Mina Draskovic, B.Psy., reviewed this content for accuracy on January 16, 2024
From disrupting your mouth’s delicate pH balance to hampering your liver’s ability to process bacteria and toxins, drinking paves the way for tooth decay and gum disease.
A study published by JCDR journal showed that “alcohol dependent subjects had slightly lower mean plaque and salivary pH and a higher prevalence of dental caries, periodontitis and mucosal lesions…” The study found a significantly higher prevalence of dental caries, periodontitis (89.61%), and mucosal lesions (31.5%) among alcohol-dependent subjects compared to nonalcoholics.
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Alcohol can compromise your teeth and gums in both the short and long term. Heavy drinking disrupts the homeostatic balance within the oral cavity, impacting everything from teeth and gums to the development of bacteria and dry mouth.
Ethanol is the primary alcohol molecule found in alcoholic drinks. When processed by the liver, ethanol is converted to acetaldehyde, alcohol’s principal metabolite. Acetaldehyde has cytotoxic, dehydrating, and immunosuppressant properties that help create the perfect oral environment to allow more harmful bacteria, viruses, and fungi to grow in the mouth, while also weakening your body’s built-in ability to fight them off.
Indian researchers discovered that alcohol “inevitably affects the oral cavity, oral mucosa and teeth,” while those dependent on alcohol “may have increased risk of dental caries, probing pocket depth and mucosal lesions.”
While moderate alcohol intake may have minimal impact on oral tissues and teeth, chronic and excessive consumption will have more substantial effects on oral health.
If you’re struggling to remain sober, our alcohol addiction treatment center can help. Our caring and supportive staff can support you through the six stages of recovery, from alcohol detox to freedom from alcohol dependence.
People struggling with alcoholism can show visible symptoms of bad oral health that will progress with excessive consumption. Some of the oral manifestations of alcoholism include:
Alcohol suppresses your immune system which enables fungal infections and other oral manifestations typically kept in check by a healthy immune response. Severe vitamin deficiencies common in those with alcohol use disorder can further exacerbate many of these symptoms.
While happy hour cocktails or a chilled beer after work may seem harmless, alcohol is bad for your brain, liver, kidneys, heart, mental health, skin, and dental health. Yet many people addicted to alcohol struggle to quit.
Contact Ardu and get the personalized treatment you need to embark on your recovery journey.
Regardless of your oral hygiene habits, heavy alcohol consumption is an express ticket to oral diseases. The longer you drink heavily, the higher the chances you’ll develop a myriad of oral health conditions that strip away enamel, eat at connective tissues, accelerate tooth decay, and ultimately lead to bad teeth.
A 2001 study found that people who drank five or more alcoholic beverages per week were 1.65 times more likely to have bleeding gums. They were also 1.36 times more likely to suffer from loss of connective tissue compared to those who drank less than that.
The study also looked into people who consumed ten or more drinks weekly and found that they had even higher odds of gum bleeding and connective tissue destruction. This supports a connection between the amount of alcohol consumed and the extent of oral health issues.
Here are eight ways that alcohol throws your oral health totally out of whack:
Gum disease, known as periodontitis, is the bacteria-laced plaque buildup on tooth surfaces that irritates the gums. This causes them to become inflamed and pull away from the teeth, forming infected pockets that progressively damage the supporting bone structure.
The Indian study revealed that periodontitis afflicts nearly 90% of alcohol-dependent participants compared to 79% of non-drinkers.
Alcohol enables gum disease by drying out the mouth, suppressing immune defenses, and creating an environment where dental plaque bacteria can grow unrestrained. This paves the way for the destruction of connective fibers and bones that anchor teeth in place.
Ethanol is a diuretic, which serves to decrease saliva flow in the mouth. Saliva is crucial for washing away food debris and neutralizing plaque acids on teeth. Without it, acids can easily demineralize and erode enamel over time.
