“Doctor, When Can I Drink Alcohol After Dental Implant Surgery”?
A question that patients often ask clinicians is when alcohol can be consumed after dental implant or bone graft surgery. Although there are no systemic reviews or meta-analyses evaluating the direct effects of alcohol on implants or bone grafts, numerous in vitro and in vivo studies exist in the literature. Therefore, implant clinicians must understand the potential morbidity associated with patient’s use of alcohol in the postoperative time period. The following is a summary of the associated consequences of alcohol use post-operatively:
Detrimental Effects of Alcohol on Dental Implant & Bone Grafting Procedures
1. IMPAIRED OSSEOINTEGRATION: decreased osteoblast proliferation, reduced alkaline phosphatase, & decreased bone morphogenic protein [1] [2] [3] [4]
2. EXCESSIVE BLEEDING: interference with coagulation via decreased platelet production and function, diminished fibrinolysis [5]
3. INCREASED INFECTION RATES: alters cell-mediated immunity, alteration of neutrophil adherence & mobility, and phagocytic activity [6]
4. COMPROMISED WOUND HEALING: wound angiogenesis is decreased by 61% & reduction (acidic) pH of the surgical site [2] [7]
5. INCREASED MARGINAL BONE LOSS: decreased bone metabolism & increased parathyroid hormone secretion [8] [9] [10]
6. INCREASED POST-OPERATIVE PAIN: [2] [11] [12]: influences systemic inflammatory cytokine levels, reduced efficacy of local anesthetics
7. INCREASED PERI-IMPLANT DISEASE: poorer hygiene [3] [9] [13]:
In the literature, the detrimental effects of alcohol are clearly evident, particularly in interfering with the osseointegration process and bone repair. Interestingly, long-term alcohol use, especially with a history of abuse, has been shown to irreversibly alter the cellular mechanisms of the bone formation and remodeling process. [14] In addition, in the post-prosthetic phase, the use of increased alcohol use has been associated with a threefold increase in peri-implant disease when patients exhibited heavy alcohol use. [15]
Prevention of Complications
INFORMED CONSENT: Patients must be well- informed about the potential consequences of alcohol use, particularly immediately after implant surgery. This information should be detailed in both verbal and written informed consent, along with being included in the post-operative instructions. (See Resnik Implant Institute Consent Forms and Post-Op Instructions at resnikimplantinstitute.com)
NO ALCOHOL USE: Abstaining from alcohol can minimize the deleterious effects on post-surgical healing. Patients should be instructed on possible cessation programs through their physician if indicated. Ideally, patients should be educated to refrain from using alcohol for a minimum of 2-3 weeks postoperatively or until complete incision line closure occurs.
Summary:
The detrimental impact of alcohol exposureontissue and bone healing via impairing normalcellular function is well established. Theconsumption of alcohol has been associatedwith diverse surgical and dental implant-relatedissues, thereby increasing the likelihoodofcomplications during the intra-operative, post-operative, and maintenance phases of dentalimplant therapy. Clinicians must possess aclearunderstanding of the pathogenic impactofalcohol on all facets of dental implant treatment,placing particular emphasis on patienteducation.
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