Should dentists ask you how much you drink?

“How much alcohol do you drink per week?”

The question, posed by my dentist as he had his back to me, surprised me so much that I presumed it was directed at his dental assistant and just remained silent.

He asked again and I realised he was talking to me – the first time I had ever been quizzed about my alcohol consumption at the dentist.

While it is the type of enquiry which is routine during a doctor’s visit I could see no reason why my dentist should ask me. He said himself that my teeth were in fairly good shape and I’m pretty certain there was no smell of alcohol from my mouth – I drink a couple of pints on a Friday night and a glass of wine with my Sunday lunch.

However, it’s a question which every adult dental patient might have to face fielding soon; a report published in the Royal College of Surgeons Dental Journal has advised that dentists should hand out questionnaires at the start of each consultation to identify heavy drinkers.

Perhaps my dentist is just ahead of his time.

Commenting on the report, which was released earlier this month, lead researcher Jonathan Shepherd of Cardiff University said: “Excessive alcohol consumption can lead to cancer of the mouth, larynx and oesophagus and dentists may be the first to notice these conditions.”

Teeth-whitening treatment and a session with a dental hygienist can sometimes help remove stains but it won’t tackle the lifestyle habits which lead to these oral problems.

Mr Shepherd and his fellow researchers believe that dentists should be able to identify signs of alcohol misuse among their patients because they tend to see them more regularly. While dentists typically see their patients once a year for a routine check-up, GPs often only see patients when they report to a surgery complaining of ill health.

According to the study, excessive alcohol use not only increases the risk of oral disease it also increases the risk of “oro-facial” injury through factors such as:

• Falls
• Road accidents
• Interpersonal violence

If the report’s recommendations are accepted, dentists could face the dilemma of deciding which patients should complete an alcohol consumption questionnaire and how to deal with underage drinkers with oral health issues.

In 2001, a study of the dietary habits of 400 14-year-olds in Birmingham discovered that those who drank heavily increased their risk of suffering from dental erosion.

One in five of the children surveyed admitted that they drank some alcohol every week. Three per cent of those polled said that they drank beer or cider between eight and 21 times a week.

Government guidelines currently advise that adults should not regularly drink more than:

• 3-4 units for men
• 2-3 units for women

A typical pint of ordinary strength beer, lager or cider contains two units, a small glass of wine often equates to 1.5 units and you should expect to consume around 1.5 units in a small pub measure of spirits.

It used to be that pub drinkers would keep a close eye on the number of units they consumed to ensure that they remained under the drink-drive limit. Nowadays, we are equally likely to monitor the unit count to stay on the right side of our doctor and (as I found out) dentist.