Chemical Dependency: Alcoholism
Center for Continuing Dental Education
Chemical Dependency: Alcoholism
Center for Continuing Dental Education
Alcohol can affect the life of certain restorative materials, particularly composites. Research has shown that composites are susceptible to chemical softening from the ethanol present in alcoholic beverages, and this will decrease their wear resistance .
Advise patients that you suspect or know to have alcohol-related disorders to abstain from smoking and drinking alcohol for at least 72 hours after cementation of porcelain veneers with dual-cure resin cements as the alcohol can jeopardize the porcelain-cement-enamel bond. Prior to dental restorative treatment, the dentist needs to ascertain any alcohol abusing patient's condition to determine to what degree they consume alcohol. It may be more effective to provide full coverage for a tooth rather than a large composite in an anterior tooth because of this. Also, an amalgam may be chosen over a composite resin for a conservative posterior lesion. Full gold coverage may also be preferred over large amalgam buildups, especially in those alcoholic patients that brux or are caries-active.
A thorough extra- and intra-oral exam needs to be performed to detect any soft tissue changes with may be indicative of squamous cell carcinoma which is directly related to heavy drinking and tobacco use. Heavy drinkers have a 10% greater chance of developing oral cancer than minimal drinkers.
A leukoplakia, erythroplakia or any other suspicious lesion should be biopsied to ascertain whether a malignancy exists in this high-risk patient. A majority of squamous cell carcinomas, including cancer of the oral cavity, pharynx, tongue and esophagus are directly connected to heavy drinking and the use of tobacco.
