Identifying the Footprint of Substance Abuse Among Dental Professionals in Pakistan A Cross-Sectional Survey

Background: Substance abuse produces clinically detectable oral and behavioral sequelae that can present during routine dental care, positioning dental professionals to contribute to early recognition and referral; however, evidence on preparedness and practice patterns in Pakistan remains limited. Objective: To assess awareness, recognition, screening behaviors, perceived training needs, confidence, referral practices, and commonly encountered substances and oral manifestations of substance abuse among dental students and dental professionals in Pakistan. Methods: A cross-sectional online survey was conducted from June to September among 420 dental students and dental professionals across Pakistan using a structured, self-administered questionnaire distributed via professional and academic networks. Data were analyzed in SPSS v27 using descriptive statistics. Results: Of 420 respondents, 358 (85.2%) reported awareness of substance abuse and 340 (81.0%) reported ability to recognize physical/oral signs. Cigarettes were the most commonly encountered substance among dental patients (291; 69.3%), followed by alcohol (58; 13.8%). The most frequently recognized oral manifestations were oral lesions (134; 31.9%), xerostomia (127; 30.2%), and periodontal disease (118; 28.1%). Only 110 (26.2%) reported always screening for oral indicators during routine examinations, despite 313 (74.5%) reporting confidence in managing such patients. Awareness of referral pathways was reported by 284 (67.6%), and 287 (68.3%) reported having referred patients for treatment. Nearly all respondents endorsed the need for training (strongly agree/agree: 407; 96.9%), while 204 (48.6%) reported no formal training. Conclusion: Dental professionals in Pakistan demonstrate high awareness and recognition of substance abuse, but routine screening and formal training remain insufficient, indicating a critical implementation gap that supports integration of structured training and referral pathways into dental education and practice.