Brief Intervention for Unhealthy Alcohol Use in Dental Practice May Benefit People with Heavy Drinking

An annual visit to a dental provider offers an opportunity to screen and counsel adults about alcohol consumption. This controlled trial tested the efficacy of a brief intervention for unhealthy alcohol use in 13 dental practices that were randomized to deliver an intervention or to a control condition. Participants were eligible if they reported weekly risky drinking (>14 drinks in a week for men or >7 drinks in a week for women) OR 1 or more episode of heavy drinking over the past 30 days (≥5 drinks in an occasion for men, ≥4 for women). Once included in the study, participants were categorized in three weekly drinking categories: ≤6, 7 to 12, and >13 drinks in a week. The intervention was delivered by dental hygienists trained in motivational interviewing techniques and included normative feedback and specific feedback with regard to the risk of oral cancer. Participants were followed-up at 3 and 6 months. Participants randomized to receive the intervention who did not receive it (n = 67) were excluded from the analyses.

• The study found decreases in the number of drinks consumed in a week in both the intervention and control groups at 3 and 6 months. Specifically, in subgroup analyses, this decrease was significant only among people with heavy weekly drinking (average consumption of ≥13 drinks in a week).
• At 6 months, among people with heavy weekly drinking, the intervention group showed continued decrease in consumption, with a 43% decrease from baseline, compared with a 21% decrease from baseline in the control group.
• There were no significant differences between groups among people with “moderate” (7–12 drinks in a week) and light (≤6 drinks in a week) weekly drinking at baseline.

Comments:

This study provides encouraging results for the efficacy of brief intervention in the dental setting, but some important limitations call for replication. The recruitment of dental practices and participants was lower than expected, leading to limited power and a small number of participants. In addition, the authors did not conduct intention to treat analyses. The small number of invited practices that agreed to participate (13 out of 387) suggests that implementation might be problematic in dental practice.

Nicolas Bertholet, MD, MSc

Reference:

Neff JA, Kelley ML, Walters ST, et al. Effectiveness of a screening and brief intervention protocol for heavy drinkers in dental practice: A cluster-randomized trial. J Health Psychol. 2014
[Epub ahead of print]. doi: 10.1177/1359105313516660.