How To Spot Addiction In Your Dental Patients

Edie Gibson, RDH, MS, like an increasing number of Americans came to know addiction firsthand in her own home. On Monday during her session, titled “Generation Rx: Uppers, Downers, And All Arounders” at the Greater New York Dental Meeting, discussed how her husband’s battle with alcohol dependency led her from her role as a dental hygienist to becoming a sounding board for women who have experience the same struggle.

She described how these experiences reinforced for her how dentists and dentistry are parts of the care continuum that can intervene in the lives of addicts and put them on a path to recovery. She also highlighted how dentists, now more than ever, have to be cognizant of addiction when dealing with their baby boomer patients.

“I am firm believer that pain is the driver of addiction,” Gibson said.

Whether that’s the physical pain of a third molar removal that leads to an opioid prescription and dependency, or emotional pain, like what her husband endured growing up in a high-pressure environment, this is the catalyst for dependency that dentists and hygienists are advantageously positioned to spot.

Spotting Addiction

What other health care providers, Gibson asked, see their patients as often as dentists do?

“Are we not health care professionals?” Gibson asked. “Are we not human beings too? … We are human beings first,” she said, compelling the professionals gathered at her session to speak up when the see signs of addiction, and go a step further in rooting them out.

Discovering an underlying addiction problem begins with engaging with patients, she said. The best way to do that, she explained, is with open-ended questions. “I noticed you’re drinking 4-6 drinks a night. How is that affecting your life?” she asked, providing an example. This sort of approach is more likely to foster a discussion than the simple alcohol question on a patient intake form will.

At this point, it falls to the dentist to take a step back and listen to the patient’s response. She drew from her experience with her husband, saying that if she had actually asked about the source of his drinking problem rather than getting angry, they likely would have arrived sooner at a solution.

The final step, she said, is to come up with a plan. Do not let the patient leave without putting them on a path to address the issue, she said, noting that in the past she has provided patients with information on counseling and recovery when appropriate.

“Be a human being and get involved,” she said.

Baby Boomers

As the Baby Boom generation ages, Gibson said, they’re arriving in the dental chair with their own distinct set of health concerns, many of which are being addressed pharmacologically with a bevy of medications. This makes a detailed overview of their medical history that much more critical. Many recovering addicts, Gibson said, will be upfront about their status and warn dentists off prescribing pain killers or even nitrous oxide. Others, however, aren’t as aware.

Baby Boomers, she added, are increasingly returning to marijuana as its decriminalization continues across the US. This pot, however, isn’t want they were accustomed to when they were younger. Modern strains contain far more THC than typical marijuana did in the 60s and 70s. It’s also difficult to calculate just how many DUIs or traffic fatalities marijuana may be causing, post-decriminalization, she said.

Gibson left those who attended her session with this final thought: Regardless of the drug, the patient’s age, or the severity of their problems, dentists and dentistry fit into a greater picture of health. She noted that those whom she counsels for addiction often look to improve their smiles as part of their journey toward recovery.

“This,” she said, passing her hand around her mouth, “is connected to this,” she said, passing her hand around her head.