Drinking alcoholic beverages is one of the oldest socially acceptable forms of behavior which can lead to the development of alcohol addiction. Long-term alcohol drinking has, together with numerous psychological and somatic complications, harmful consequences for the oral health. Patients suffering from alcoholism generally have poorer oral hygiene, dental care, periodontal status, fewer teeth, more carious lesions, gingival diseases, inter-dental papillae bleeding and deep gingival pockets associated with bone loss, as well as higher rate of oropharyngeal cancer. The changes in the oral microbiome affect the immune system, metabolism of carcinogens and digestion, which also leads to the development of local oral diseases as well as systemic gastrointestinal and cardiovascular illnesses. Harmful impact of alcohol on oral health can be direct, caused by local toxic effects of alcohol and as a consequence of systemic diseases associated with alcohol drinking, causing changes in the entire oral mucosa. Poor dietary habits additionally contribute to a poorer dental status while frequent simultaneous usage of tobacco products additionally increases the risk of developing periodontitis, tooth loss and oral carcinoma. Excessive alcohol drinking can seriously affect the oral cavity where, despite easy access via clinical examination, we still lack clinical data and a clear mechanism of development of the described changes.