A 2019 article revealed that “regular consumption of acidic drinks such as wine, cider and alcopops can contribute to [tooth decay].” Sugary cocktail mixers such as juices, sodas, or sweet liqueurs also coat the teeth and provide prime food for destructive plaque bacteria. Even moderate regular intake hampers saliva function enough to escalate tooth decay over time.
As the germs metabolize fermentable carbohydrates, their acidic waste eats away precious minerals from enamel and dentin. After years of sustained drinking, your small lesions are likely to develop into full-blown cavities.
Heavy alcohol consumption triggers inflammation that destroys the alveolar bone, which is the part of the jaw that forms the tooth sockets, anchoring teeth in place. Alcohol’s irritating effects cause loosening or eventual tooth loss if periodontitis is left untreated.
Researchers in Brazil demonstrated that chronic alcohol consumption can increase alveolar bone loss, especially in excessive amounts. This can be particularly detrimental in the presence of periodontitis. Frazão, et. al. confirmed and concluded that “intense and episodic ethanol intake decreased alveolar bone quality in all microstructural parameters analyzed which may be considered a modifying factor of periodontitis, intensifying the already installed disease.”
Ethanol also disrupts the optimal absorption and retention of bone-supporting minerals such as calcium and phosphorus. Deficiencies in these nutrients translate to reductions in bone mineral density over time. Our nutrition therapy offers counseling on how to repair your health and fix alcohol-induced damage to your teeth.
Read more about why nutrition is important during recovery.
The tissues lining the inside of your mouth are delicate and easily injured. Even everyday activities like eating crunchy food or brushing too vigorously can do damage. Heavy drinking can directly damage the oral mucosa through chemical irritation and indirectly increase the risk of mechanical trauma.
Guo and DiPietro showed that even one drink can significantly disrupt the wound-healing process. Exposure to a single dose of alcohol, which elevated blood concentrations to just above legal intoxication limits, was enough to impair critical repair pathways like new blood vessel growth, collagen remodeling, and mucosal closure in oral tissue injuries.
Alcohol’s interference means oral wounds heal at turtle speed. It’s even worse for those prone to painful complications such as dry sockets after wisdom teeth removal or failed integration of dental implants.
While the ethanol itself does not cause staining, it can pave the way for pigmented foods and liquids to adhere to enamel. Acidic components of wine, coffee, and dark liquors eat away at the mineralized surface, eroding smoother areas for stains to seep into micropores. Throw the alcohol’s dehydrating effects into the equation, and you lack the saliva needed to naturally clean your teeth after drinking.
Arrowhead Dental Associates reveals that “the acid in alcohol wears away the tooth enamel; once the tooth enamel has been compromised, it’s easy for dark colored beverages like red wine and dark beers to cause dullness and stains.” Even clear liquors mixed with highly pigmented sodas, juice purees, and berries can coat your healthy teeth with tenacious organic stains over time.
The science is irrefutable: if you want to keep your pearly whites white, limit your alcohol consumption. Or even better, quit for good.
Bad breath, or halitosis, begins in the back of the throat when high levels of odor-producing bacteria coat your oral surfaces. Alcohol may be one of the most prominent causes of halitosis. Here’s how:
Alcohol is carcinogenic. A 2018 study found that heavy drinkers have up to a 20% higher chance of developing oral cancer compared to those who don’t drink, with risk rising in proportion to the amount of alcohol consumed.
While oral cancer can certainly form without alcohol misuse, research shows that heavy drinkers are five times more likely to develop oral cavity and pharynx cancers.
Booze increases oral cancer risk in several ways:
As if drinking wasn’t bad enough, the combination of alcohol and tobacco further exacerbates damage, putting people who use both substances at an especially high risk of contracting oral cancer. According to the Oral Cancer Foundation, “the dehydrating effect of alcohol on cell walls enhances the ability of tobacco carcinogens to permeate mouth tissues.”
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When you’re addicted to alcohol and you suddenly stop, it causes both physical and psychological symptoms. The abrupt drop in blood alcohol levels throws the nervous system into overdrive, causing anxiety, tremors, and seizures, and eventually leads to alcohol withdrawal syndrome.
