The Effects of Alcohol on Oral Health, a Review

Abstract

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.

A meta-analysis of the effect of binge drinking on the oral microbiome and its relation to Alzheimer’s disease

“…High levels of alcohol present in the oral cavity due to binge drinking may alter the oral environment and lead to oral microbiome dysbiosis. Alcohol can cause the reduction of salivary glands as well as the reduction of the oral mucosa based on a previously conducted study 20 . These changes lead to the overall change in the oral pH, which allows the microbiome to shift from a healthy microbiome to the pathogenic microbiome 34 .…”

“…Despite the fact that alcohol metabolism takes place mainly in the liver, studies have found that the level of a byproduct of alcohol metabolism, acetaldehyde, is higher in saliva than in the blood immediately after alcohol consumption while the concentration of alcohol in the saliva is equivalent to the blood alcohol within thirty minutes of consumption 19 . This leads to the accumulation of toxic molecules like acetaldehyde that damage the mucosal and glandular tissues 20 . The damaged mucosa causes an impairment of the immune function that may lead to microbial infection and changes to the oral microbiome 20 .…”

“…This leads to the accumulation of toxic molecules like acetaldehyde that damage the mucosal and glandular tissues 20 . The damaged mucosa causes an impairment of the immune function that may lead to microbial infection and changes to the oral microbiome 20 .…”

Current View on the Mechanisms of Alcohol-Mediated Toxicity

“…Among those well described are vitamin deficiencies, which may support a dramatic worsening of ethanol-related pathological conditions. A wide range of presentations related to vitamin deficiencies in alcohol consumers may be visible in the oral cavity, such as inflammatory changes, hemorrhages, ulcers, precancerosis, sensory presentations, or salivary gland problems [ 122 ]. Alcohol consumption decreases the transport of thiamine (vitamin B1) across the intestinal mucosa, decreases the storage of thiamine in the liver, and impairs the activation by inhibiting thiamine phosphorylation to thiamine diphosphate [ 123 ].…”

“…Similarly, this “drying effect” is on mucous surfaces of the mouth and upper part of the gastrointestinal tract after ingesting concentrated alcoholic beverages. About 30 min after alcohol ingestion, higher ethanol concentrations occur in saliva and salivary glands than in blood [ 122 ]. In short-term experiments, the direct local toxic action of the alcohol leading to damage of the mucous membrane proportional to the degree of alcohol concentration was proven [ 132 ].…”