Mental health screening and referral to treatment in dental practices: A scoping review

Nathan P Culmer; Todd Brenton Smith; M Blake Berryhill; JoAnn Gurenlian; Lance Simpson; Shawnna Ogden; Jonathan Parrish; Lacey Ryan; Nicole White; Merrill Bettis; Charlotte Greenwood

doi:10.1002/jdd.13444

Mental health screening and referral to treatment in dental practices: A scoping review

J Dent Educ. 2024 Apr;88(4):445-460. doi: 10.1002/jdd.13444. Epub 2024 Jan 28.

Authors

Nathan P Culmer¹, Todd Brenton Smith², M Blake Berryhill³, JoAnn Gurenlian^{4

5}, Lance Simpson⁶, Shawnna Ogden¹, Jonathan Parrish^{7

8}, Lacey Ryan⁸, Nicole White⁹, Merrill Bettis⁸, Charlotte Greenwood⁸

Affiliations

¹ College of Community Health Sciences, The University of Alabama, Tuscaloosa, Alabama, USA.
² Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA.
³ Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, Alabama, USA.
⁴ Education and Research Division, American Dental Hygienists' Association, Chicago, Illinois, USA.
⁵ Department of Dental Hygiene, Idaho State University, Pocatello, Idaho, USA.
⁶ University Libraries, The University of Alabama, Tuscaloosa, Alabama, USA.
⁷ College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA.
⁸ College of Arts and Sciences, The University of Alabama, Tuscaloosa, Alabama, USA.
⁹ Department of Psychology, The University of Mississippi, Oxford, Mississippi, USA.

PMID: 38282325
DOI: 10.1002/jdd.13444

Abstract

Objective: The purpose of this study was to conduct a scoping review to examine and summarize the characteristics of research related to mental health (MH) screenings and/or referrals to treatment in dental practices.

Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for Scoping Reviews and searched multiple databases for terms connected with dental care, MH concerns, screening, and referral. Included articles: (1) described care provided in a dental practice, (2) described a situation where the patient is experiencing the potential MH problem, (3) did not involve dental anxiety exclusively, and (4) involved some form of MH screening and/or referral to treatment. Article analysis included a summary of key study characteristics, types of evidence, study design, and central concepts and definitions.

Results: The search generated 2050 records, with 26 ultimately included. Most studies involved only adults (22, 85%), but only three (12%) reported on rurality (two urban; one mixed) and only two each (8%) reported race or ethnicity. Fifteen (58%) articles were prospective and 11 (42%) were retrospective. The studies varied widely in study designs, from 11 (42%) cross-sectional methodologies to only one (4%) randomized controlled trial. Thirty-four screening tools were used to screen for symptoms of 43 MH conditions, with depression and anxiety screened for most frequently. Few articles discussed making referrals, practice workflows, or follow-up outcomes.

Conclusions: Included studies provide evidence of viable options for dental practitioners regarding MH screening, referring, and conducting follow-up, but lack specificity regarding these processes. Overall, more research is needed to clarify what workflows are most efficient for dental practitioners and efficacious in identifying patients with MH concerns.

Keywords: community health care; mental health; mental health referral; mental health screening; patient‐centered care; psychosocial aspects; public health; scoping review; systems‐based practice.

Publication types

Systematic Review
Review

MeSH terms

Adult
Cross-Sectional Studies
Dentists*
Humans
Mental Health*
Professional Role
Prospective Studies
Referral and Consultation
Retrospective Studies