Silva Furtado Amaral C, Vettore M V, Leão A. The relationship of alcohol dependence and alcohol consumption with periodontitis: A systematic review. J Dent 2009; 37: 643-651.

  11. Rosenberg M, Knaan T, Cohen D. Association among Bad Breath, Body Mass Index, and Alcohol Intake. J Dent Res 2007; 86: 997-1000.

  12. Robb N D, Smith B G. Prevalence of pathological tooth wear in patients with chronic alcoholism. Br Dent J 1990; 169: 367-369.

  13. Suwama K, Yoshihara A, Watanabe R, Stegaroiu R, Shibata S, Miyazaki H. Relationship between alcohol consumption and periodontal tissue condition in community-dwelling elderly Japanese. Gerodontology 2018; 35: 170-176.

  14. Pitiphat W, Merchant A T, Rimm E B, Joshipura K J. Alcohol consumption increases periodontitis risk. J Dent Res 2003; 82: 509-513.

  15. Department of Health. UK Chief Medical Officers' Low Risk Drinking Guidelines. 2016. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf (accessed April 2021).

  16. NHS Digital. Health Survey for England 2018: Adult's health-related behaviours. 2019. Available at https://files.digital.nhs.uk/B5/771AC5/HSE18-Adult-Health-Related-Behaviours-rep-v3.pdf (accessed April 2021).

  17. National Institute for Health and Clinical Excellence. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence. 2011. Available at https://www.nice.org.uk/guidance/cg115/resources/alcoholuse-disorders-diagnosis-assessment-and-management-of-harmful-drinking-highrisk-drinking-and-alcohol-dependence-pdf-35109391116229 (accessed April 2021).

  18. Hodgson R, Alwyn T, John B, Thom B, Smith A. The FAST Alcohol Screening Test. Alcohol Alcohol 2002; 37: 61-66.

  19. King's College London. Screening and Intervention Programme for Sensible drinking (SIPS) - Modified-Single Alcohol Screening Question (M-SASQ). 2008. Available online at https://www.kcl.ac.uk/research/sips (accessed April 2020).

  20. Saunders J B, Aasland O G, Babor T F, de la Fuente J R, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II. Addiction 1993; 88: 791-804.

  21. Bush K, Kivlahan D R, McDonell M B, Fihn S D, Bradley K A. The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Arch Intern Med 1998; 158: 1789-1795.

  22. National Institute for Health and Care Excellence. Alcohol-use disorders: prevention. 2010. Available at https://www.nice.org.uk/guidance/ph24/resources/alcoholuse-disorders-prevention-pdf-1996237007557 (accessed April 2021).

  23. Bradley K A, Debenedetti A F, Volk R J, Williams E C, Frank D, Kivlahan D R. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res 2007; 31: 1208-1217.

  24. NHS Dental. NHS Dental Statistics for England 2019-20, Biannual Report. 2020. Available online at https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2019-20-biannual-report (accessed April 2020).

  25. McAuley A, Goodall C A, Ogden G R, Shepherd S, Cruikshank K. Delivering alcohol screening and alcohol brief interventions within general dental practice: rationale and overview of the evidence. Br Dent J 201; 210: E15.

  26. Public Health England. Delivering better oral health: an evidence-based toolkit for prevention. 2017. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/605266/Delivering_better_oral_health.pdf (accessed July 2020).

  27. Goodall C, Crawford A, Macaskill S, Welbury R. Assessment of hazardous drinking in General Dental Practice. J Dent Res 2006; 85: 1219.

  28. Csikar J, Paige C, Godson J. The feasibility of using an alcohol screening tool in a UK dental setting to identify patients' alcohol consumption. Community Dent Health 2015; 32: 196-198.

  29. Roked Z, Moore S, Shepherd J. Feasibility of alcohol misuse screening and treatment in the dental setting. Lancet 2015; 385 Suppl 1: S84.

  30. Ntouva A, Porter J, Crawford M J et al. Assessing the feasibility of screening and providing brief advice for alcohol misuse in general dental practice: a clustered randomised control trial protocol for the DART study. BMJ Open 2015; DOI: 10.1136/bmjopen-2015-008586.

  31. Alzahrani S G, Sheiham A, Tsakos G, Watt R G. Psychosocial determinants of clustering health-compromising behaviours among Saudi male adolescents. Int J Pediatr Adolesc Med 2017; 4: 26-32.

  32. Singh A, Rouxel P, Watt R G, Tsakos G. Social inequalities in clustering of oral health related behaviours in a national sample of British adults. Prev Med 2013; 57: 102-106.

  33. Myint P K, Luben R N, Wareham N J, Bingham S A, Khaw K T. Combined effect of health behaviours and risk of first ever stroke in 20,040 men and women over 11 years' follow-up in Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk): Prospective population study. BMJ 2009; DOI: 10.1136/bmj.b349.

  34. Blot W J, McLaughlin J K, Winn D M et al. Smoking and Drinking in Relation to Oral and Pharyngeal Cancer. Cancer Res 1988; 48: 3282-3287.

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Acknowledgements

The authors would like to express their gratitude to all the dental staff and patients for their cooperation and participation in the study.

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Authors and Affiliations

  1. Department of Epidemiology and Public Health, UCL, UK

    Renato Venturelli, Antiopi Ntouva, Jessie Porter, Michelle Stennett, Annie Britton, Christine Gratus, Georgios Tsakos, Anja Heilmann, Hynek Pikhart & Richard G. Watt

  2. Department of Medicine, Imperial College London, UK

    Mike J. Crawford

  3. King’s College London Dental Institute, King’s College London, UK

    Tim Newton

  4. General Dental Practitioner and Health Education England, UK

    Caillin Redican

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  1. Renato Venturelli
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Corresponding author

Correspondence to Richard G. Watt.

Ethics declarations

The authors declare no conflicts of interest. This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit Programme (Grant Reference Number PB-PG-0212-27029). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

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Venturelli, R., Ntouva, A., Porter, J. et al. Use of AUDIT-C alcohol screening tool in NHS general dental practices in North London. Br Dent J (2021). https://doi.org/10.1038/s41415-021-2964-5

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