Alcohol Excess and Oral Health

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Waterpik’s Deborah M. Lyle, warns against too much of “The Spirit of the Season

How about a bucks fizz with your breakfast, a little tipple with a neighbour mid-morning, a nice bottle of wine (or three) with dinner, a few beers, mulled wine, a couple of cocktails and perhaps a nightcap?

Along with the novelty jumpers, glittering decorations and multi-coloured festive lights, this might all seem a bit over the top, but it may be more realistic than you think! In London alone, 40% of people consume over 10 units of alcohol between Christmas Eve and Boxing Day [1] as they let their hair down and welcome in the spirit of the season (quite literally).

Worryingly, it is not just the holiday period; over a quarter (26%) of UK adults typically exceed the recommended limit of 14 units of alcohol per week [2] and 15% of adults aged between 18 and 75 ‘binge’ drink on a weekly basis [3].

The Chief Medical Officer of the UK warns that there is “no safe level of alcohol consumption”2 and as a leading risk factor for global disease burden that causes substantial health loss, policies to decrease worldwide alcohol consumption are currently being reviewed [4].

Accordingly, and with festivities just around the corner, dental professionals have the ideal opportunity to help raise awareness and in particular, remind patients of the often-overlooked effects that alcohol can have on oral health.

One can assume that most people realise that consuming a large amount of alcohol and becoming intoxicated has the potential to result in dental injuries or trauma following an accident, a fall or by misjudging a risky situation. Your patients will probably be familiar with the diuretic effect of alcohol. Thanks to excess urination they may suffer from the symptoms of dehydration, including headache, bad breath and dry mouth that often occurs when fluids are flushed from the body.

Orally related diseases

However, they may not realise the full impact of dry mouth and the important role that an adequate flow of saliva serves by helping rinse away food debris, lubricating the oral cavity, limiting the growth of bacteria and controlling the pH balance within the mouth by helping neutralise harmful acids [5]. Indeed, the drying effect that alcohol can have on the mouth may contribute to the formation of plaque and trigger an inflammatory response in the gums [6].

Hopefully most patients are acquainted with ‘good’ and ‘bad’ bacteria, yet they may not associate or relate this knowledge to their oral health. For instance, many patients may not appreciate that the diverse and complex microorganisms that colonise the oral cavity play a fundamental role in the digestion of nutrients, immune response and the metabolism of carcinogens [7], which can be disturbed when alcohol is consumed.

As dental professionals know, the oral microbiota is closely linked to oral health status, so it is important to educate patients about the effects of alcohol on orally related diseases. Following a large human study conducted in April 2018, there is evidence to indicate that alcohol may deplete ‘good bacteria’ and increase the colonisation of potentially pathogenic bacteria. These changes to the composition of the oral microbiome may contribute to alcohol related diseases including periodontal disease, digestive tract cancers and head and neck cancers [8].

It is inevitable that many patients will have at least a few drinks over the holiday season but to keep their health risks to a minimum, remind them to:

• Alternate a drink of water with alcoholic beverages to prevent dehydration.
• Have a good meal before drinking to keep the alcohol in the stomach rather than the small intestine, where alcohol can be absorbed quickly into the bloodstream and cause intoxication.
• Don’t mix alcohol with medication as some combinations may cause rapid intoxication, drowsiness, disturbed behaviour and even blackouts.
• Check the strength of the drinks and remember that many mixers can hide the taste of alcohol and be consumed very quickly.
• Be aware of the volume of alcohol that may be consumed when pouring drinks at home.

Of course, it is extremely important that patients do not neglect their oral hygiene routine at any time of the year. Therefore, oral health instructions should be reinforced regularly to help prevent dental problems and disease. It is worth recommending a Waterpik® Water Flosser as flossing can be fiddly and time-consuming for many people whether they drink alcohol or not.

This technology ensures that patients can floss easily and effectively every day and the Waterpik Water Flosser is clinically proven to be significantly more effective than string floss for removing plaque [9] and twice as effective for improving gum health [10].

By equipping your patients with the knowledge and advice they need to maintain optimum oral hygiene levels and enjoy alcohol sensibly, it is hoped that they can look forward to a very happy holiday and good oral health for many years to come.


Deborah M. Lyle is Director of Professional and Clinical Affairs for Waterpik. For more information about Waterpik visit Waterpik products are available from Amazon, Asda, Costco UK, and Superdrug stores across the UK and Ireland.

Photos by Element5 Digital (top) and Yutacar on Unsplash


1] UK Christmas Drinking Habits blog at Source: Drink Aware. [Accessed 28th August 2018]

2] Department of Health. UK Chief Medical Officers’ Low Risk drinking Guidelines. 2016. Click HERE  [Accessed 22nd August 2018]

3] Gunstone, B. and Butler, B. (2017) UK adult drinking behaviours and attitudes: Findings from Drinkaware Monitor 2017. London: YouGov and Drinkaware. [Accessed 28th August 2018]

4] GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet 2018. Published online 23rd August 2018. [Accessed 28th August 2018]

5] Tiwari M. Science behind human saliva. J Nat Sci Biol Med. 2011 Jan-Jun; 2(1): 53–58. [Accessed 28th August 2018]

6] Lages E.J. et al. Alcohol Consumption and Periodontitis: Quantification of Periodontal Pathogens and Cytokines. J Periodontol. 2015 Sep;86(9):1058-68. [Accessed 28th August 2018]

7] Le Bars P. et al. The oral cavity microbiota: between health, oral disease and cancers of the aerodigestive tract. Can. J. Microbiol. 63: 475–492 (2017) [Accessed 28th August 2018]

8] Fan X. et al. Drinking alcohol is associated with variation in the human oral microbiome in a large study of American adults. Microbiome 2018 6:59. [Accessed 28th August 2018]

9] Goyal CR, et al. Waterpik® Water Flosser: Significantly More Effective than String Floss for Removing Plaque. Journal of Clinical Dentistry 2013; 24(2):37-42. Click HERE  [Accessed 28th August 2018]

10] Rosema NAM et al. The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol 2011; 13(1): 2-10. Click HERE  [Accessed 28th August 2018]