Alcohol and Relevance in Dentistry -Impact of Alcohol on Oral General Health - Part 3

Alcohol and Oral Health - Part 3

• GDC Learning Outcomes:
  • Recognize psychological and sociological factors contributing to poor oral health, the course of diseases, and treatment success.
  • Recognize the importance of and perform appropriate intra- and extra-oral clinical examinations.
  • Recognize the significance of reported oral health changes and take action.
  • Refer to other dental team members or health professionals.
  • Recognize the need for and arrange appropriate follow-up care.
  • Underpin patient care with a preventive approach that promotes long-term oral and general health.
  • Describe health risks of diet, drugs, substance misuse, and tobacco/alcohol on oral and general health. Provide appropriate advice, referral, and support.
  • Communicate effectively and sensitively with patients and their representatives in all situations, especially when discussing sensitive issues like alcohol use or smoking.

Intended Learning Outcomes

• Outline the relevance of alcohol consumption and its impact on the UK population.
• Develop and demonstrate the role of dental care professionals in delivering key general health messages.
• Screen patients using recommended screening toolkits.
• Evaluate data to provide appropriate advice and signpost patients when necessary.
• Discuss the impact of alcohol on oral and general health.

Assessment

• Formative:
  • Unseen cases
  • Class discussion
  • Clinical activity
• Summative:
  • Unseen cases
  • Case presentations

Oral Effects of Alcohol

• Cancer
• Halitosis
• Trauma
• Staining
• Periodontal Disease
• Tooth Wear
• Caries
• Self-care

Alcohol and Mouth Cancer Risk

• Alcohol consumption linked to mouth cancer risk, risk increases with higher consumption.
• The acetaldehyde metabolite of alcohol and its impact on DNA damage are key factors in cancer development.
• Aldehyde Dehydrogenase (ADH) is the enzyme involved in alcohol metabolism.
• Individuals with mutations in the aldehyde dehydrogenase (ALDH) gene are at higher risk for alcohol-related cancers.
• Risk increased for patients who consume above recommended levels.

Alcohol and Increased Risk of Oral Cancer

• Studies show no safe limit for alcohol intake and an increase in oral cancer risk with greater alcohol consumption, especially when combined with tobacco use.
• Patients should be aware of the alcohol content of their drinks and consider recording their intake.

Halitosis

• Increased level of volatile sulfur compounds in daily alcohol drinkers compared to non-daily drinkers.
• Theories of malodour.

Trauma

• 22% of facial trauma cases were related to alcohol consumption in the past.
• Alcohol consumption is associated with higher rates of dental trauma, particularly in binge drinkers.

Staining

• The effect of alcohol on tooth staining.

Periodontal Disease

• Increased bleeding associated with alcohol consumption.
• Impact on periodontal pathogens.
• Immunological pro-inflammatory cytokines affected by alcohol.
• Quantifiable relationship between alcohol consumption & periodontitis with possible connection to cytokine levels & pathogenic profiles as evidenced by studies from Lagos J P, Costa F, Corelli S et al.
• Factors such as compliance, immunosuppression, and diet influence alcohol and periodontal effects.

Tooth Wear

• Patients with chronic alcoholism tend to show greater tooth wear.
• Palatal surfaces of upper anterior teeth are commonly affected due to alcohol consumption.
• Drinks over 9% alcohol correlate with a higher risk for tooth wear.

pH of Alcoholic and Mixer Drinks

• Table providing the pH values of different drinks (White Wine, Beer, Red Wine, Cider, Orange Juice, Pepsi, Coke, Diet Coke, Lime Juice)

Caries

• Caries are multifactorial conditions.
• Alcohol-dependent individuals show higher caries rates compared to social drinkers.
• Consideration of factors like salivary flow, buffering capacity, sugar content in mixers and drinks, pace of consumption, cravings, and self-care are important.

Sugar Content of Alcoholic and Mixer Drinks

• Table listing sugar content (grams per 100 grams) for various drinks (Beer, Cider, Liqueurs, Red Wine, Rose, White wine, Sparkling Wine, Cola).

Self-Care

• Discussion needed on the impact of frequent alcohol consumption that's higher than recommendations.
• Patients' thoughts and findings on alcohol and self-care should be placed on the discussion board.

Required Reading

• Refer to Moodle page for reading materials.

Additional Reading

• Relevant articles by authors: Harris, Warnakulasiriya, Johnson, Gelbier, Peters, Sarrett, Coletti, Peluso, Tezal, Grossi, Ho, Genco.

Alcohol and General Health

• Linked to over 60 different diseases and conditions.
• Divided into short-term and long-term health risks.

Alcohol and Physical Health

• Alcohol linked to more than 60 diseases and conditions.
• Can be divided into short-term and long-term health risks.

Short-Term Health Risks

• Injuries
• Violence
• Alcohol poisoning
• Reproductive health

Long-Term Health Risks

• Refer to liver disease lecture
• Cancer (group 1 carcinogen) as a causative factor in cancers of the mouth and other parts of the body.
• Weight gain.