The high consumption of alcohol can be a major factor for declining oral health, with the impact of the pandemic leading to dramatic surges in UK alcohol consumption. A 2023 survey found that 26 per cent of UK adults are concerned about someone’s drinking, emphasising the need to promote oral health and raise conversations on alcohol consumption.
Young adults are now more likely to develop dental complications, such as oral cancer, from drinking than they are from smoking. University students are particularly vulnerable to oral health problems, with a survey finding that 81 per cent of students believe binge drinking and being drunk is part of the culture. Managing alcohol consumption and educating its younger drinkers on the long-term health impacts is integral.
Hidden sugars
Unlike in food and soft drinks, the high sugar content in alcoholic products is not required to be labelled and can therefore go unseen. The use of fizzy drinks as mixers, notably among younger adults, accelerates tooth decay as they are often used in binge drinking. Cider, among alcoholic drinks, is the leading sugar titan – one pint can contain over half of the recommended daily sugar intake. If not washed down with food or water, high consumption of cider can cause rapid tooth decay, especially when teeth are not brushed and cleaned interdentally.
Excessive drinking has been found to increase the risk of periodontitis, with alcohol-dependents being very vulnerable, especially if they also smoke. Immoderate alcohol consumption impairs neutrophil function and pathogenic bacteria is then able to amass. Inconsistent oral healthcare will allow the growth in bacteria to create a fertile environment for periodontitis.
Hidden acids
Alcoholic beverages are acidic, skewing a pH 4 or lower. Their erosive qualities damage teeth. White wine is particularly harmful as it houses a high concentration of titratable acids, with wine industry workers being immensely susceptible to enamel erosion as they swirl the liquid around their mouths for longer – a hidden occupational hazard.
Identifying patients who primarily drink white wine is crucial, as dental erosion directly correlates with its consumption, though the effects take time to emerge. Most patients will not be aware of erosion until it has manifested into a major problem. Tackling this health hazard early through effective interdental cleaning is heavily advised, as the demineralisation of the effected teeth can lead to erosion, with the potential to be further damaged by brushing.
Curbing the problem
The summer period, especially over the holidays and when events like the UEFA Euro 2024 Championships are on, inevitably sees alcohol sales boom. Similarly, this feeds into September and beyond as university freshers begin their new lifestyle. It should be suggested to new students the urgency in governing alcohol consumption and, in cases of alcohol-induced vomiting, to immediately rinse their mouth with water, rather than brushing, to neutralise the erosive acids.
In 2023, nine million UK residents tried Dry January, a million more than in 2022. Each year, more people are interested in going alcohol-free and this should be encouraged by clinicians year-round. Dental practices can display leaflets and brochures about alcohol’s negative oral impacts to generate awareness and expose more patients to ideas of moderation or abstinence.
Furthermore, exhibiting educational posters and leaflets on alcohol consumption can break the taboo around alcoholism, giving patients a greater comfortability in being honest and addressing their problems – this will ensure their dental treatment and clinical advice is as apt as possible. Motivating patients to go alcohol-free for two weeks every month can be an effective deterrent against oral health complications, with a focus during the summer and autumnal periods.
Encouraging patients to consistently use fluoride toothpastes is essential to keeping tooth decay away, and it is also worth recommending specific interdental cleaning solutions, like the Waterpik Cordless Slide Water Flosser. It is clinically proven to eliminate up to 99.9 per cent of plaque from treated areas and is up to 300 per cent more effective for removing plaque around braces than string floss.
Educating patients on the importance of regulating alcohol intake and promoting consistent oral hygiene exercises will give patients their best possible chance to protect their teeth from erosion and periodontitis, without having to feel guilty about enjoying a drink.
References available on request.