DT News - UK - Dentists central to tackling alcohol abuse

Dental Tribune International

Wed. 11 April 2012

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LONDON – In a recently published paper on alcohol abuse in the UK, researchers have pointed out the key role of dental professionals in the detection of oral cancer. They suggest that dental settings might provide an ideal place for identification and intervention, since those working in primary care are often the first to notice abnormalities of the oral cavity caused by excessive drinking, among other factors.

The authors of the paper estimate that around 40 million British adults regularly consume alcoholic drinks, with about 25 per cent exceeding the Department of Health guidelines.

Since heavy drinking is a major risk factor for developing oral cancer, the lead author, Jonathan Shepherd, Professor at the Royal College of Surgeons, identified the unique position of dentists, dental nurses and dental hygienists in the early detection of oral cancer.

National surveys show that primary dental care services are used by patients on a regular, prevention-orientated basis, in contrast to primary medical care. The majority attends primary care services for routine check-up, while medical practitioners are only consulted in case of a health problem. Primary dental professionals should therefore be willing to screen patients for alcohol misuse and educate them to reduce their exposure to risk, according to the authors.

Heavy drinkers are more likely to suffer from dental erosion and periodontitis, among others. “Excess alcohol consumption can lead to cancer in the mouth, larynx and oesophagus and dentists may be the first to notice these conditions,” said Shepherd.

Although dental settings have not yet been systematically examined as detection and treatment areas of alcohol abuse, he recommended the introduction of an alcohol-screening tool that detects harmful drinking alongside effective treatment. Dentists should administer screening questionnaires to patients to enquire about alcohol consumption explicitly as a routine component of medical history taking. Once heavy drinking has been identified, patients can be referred to specialists at an early stage to tackle the problem.

According to the British Dental Health Foundation, early detection of cancer can increase survival rates to more than 90 per cent. Since many patients and young people in particular may be borderline risky drinkers, the authors of the paper view dental practices as important institutions for intervention.

Up to this point, research into the use of abuse-related questionnaires in dental care has been rather limited but the authors point out that there is some evidence that such screening methods can be successful in general dental practice settings.

The authors estimate that approximately one in three men and one in five women binge drink in the UK, with statistics suggesting that eight per cent of men and two per cent of women drink more than 50 and 35 units a week, respectively.

The National Health Service recommends that men not exceed three to four and women not exceed two to three units of alcohol a day regularly (one unit equals 10 ml of pure alcohol).

The British Dental Health Foundation estimates that almost 60,000 people in the UK will be diagnosed with oral cancer over the next ten years. They said that heavy drinking can increase the risk of mouth cancer by four times. For those who drink and smoke to excess, the risk of developing the disease is up to 30 times higher. In the UK, Scotland has the highest incidence rate of oral cancer and 87 per cent of the cases occur in patients aged 50 or over.

The paper “Alcohol misuse: Screening and treatment in primary dental care” was published in the April issue of the Faculty Dental Journal of the Faculty of Dental Surgery at the Royal College of Surgeons of England.

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