Chapter 20- Misuse of substances and your teeth.

Alcohol and smoking.

I have already written about the effects of alcohol and smoking on your dentition and your mouth in general in previous chapters but suffice it to say that they are major risk factors in both gum disease [periodontal disease] and oropharyngeal cancer. See chapters 5 and 14.

Some other things to be considered with alcohol and dental treatment are; –

  • General Anaesthetic– People who use alcohol to excess are more resistant to general anaesthetic, however once liver damage sets in because it is not working properly some drugs can have a greater effect than normal.
  • Painkillers such as aspirin and Ibuprofen [Nurofen] a NSAID [non-steroidal anti-inflammatory] should not be taken for mouth problems such as after an extraction as they are more likely to cause bleeding and stomach ulcers. Anyone with a damaged liver should also not use paracetamol of course but it’s probably the safest choice if desperate.
  • Antibiotics– penicillins and erythromycin will not work as well and metronidazole MUST NOT BE TAKEN at all with alcohol or the patient will be severely, dangerously ill.
  • Wound healing– anyone using alcohol to excess will not heal as well and extraction sockets will have a greater chance of developing severe infection.

Illegal Drugs.

You don’t need me to tell you they are not a good idea. They are an expensive, harmful habit to partake in and even more expensive habit to kick emotionally, psychologically, socially and monetarily.

Illegal drugs are classified into;-

  • Class A- Most dangerous [includes cocaine in all its forms, heroin, LSD and magic mushrooms]
  • Class B- Dangerous [includes ecstasy, barbiturates, cannabis].
  • Class C- Least harmful [includes ketamine].

They are all illegal to possess and illegal to supply leading to heavy fines and/or a prison sentence.

FRANK is ‘a national anti-drug advisory service jointly established by the Department of Health and the Home Office of the British Government in 2003. It is intended to reduce the use of both legal and illegal drugs by education especially amongst the young’.

It is a very good easily navigable website, it lists every single drug you can think of including all the current street and club names with a host of information on each one of them. There is lots of help and advice for anyone who may need it for themselves or someone they may be worried about including a phone number for anyone needs to talk to someone.

Effects of drug abuse on teeth and the mouth are;-

  • Rampant, rapid decay [caries] affecting all tooth surfaces caused by lack of saliva, poor oral hygiene due to self-neglect, excess sugar consumption as some drugs lead to a sugar craving.
  • Tooth surface loss, caused by grinding and clenching of the teeth, erosive acidic drinks taken to rehydrate and satisfy sugar craving, regurgitating and vomiting especially in alcoholism.
  • Thrush infection in the mouth [candida]- often seen in drug users due to a dry mouth from lack of saliva, a compromised immune response and poor dental hygiene.

Coupled with these problems is the associated problem that many IV drug users are also HIV+ve and so also suffer from the associated mouth infections/ diseases due to immune suppression.

Please get help if you need it.

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