Abstract
BACKGROUND: Although individuals struggling with mental health (MH) issues often do not have regular visits with primary care or MH providers, a subset receives consistent dental care. Recognizing the potential for MH screening in dental settings, this sequential mixed-methods study assessed the feasibility and barriers to implementing MH screening in dental practices. METHODS: Focused interviews were conducted with 15 dental professionals from July to October 2021. A qualitative analysis identified four themes; (1) Holistic Perspective, (2) Stress Manifestations, (3) Comfort and Concerns, and (4) Resources and Supports. These themes guided the development of a survey questionnaire, which was distributed to dental practitioners in the Maryland Practice-Based Research Network in November 2022. The survey included demographic questions and items related to psychosocial stress, dental practices for MH screening, dental providers’ comfort levels, and barriers for MH screening. Descriptive statistics were conducted. RESULTS: 48 dentists (71%) and 20 dental hygienists (29%) completed the questionnaire. Most participants were age ≥ 45 years old with > 20 years of experience in private general practice. 57 participants (84%) observed patients experiencing psychosocial stress; 53 (78%) noticed an increase in stress during the COVID-19 pandemic. While 42 participants (62%) perceived MH screening at dental settings as feasible and 40 (59%) felt comfortable providing MH screening, only 24 (35%) were willing to pilot test MH screening. The primary barrier was the scope and business of the dental practice, followed by concerns about patient comfort and a lack of training and knowledge in MH screening. CONCLUSION: This study found that while most dental professionals perceived MH screening in dental settings as feasible and felt comfortable with it, relatively few were willing to implement it. Future efforts should address the identified barriers and leverage these positive perceptions to support the integration of MH screening into dental practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12903-025-06300-y.