More than three-quarters of dentists in the United States ask their patients about illicit drug use, a new survey finds. However, only 54 percent say such drug screening should be their responsibility.

The survey included more than 1,200 dentists nationwide, HealthDay reports. Dentists who believed it was their responsibility to conduct drug screenings were much more likely to do so than their colleagues who did not think they should have to screen patients for drug use.

The Columbia University researchers said illegal drug use can cause significant dental problems, including tooth decay, gum disease and tooth loss. They also note dentists are the second-largest group of prescribers of opioids, such as hydrocodone and oxycodone.

“Because dental care routinely involves treating pain and emergencies, dentists may encounter substance-seeking patients who complain of pain more severe than anticipated based on the nature of their dental condition, who report lost prescriptions for opioid pain medications, or who only seek dental treatment sporadically,” lead author Carrigan Parish said in a university news release.

Older dentists were less likely to screen patients for drug use, or to feel it was their responsibility to do so, the survey found.

“There are a sizeable number of people whose visit to a dentist represents their sole interaction with the healthcare system, highlighting the significance of the dental visit as a key opportunity to identify substance use disorders,” Parish noted. “However, our findings underscore a significant barrier in dentists’ attitudes that may limit the potential of the dental venue to play a role in screening for substance misuse.”

The findings appear in Addiction.