This kind of severe fluctuation in the body also causes inflammation and a weakened immune system. As a result, people going through alcohol withdrawal often develop painful canker sores or mouth ulcers. The sores appear as round white patches or red lesions on the soft tissues of the mouth. They can build up on the gums, inner cheeks, bottom lip, or tongue.
Thera Breath explains that “after a night of drinking, some people may notice a canker sore or two—which are little round ulcers inside the protective lining of their mouths.” Alcohol interferes with folate absorption and increases excretion, resulting in a deficiency of vitamin B critical for oral tissue repair.
Alcohol also dehydrates oral surfaces, decreasing protective saliva flow which enables irritation and unrestrained microbial growth. Together, these two prompt painful ulcerative lesions during withdrawal.
If you’re drinking too much and notice that your health is suffering, don’t hesitate to seek professional help. There is more at stake than your oral health, so take action before the situation gets out of hand.
Ardu is here for you every step of the way.
Anyone struggling with alcohol abuse or addiction is welcome in our alcohol addiction treatment program. We help people overcome their addictions and restore all aspects of their well-being. Our dedicated team of professionals is here to guide and support you in your recovery journey, provide education on relapse prevention, and help lay the foundation for long-term sobriety.
At our rehab center in Provo, Utah, our team specializes in:
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Getting proper treatment empowers you to manage alcoholism while implementing lifestyle changes that will help you heal. With compassion and expertise, we can help you achieve lasting sobriety and get your health back on track.
Dentists can often identify signs of excessive alcohol consumption during oral examinations. Chronic heavy drinking enables dental decay, gum disease, persistent bad breath, and oral thrush. This cumulative evidence of alcohol-induced effects on your oral health is visible to your dentist as soon as you open your mouth.
Dentists may suspect alcoholism based on rapid tooth deterioration, repeated failed restorations, or behavioral indicators like missed appointments that indicate neglect of oral healthcare routines. While only long-term alcohol misuse leads to pathognomonic oral manifestations that could diagnose alcoholism outright, it’s still better to reduce your drinking or eliminate alcohol from your system altogether. A nice glass of water is a great alcohol replacement from which your mouth can actually benefit.
All types of alcohol are bad for your teeth. Fermented alcohol such as red wine, beer, and dark liquor tend to stain teeth more heavily than lighter-colored booze, but all alcoholic beverages are bad for your teeth in some capacity. The highest-proof options like fortified wines or cask-strength whiskies promote accelerated cellular dehydration, while sugary cocktails and acidic wine or cider also expedite enamel erosion.
Beyond straight alcohol, mixed drinks with soda and fruit juice are high in sugar content. Cocktails are particularly sugary drinks and can be equally if not more damaging to your teeth, as they feed decay-inducing dental plaque bacteria, accelerating the formation of dental caries.
The most common oral infection associated with alcohol is Candida fungal overgrowth, known as oral thrush. These unsightly white-yellow plaques stud the cheeks, gums, and tongue due to ethanol allowing unrestrained yeast proliferation while suppressing immune defenses regulating Candida. If resistant to antifungal treatment, the chronic painless lesions require abstinence and nutrition changes to facilitate immune recovery. Periodontal infections such as gingivitis are also exacerbated by heavy drinking.
Alcohol can accelerate the progressive destruction of tooth enamel and underlying structures, ruining your teeth and potentially leading to permanent tooth loss. Ethanol, acidic mixers, and staining drink components erode protective enamel layers. Residual sugars left on teeth then feed plaque bacteria that release enamel-demineralizing acids, enabling the formation of cavities.
Oral health risks increase in proportion to the frequency and quantity of alcohol consumption. Over time, you can experience fractures, decay, hypersensitivity, and eventual tooth loss, even with moderate alcohol consumption.
