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Alcohol

Prolonged or excessive alcohol use can negatively affect your central nervous system, liver, kidneys, and other organs. It can also dramatically increase your risk of developing unhealthy oral conditions affecting your teeth, gums, and soft tissues in your mouth. Heavy alcohol use is defined as more than two drinks a day for men and one per day for women.¹

Common effects on your mouth of excessive alcohol use include:

• Dry mouth: Alcohol use can seriously affect your salivary glands. In the short term, alcohol can interfere with the nerves that signal these glands resulting in reduced saliva production. Long-term alcohol use can cause your salivary glands to shrink (atrophy). Reduced saliva creates an environment that supports bacteria growth and tooth decay. This can lead to expensive and potentially painful restorative procedures.

• Mouth sores: Alcohol dries out and irritates the soft tissues in the lining of your mouth. As it does, bacteria can enter the tissue and cause white patches and bumps to form. Vitamin deficiencies such as vitamin B12 have also been shown to contribute to mouth sores. Even moderate consumption of alcohol can contribute to reduced levels of vitamin B12 and other nutrients.

• Tooth decay: Many alcoholic drinks contain sugar (even more so when mixed with other sugary beverages). Sugar supports bacterial growth, which is further accelerated by the environment created by dry mouth. Both of these combine to increase your risk of tooth decay.

• Gum disease: Excessive drinking can increase your risk for gum disease by impairing your immune function and disrupting proper circulation. If you already have gum disease, alcohol can worsen its symptoms or accelerate its effects. Gum disease begins when "bad" bacteria on your teeth multiply and get under your gums. This can lead to inflammation (gingivitis) and progress to damage the soft tissue and bone surrounding your teeth (periodontal disease).

• Missing teeth: If the bone surrounding your teeth has deteriorated significantly due to periodontal disease, your teeth will loosen and ultimately fall out. Missing teeth can have significant consequences on other areas of your mouth as well as throughout your body. People with alcohol dependence or addiction are three times as likely to experience permanent tooth loss either through the direct effect on their oral health or the personal neglect that often accompanies alcoholism.²

• Oral cancer: Alcohol is an irritant that breaks down the cells in the lining of your mouth. These cells continually try to repair themselves. Repeatedly breaking these cells down through alcohol use may make them more susceptible to changes in their DNA, which may help explain why heavy alcohol use is a key oral cancer risk factor. According to the American Cancer Society, 7 out of 10 oral cancer patients are heavy drinkers.³ When combining heavy alcohol use with the use of tobacco products, your risk of oral cancer increases by 5-14 times versus those who do not drink, smoke, or chew tobacco products.¹

• Grinding or clenching: People who drink alcohol are twice as likely to have a habit of grinding or clenching, especially at night (a condition known as sleep bruxism).⁴ Bruxism can lead to tooth wear, chipped teeth, or cracked teeth.

• Oral health habits: Many dentists have observed that patients who admit they drink excessively tend to display symptoms consistent with poor oral care habits and fewer dental visits than patients who do not. The combination of higher risk levels, poor habits, and fewer dental visits may lead to dental conditions that require extensive treatment.

• Appearance: Regular drinking of red wine, dark liquors, and dark beers can stain your teeth. Alcohol may also contribute to bad breath and more severe oral disease. While you may reduce the outward effects of alcohol use with tooth whitening procedures, whitening toothpaste, or tooth replacement, none of these will protect, reverse or cure the underlying oral disease.⁵

What to do

At home

• Don't drink, or do so only in moderation.
• Alternate between alcoholic drinks and water to keep your mouth moist to increase saliva flow, stay hydrated, and reduce mouth sores and plaque build-up.
• If you have been drinking, alternate your alcoholic beverages with plenty of water to prevent sugars from sticking to your teeth and providing an environment for bacteria.
• It may be a good idea to supplement certain vitamins which may be deficient in heavy drinkers, including B12, folate, B6, and thiamine. Always speak with your doctor before starting vitamin supplements.
• Brush, floss, and use a non-alcoholic mouthwash after you drink alcohol (or any beverage containing sugar, for that matter).
• Maintain proper oral health by brushing at least twice a day and flossing daily to help remove plaque.
• When taking alcohol deterrent medications, refrain from using alcohol of any kind as the combination can be life-threatening.

At the dentist

• See your dentist regularly for oral exams and professional teeth cleanings.
• Be honest with your dentist about your past and current alcohol use. If you feel you may be drinking excessively, talk to your dentist or physician about guidance and medications they can provide to reduce or eliminate your dependency. Keep in mind that they are there to help you, not make judgments on your personal lifestyle choices.
• You may be asked if you would like additional information on the effects of alcohol use on your mouth.
• Dentists and hygienists are trained to conduct soft-tissue and external oral cancer screenings. If your dentist does not perform these essential parts of your exam, do not hesitate to ask for them.
• Always follow your dentist's directions regarding your specific oral health needs.

Author: Fluent staff
Last updated: 5/3/2021 • Medical review: Thomas J. Greany DDS, 4/25/2021
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