Review of pharmacologic and toxicologic effects of alcohol.

Oral neglect and dental diseases are common; consumption of alcohol is common. To appreciate the frequency of alcoholism, the dental specialist must recognize that no persons will seek attention for alcoholism. Suspicion of alcohol related dental disease is the key. Heavy smoking, malnutrition, bleeding gingiva, cancer of the head and neck, and enlargement of the parotid glands should all raise a question of alcoholism. Alcohol affects most organ systems, but toxicity is extremely variable. Single organ systems may be severely damaged whereas others are spared. Current evidence suggests that variations on the total amount of alcohol consumed and genetic variations in specific pathways may contribute to the multifaceted clinical presentations of alcoholism. Because alcohol is the single most common drug ingested by patients, common interactions of drugs that have dental significance should be suspect. Most commonly, these interactions involve anesthetic agents and sedative hypnotic drugs. Dental specialists may encounter alcoholic persons in intoxicated, withdrawing, or rehabilitating states. In any of these phases, appropriate recognition and judicious support of the dental problems will contribute to the overall well-being of these persons.