Chemical Dependency: Alcoholism
Center for Continuing Dental Education
Chemical Dependency: Alcoholism
Center for Continuing Dental Education
The clinician also needs to identify the recovering alcoholic so over-the-counter and prescription medicines are not dispensed which contain alcohol or other drugs which can trigger an episode of drinking, such as chlorohexadine rinses, over-the-counter mouthwashes, antiplaque rinses, and fluoride rinses. Some over-the-counter mouthwashes are over 25% alcohol. Also, avoid prescribing medications that have an adverse reaction with alcohol (always check the Dental Drug Reference which should be in every dental office). If reactions do occur, the patient will probably discontinue the medication rather than abandon their addiction.
If your patient is into recovery and is taking disulfiram as an adjunctive therapeutic measure, even minute amounts of alcohol consumed can result in a violent reaction, ranging from respiratory depression to cardiovascular distress. This can occur from fluoride rinses containing alcohol, chlorhexadine rinses, and other agents that contain even small amounts of alcohol which are used in dentistry. It is imperative that these patients not come in contact with any alcohol-based products OR nitrous oxide. If you must use one of these agents, the patient should discontinue the disulfiram at least 30 days prior to the procedure. The patient's physician should be contacted to coordinate treatment.
