Alcohol, It’s Effect on Dental Structures and the Role of a Dentist

The first recognized and the most devastating effect of alcohol was the consequence of maternal ingestion of alcohol during pregnancy. Fetal Alcohol Syndrome (FAS) is a distinct condition associated with maternal alcoholism which causes serious birth defects in children due to disruption of normal embryonic development. Other problems that can occur are weak muscles around the mouth that make it difficult to consume food; unusual taste preferences for salty or spicy food at an inappropriate age; gross caries at a young age; prolonged and excessive drooling; weak buccinators muscles that prevent the proper placement of food for chewing. These are a few amongst the many problems which children diagnosed with FAS have to face thus increasing their predilection for caries and require special oral health care. Also, there are other direct and indirect effects of alcohol consumption on dental structures of which a few to be mentioned are dental erosion, attrition sometimes along with behavioral problems. effects due to consumption of alcohol by mother on fetus and (ii) direct or non-teratogenic as in effects seen in the individual themselves due to consumption of alcohol. Dental problems occur in nearly 80% of children with FAS. The teratogenic effects on dental structures include the lips, teeth, palate, oral musculature etc. The lips are one of the diagnostic criteria for FAS i.e. smooth philtrum, thin vermilion border of the upper lip and a lack of the classic Cupid’s bow indentation. FAS patients will also have hypoplastic maxillas/ mandibles. It has also been reported that FAS spectrum patients may have malformed teeth or microdontia, malocclusions and sometimes even missing teeth with delayed exfoliation of deciduous teeth and delayed eruption of permanent teeth [15-17]. Very often they also have wide palatal defects including cleft lip or palate [18]. Other problems that can occur are weak oris orbicularis muscles around the mouth that make it difficult to take food off a fork or spoon or suck on a straw or the nipple of a bottle; unusual taste preferences for salty or spicy food at an inappropriate age; gross caries at a young age; prolonged and excessive drooling; weak buccinators muscles that prevent the proper placement of food for chewing. Multiple facial deformities contributing to mouth breathing and corresponding dry mouth. Mouth breathers tend to have a higher incidence of caries and gingivitis due to loss of the buffering capacity of saliva and gingival irritation on account of drying. Also have CNS and oral/motor deficits, poor tongue-thrusting and speech disorders [19,20]. Now, coming to the direct or non-teratogenic effects, this group consists of Dental caries; tooth loss, Periodontium and tooth wear i.e. attrition and erosion. There have been contradictory reports of dental caries. While some show decrease in incidence of dental caries and Journal of Alcoholism & Drug Dependence J o u r n a l o f A lco hol ism and DruDepen d e n c e