Dental disease among alcoholic individuals

A comparative study of hospitalized patients


Objective: To measure the presence and severity of dental disease, as assessed by physicians, among consecutively hospitalized alcoholic and nonalcoholic medical patients.

Design: Descriptive cross-sectional study. Patients who had Michigan Alcoholism Screening Test (MAST) scores ≥8 were identified as being alcoholic. Nonalcoholic patients were defined as individuals with MAST scores ≤4. These patients were matched with alcoholic patients for gender and age (±5 years). The decayed, missing, and filled teeth (DMF) score and its components were used as a measure of dental disease.

Setting: General wards of internal medicine of a 1,000-bed urban teaching hospital in Lausanne, Switzerland.

Results: Among patients aged 20–75 years, the mean DMF score was higher among alcoholic patients than among nonalcoholic patients (26 vs 23, respectively; p<0.001). This difference was greater among patients aged 20–39 years (20 vs 14, respectively) than among those aged 60–75 years (29 vs 27, respectively). The positive association between alcoholism and dental disease (crude odds ratio, 2.24; 95% CI, 1.15–4.31) remained after sequential stratification for several confounding factors.

Conclusion: The study suggests that dental disease is frequent and severe in hospitalized medical patients and that alcoholism is an independent predictor of its severity. Routine assessment of dental disease by the physician is important for medical inpatients, especially among those who are alcoholic.

This is a preview of subscription content, access via your institution.


  1. 1.

    Greene JC, Louie R, Wycoff SJ. Preventive dentistry I: Dental caries. JAMA. 1989;262:3459–63.

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Greene JC, Louie R, Wycoff SJ. Preventive dentistry II: Periodontal diseases, malocclusion, trauma and oral cancer. JAMA. 1990;263:421–5.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    King WH, Tucker KM. Dental problems of alcoholic and nonalcoholic psychiatric patients. J Stud Alcohol. 1973;34:1208–11.

    CAS  Google Scholar 

  4. 4.

    Dunkley RP, Carson RM. Dental requirements of the hospitalized alcoholic patient. J Am Dent Assoc 1968;76:800–3.

    PubMed  CAS  Google Scholar 

  5. 5.

    Friedlander AH, Solomon DH. Dental management of the geriatric alcoholic patient. Gerodontics. 1988;4:23–7.

    PubMed  CAS  Google Scholar 

  6. 6.

    Friedlander AH, Mills JD, Gorelick DA. Alcoholism and dental management. Oral Surg Oral Med Oral Pathol. 1987;63:42–6.

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Christen AG. Dentistry and the alcoholic patient. Dent Clin North Am. 1983;27:341–61.

    PubMed  CAS  Google Scholar 

  8. 8.

    Bergman MM, Gleckman RA. Infectious complications in alcohol abusers. Hosp Pract. 1988;23(Sept 15):145–56.

    CAS  Google Scholar 

  9. 9.

    Bayliss R, Clarke C, Oakley C, Somerville W, Whitneld AGW. The teeth and infective endocarditis. Br Heart J. 1983;50:506–12.

    PubMed  CAS  Google Scholar 

  10. 10.

    Rienhoff HY Jr (ed). Clinical conferences at the Johns Hopkins Hospital: lung abscess. Johns Hopkins Med J. 1982;150:141–7.

  11. 11.

    Eckardt MJ, Harford TC, Kaelber CT, et al. Health hazards associated with alcohol consumption. JAMA. 1981;246:648–66.

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Niquille M, Koehn V, Magnenat P, Paccaud F, Yersin B. Utilization of hospital resources by alcoholic and nonalcoholic patients: a prospective study. J Gen Intern Med. 1991;6:216–22.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Selzer ML. The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. Am J Psychiatry. 1971;127:89–94.

    Google Scholar 

  14. 14.

    Mischke HD, Veneri RL. Reliability and validity of the MAST, Mortimer-Filkins questionnaire and CAGE in DWI assessment. J Stud Alcohol. 1987;48:492–501.

    PubMed  CAS  Google Scholar 

  15. 15.

    Selzer ML, Gomberg ES, Nordhoff JA. Men and women’s responses to the Michigan Alcoholism Screening Test. J Stud Alcohol. 1979;40:502–4.

    PubMed  CAS  Google Scholar 

  16. 16.

    Cyr MG, Wartman SA. The effectiveness of routine screening questions in the detection of alcoholism. JAMA. 1988;259:51–4.

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Yersin B, Trisconi Y, Paccaud F, Gutzwiller F, Magnenat P. Accuracy of the Michigan Alcoholism Screening Test for screening of alcoholism in patients of a medical department. Arch Intern Med. 1989;149:2071–4.

    PubMed  Article  CAS  Google Scholar 

  18. 18.

    Grant JP, Custer PB, Thurbow J. Current techniques of nutritional assessment. Surg Clin North Am. 1981;61:437–63.

    PubMed  CAS  Google Scholar 

  19. 19.

    Gurney JM, Jelliffe DB. Arm anthropometry in nutritional assessment. Nomogram for rapid calculation of muscle circumference and cross-sectional muscle and fat areas. Am J Clin Nutr. 1973;26:912–5.

    PubMed  CAS  Google Scholar 

  20. 20.

    Klein H, Palmer CH. Dental care in American Indian children. P.H. Bull, no 239. Washington, DC: US Government Printing Office, 1938.

    Google Scholar 

  21. 21.

    Kleinbaum DG, Kupper LL, Morgenstern H. Epidemiologic research, principles and quantitative methods. New York: Van Nostrand Reinhold, 1982.

    Google Scholar 

  22. 22.

    Feldmann DE. Oraler Zustand bei Erwachsenen in der Schweiz. Eine Erhebung in 47 zufallig ausgewählten Praxen [doctoral dissertation]. Zahnärtzlichen Institut der Universitat Zürich (Director: Marthaler TM, MD). Zürich, 1989.

  23. 23.

    Arnljot HA, Barmes DE, Cohen LK, Hunter PB, Ship II. Oral health care systems. An international collaborative study. Quintessence, London: coordination by the WHO, 1985.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Dr. Bertrand Yersin MD.

Additional information

Presented in part at the 1990 National Meeting of the Societe Suisse de Medecine Interne, May 10–12, 1990, Lausanne, Switzerland.

Supported by a grant from the Swiss National Research Foundation (no 3200-009282) and by a grant from the “Fondation du 450ème anniversaire de l’Université de Lausanne.”

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Niquille, M., Burnand, B., Macnenat, P. et al. Dental disease among alcoholic individuals. J Gen Intern Med 8, 470–475 (1993).

Download citation

Key words

  • alcoholism
  • dental disease
  • preventive medicine