The Oral Health Foundation offers advice on communicating the risks to patients.

This title is a little misleading, simply having a glass of wine occasionally will not necessarily give our patients dental issues, it is more about the amount, frequency and type of alcohol that they consume.

However, alcohol has the properties to change the oral microbiome in patients' mouths. Heavy drinking may influence bacterial composition, including potential depletion of beneficial commensal bacteria and increased colonisation of potentially pathogenic bacteria.

This means that alcohol is a risk factor for various oral health conditions, including dry mouth, halitosis, tooth decay, gum disease and mouth cancer. The consumption of alcoholic is very common within society, so it’s important that all members of the dental team are aware of the various risks that alcohol could cause their patients.

Xerostomia (Dry mouth)

A common problem that can affect anyone for several different reasons. Many prescription medicines have dry mouth listed under possible side effects. Radiotherapy and chemotherapy to treat cancer can impact the function of salivary glands. However, dry mouth can also be caused by drinking alcohol. It can affect the amount of saliva our mouths can produce. Studies have shown a decrease in salivary secretion in heavy drinkers. Many people experience a dry mouth the ‘morning after the night before’.

Whilst dry mouth may not seem serious, it can be truly debilitating for patients. It can lead to other, more serious dental issues and make it incredibly difficult to talk, swallow food and affect general quality of life.

Halitosis

Dry mouth and strong-smelling drinks could also cause patients to develop halitosis, more commonly known as bad breath. In today's society, bad breath is one of the most undesirable conditions in social situations.

Helping patients understand how heavy drinking can affect their breath may also encourage them to be more aware of how much alcohol they are drinking.

Tooth decay

Some alcohol, especially when mixed with high-sugar mixers, can increase the likelihood of tooth decay.

Education is the key to helping patients to understand the hidden dangers of constantly sipping on sugary cocktails. These drinks keep the sugar levels in the mouth higher for longer, causing the dental decay we often see.

Gum disease

The main cause of gum disease is still ineffective or insufficient oral hygiene, however hereditary factors, systemic and autoimmune conditions can also play an active role in gum disease. Research is not entirely conclusive, but it is thought that the vast majority of the population could be affected by gum disease at some time during their lives. Some research studies suggest that up to 90 per cent of the population has chronic gingivitis.

Mouth cancer

Consuming large amounts of alcohol regularly can increase the risk of developing mouth cancer. Typically, in the past, it was thought that the highest risk of mouth cancer was for older men, but in the UK, there is still a culture of binge drink for both men and women of all ages.

Drink recommendations level have been lowered for men, now men and women are now advised not to drink more than 14 units per week regularly.

Alcohol can often be paired with smoking, which also increases the risk of mouth cancer. This is why it is important to discuss a patient’s drinking and smoking habits so that we can advise and help them to understand the risks better.

Trauma to teeth

There is good evidence that alcohol consumption increases the risk of dental and maxilla-facial trauma. A study of patients attending Accident and Emergency for facial injuries found that 55 per cent of injuries by assault were associated with alcohol consumption.

Diving deeper into these results, it was found that it was 11 per cent for falls and 15 per cent for people injured in road traffic accidents. In over 15-year-olds, alcohol was associated with 90 per cent of all facial injuries occurring in bars and 45 per cent on the street. Overall, 22 per cent of all facial trauma was related to alcohol consumption.

What can we do to help?

Alcohol advice and risk level guidance can be the first step to making a positive difference in the lives of patients.

Asking the right questions to learn about our patients’ social habits, can help us to understand when and if more outside or specialised help may be appropriate. This may include a referral to other health practitioners or organisations in your area, if the patient is willing.

As dental professionals, the Oral Health Foundation urges that information on the oral health risks of alcohol, is made easily available to all members of the dental team, so that the support and education is available to all patients.

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