While even low levels of alcohol consumption are risk-free, you may consider straws to drink alcohol, bypassing contact with your teeth and avoiding damage. Rinse with water between drinks, avoid sugary mixers, take calcium supplements, limit drinking to maintain saliva flow, and properly hydrate after drinking alcohol. Practice good oral hygiene and get routine dental care to stay away from oral health issues.
Alcoholism encourages oral thrush, ulcerations, tissue atrophy, numbness, discoloration, painful inflammation, and loss of taste bud sensation on the tongue’s surface. Chronic tissue irritation combined with nutritional deficiencies from heavy drinking can also inflame the tongue, causing glossitis. Ethanol facilitates cellular damage, giving the typically smooth, pink tongue a coated, fissured appearance studded with lesions.
Years of heavy alcohol use can irreversibly reduce saliva production from the major salivary glands by destroying secretory cells and ultimately causing permanent dry mouth. Without lubricating saliva to cleanse tissues or neutralize acids, conditions like dental caries, mucosal atrophy, and halitosis can develop unchecked. A powerful urge to drink saliva-stimulating liquids despite oral dryness can further exacerbate alcohol dependence.
Alcohol disrupts the mouth’s pH balance and dehydrates oral tissues, while also depleting vitamins and minerals critical for wound healing. This combination of irritation, trauma, and immune impairment sets the stage for aggravating mouth ulcers to form after drinking episodes. Even minor lip bites or cheek bites that occur accidentally while intoxicated can prompt painful sores, especially without adequate nutritional support and immune defenses to control oral bacteria and accelerate healing.
Even clear and lighter-colored alcohol such as white wine, champagne, and prosecco can slowly discolor teeth over time with frequent consumption. While white wines do not contain intense artificial coloring agents, they still possess pigments from the grape skins used during fermentation.
Acidic tannins facilitate the binding and accumulation of these staining particles into microscopic enamel cracks vulnerable to stained teeth and early tooth decay. Over months to years, gradual yellow-brown composite discoloration becomes increasingly stubborn to remove. While an occasional glass of wine may pose a low risk, alcoholic patients often exhibit gumline darkening or overall dulling of their once pearly white smile.
Priyanka, K., Sudhir, K. M., Sekhara Reddy, V. C., Kumar, R. K., & Srinivasulu, G. (2017). Impact of Alcohol Dependency on Oral Health – A Cross-sectional Comparative Study. Journal of Clinical and Diagnostic Research JCDR, 11(6), ZC43. https://doi.org/10.7860/JCDR/2017/26380.10058
Tezal M, Grossi SG, Ho AW, Genco RJ. The effect of alcohol consumption on periodontal disease. J Periodontol. 2001 Feb;72(2):183-9. doi: 10.1902/jop.2001.72.2.183. PMID: 11288791.
Alcohol consumption can damage oral health, warn dental surgeons — Royal College of Surgeons. (n.d.). Royal College of Surgeons. https://www.rcseng.ac.uk/news-and-events/media-centre/press-releases/alcohol-and-teeth/
Cabrera Pazmino, V. F., Noronha Novaes, V. C., Mogami Bomfim, S. R., Hitomi Nagata, M. J., Pinto Oliveira, F. L., Matheus, H. R., & Ervolino, E. (2020). Chronic consumption of alcohol increases alveolar bone loss. PLoS ONE, 15(8). https://doi.org/10.1371/journal.pone.0232731
Guo, S., & DiPietro, L. A. (2010). Factors Affecting Wound Healing. Journal of Dental Research, 89(3), 219-229. https://doi.org/10.1177/0022034509359125
Ogden, G. R. (2018). Alcohol and mouth cancer. British Dental Journal, 225(9), 880-883. https://doi.org/10.1038/sj.bdj.2018.921
Alcohol and Cancer Risk Fact Sheet. (2021, July 14). National Cancer Institute. https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet
Can Drinking Alcohol Cause Ulcers and Canker Sores? | TheraBreath. (n.d.). TheraBreath. https://www.therabreath.com/articles/fresh-breath-happenings/can-drinking-alcohol-cause-canker-sores/