By Dr Andre Clarke
Alcohol is the most common drug of abuse and is a depressant of the central nervous system. It is generally a socially accepted drug and its use is not commonly frowned upon. It is nonetheless, a drug. It impairs the capacity to reason and alters coordination with the potential to cause unconsciousness.
The excessive use of alcohol is alcoholism (alcohol dependence). Alcoholism is a psychological and physical state, characterized by compulsive continuous or episodic use of alcohol with the intention of achieving a high or to avoid the unpleasantness associated when ending its use.
Prolonged use affects the entire body. It can cause malnutrition, anaemia (low blood), fatty liver, inflamed liver, stomach disease, ulcers, memory loss, enlarged heart and hypertension (high blood pressure). No part of the body is left unaffected and the mouth is no exception.
The most common mouth effect of alcoholism is neglect, leading to advanced cavities and gum disease. Tooth erosion (wearing away) is also common and is a result of constant vomiting and food refluxing into the mouth. Temporo-mandidular joint (TMJ) disorders, which display indicative pain in the ears and problems chewing, usually result from night time teeth grinding. The night time teeth grinding is a result of alcohol’s affect on the part of the brain that helps with sleep.
Frequently, alcoholism results in a deficiency of folate and other B complex vitamins (niacin, pyridoxine, riboflavin and thiamine). When these deficiencies occur, they affect the mouth drastically. The person can develop a sore mouth, recurrent ulcers, swollen tongue, altered taste, smooth tongue; tingling in and around the mouth and angular stomatitis (inflammation of tissue around the corners of the mouth). In addition, the salivary glands that are found immediately in front of the ears, on both sides of the face, commonly become swollen because of fat deposits and can be a distinguishing facial feature of those persons who drink heavily. It tells the tale of liver problems in the alcoholic.
Other head and neck features that are noteworthy include the smell of alcohol on the breath; prominent small spider-looking blood vessels and a swollen, red nose tip.
Persons, who are alcoholics, typically have delays in the breakdown of medications in their bodies and they typically have bleeding tendencies. The dentist will take extra caution in these impaired patients to ensure a safe dental experience. Alcohol is also a known risk factor for oral cancer development and yearly mouth evaluations should be completed by the dental healthcare professional.
In addition to increased oral cancer risks and bleeding tendencies, alcoholics sometimes develop a tolerance to the local anaesthesia that dentists use to make the mouth go numb. It is often necessary to increase the number of local anaesthesia injections given, to achieve and maintain mouth numbing. Consequentially, this influences the expected length of dental appointments and alcoholics usually need to be scheduled for longer dental appointments, to ensure enough time is allotted for the local anaesthetic to work. It is also common practice for dentists to schedule appointments for morning hours, so as to reduce the chance of the alcoholic attending the appointment drunk.
The dental professional has many things to consider when managing the alcoholic patient and will ensure the patient receives the best management depending on the patient’s health status. It is necessary for the dentist to get a complete picture of the alcoholic’s health status before performing any procedures. A complete picture is gathered through asking many different types of questions and social questions must be included. Therefore, when the dental professional asks about drinking habits, he is not being nosey, but is ensuring that the patient receives the best care possible.
Remember that social habits (e.g. drinking) affect everyone’s mouth and the only question is, to what extent it is affecting you. Please visit your dental healthcare professional to ensure a holistic approach to your health.
• This article is for informational purposes only. It is not intended and may not be treated as, a substitute for professional medical/dental advice, diagnosis, or treatment. Always seek the advice of a physician or dental professional with any questions you may have regarding a medical/dental condition. Never disregard professional medical/dental advice or delay in seeking it because of a purely informational publication. If you have questions, please send email to dr_andreclarke@hotmail.com.
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