Medical and Dental Issues of Alcohol

Question 1

How is alcohol processed in the body?

Answer 1

90% metabolised in the liver
2-5% excreted in sweat, urine or breath

Question 2

Describe the blood alcohol concentration ratio

Answer 2

Peaks 1 hour after drinking on empty stomach
Declines over next 24 hours
Removed at a rate of 15mg/100ml/hr

Question 3

What are the genetic factors of alcohol problems?

Answer 3

4x increased risk of alcoholism in relatives
More common in monozygotic twins
Adopted away children of alcoholics 4x increased risk

Question 4

What is the safe weekly limit of alcohol?

Answer 4

14 units per week
Spread over 3 or more days

Question 5

Give examples of problems can be seen in the GI tract from chronic heavy drinking

Answer 5

GI bleeding
Acute gastritis
Oral, oesophageal, stomach, bowel cancer

Question 6

Give examples of heart problems that can be seen from chronic heavy drinking

Answer 6

Cardiomyopathy
Cardiac arrhythmias
Hypertension

Question 7

Give examples of skin, muscle, nerve and bone issues associated with chronic heavy drinking

Answer 7

Acute or chronic myopathy
Osteoporosis
Osteomalacia

Question 8

Give examples of oral problems seen in chronic heavy drinking

Answer 8

Sialosis - salivary gland enlargement
Xerostomia
Poor wound healing and osteomyelitis
Suppression of immune system by alcohol
Erosion
Bruxism

Question 9

What percentage of alcoholics will develop liver disease?

Answer 9

20%

Question 10

What are the signs of liver disease?

Answer 10

Jaundice
Ascites
Bleeding
Infections
Encephalopathy

Question 11

What is the life expectancy of alcohol related liver disease and liver cancer?

Answer 11

5 year survival is 90% if they stop drinking
60 if they don’t stop
Liver cancer - death in most within 10 years

Question 12

What are the complications of liver disease?

Answer 12

Reduced synthesis of clotting factors
Reduced absorption of vitamin K
Platelet aggregation reduced
Prolonged bleeding

Question 13

How does liver damage affect drug metabolism?

Answer 13

Reduces drug metabolism
Includes LA, analgesia, sedatives and antibiotics

Question 14

How does having hep C affect alcoholics?

Answer 14

25% of hep C patients develop cirrhosis
Alcohol leads to more rapid development of liver disease
Patients with hep C should abstain from alcohol completely

Question 15

What happens if alcohol is taken in combination with illegal drugs?

Answer 15

Cannabis - increased sensation of confusion and disorientation making accidents more likely
Amphetamines - increased impairment of judgement
Ecstasy - alcohol will reduce the potentially fatal fluid retention effect of ecstasy

Question 16

What are the nutritional problems of alcohol?

Answer 16

Alcohol is very calorific
Alcoholics are generally malnourished eg - vitamin C causing scurvy

Question 17

How may alcohol be cardio protective?

Answer 17

Moderate alcohol intake is associated with decreased risks of coronary artery disease
1-2 units, 2-3 times a week
Most benefit seen in older men and post-menopausal women

Question 18

Describe the prevalence of oral cancer

Answer 18

2% of all cancers
75-80% patients frequently consume alcohol
Smoking and alcohol act synergistically
Heavy smoking and drinking increases risk 38x
5 year survival 45-55%

Question 19

What percentage of assault victims have consumed alcohol?

Answer 19

57.6% male
21.4% female

Question 20

What percentage of facial injuries are the result of violent behaviour and alcohol?

Answer 20

24% violent behaviour
Half of these alcohol related

Question 21

Give examples of dental trauma often seen from excessive alcohol consumption

Answer 21

Broken teeth
Lost teeth
Damage to soft tissues
Lost dentures
Falls

Question 22

What other dental problems are commonly seen with excessive alcohol consumption?

Answer 22

GORD
Vomiting
Multi-factorial bruxism
Erosion