Alcohol related health advice and the role of the General Dental Practitioner

  • Simon Shepherd

Student thesis: Doctoral ThesisDoctor of Philosophy


Alcohol misuse and related harm costs money, drains resource and takes lives. Alcohol brief interventional advice forms an important method to moderate alcohol consumption at both individual and population level.

Alcohol exerts a significant negative influence on the oral cavity and is implicated in the development of oro-mucosal and dental disease. Alcohol and tobacco smoking are recognised a key aetiological agents in the development of oral cancer which is the 14th most common cancer, accounting for approximately 2% of new cases, killing over 2300 people in the UK every year. A crucial weapon to tackle the disease is prevention through management of those modifiable lifestyle factors.

The role of the general dental practitioner (GDP) in providing alcohol advice has received sparse attention, however evidence suggests that GDPs do not routinely engage in this activity. The aim of this research was to identify factors preventing or facilitating GDP engagement and develop strategies to support them to deliver alcohol advice.

GDPs salient beliefs were applied, using behaviour change theories (the Theory of Planned Behaviour and Social Cognitive Theory), to formulate a theory based questionnaire. A postal survey (n=300, RR 60%) identified that few (17%) GDPs routinely provide advice to patients exposing potential for improvement. Subsequent exploratory multiple regression analysis identified 5 key items which might act as targets. The resultant five-item model accounted for 41% of the variance in intention [Adjusted R2 for this model is .41; F = 15.34 (.001)].

A theoretically informed intervention was administered as a multi-centre, parallel group, three-arm randomized controlled pilot study. The aims were to test the feasibility and acceptability of implementing an alcohol advice intervention in dental primary care. The intervention was not entirely acceptable to patients or dentists. Qualitative analysis revealed factors (not limited) to remuneration, perceived relevance, confidence, embarrassment and fear of consequences mar progress. Modifications to study processes and methods would seem a sensible prior to further study.
Date of Award2017
Original languageEnglish
SupervisorGraham Ogden (Supervisor) & Janet Clarkson (Supervisor)


  • Alcohol
  • Dentistry
  • Oral
  • Dentist
  • Advice
  • Dental
  • Risk communication
  • Theory of planned behavior
  • Health advice
  • Qualitative
  • Intervention development
  • RCT
  • Behaviour change
  • Mouth

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