Dental treatment and the alcoholic

Practising dentists must include in their diagnostic skills the ability to identify the patient with a high intake of alcohol. Dental status can often reflect the patient's perception of health and disease. The development of an appropriate treatment plan for these patients needs to take into account their generally unreliable nature. Appointments are often not kept; there is poor compliance with general health-care information, and compliance with preventive advice on dental care is achieved with difficulty. Symptomatic presentation is common with the alcoholic patient. The dentist should avoid "rushing in" to treat the presenting acute problem without appropriate investigation of the medical history. This should include consultation with the patient's medical advisor and other involved health professionals. A careful review of the oral mucosa for pre-cancerous or cancerous changes should be systematically included in the examination of any patient. Patients with a high intake of alcohol, and especially those who smoke, need to be carefully screened.