Alcohol and the Mouth

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Hello Sobertown

First a note: What we observe in these articles can be A DOSE OF REALITY and I recommend you only read or listen on if you are ready to hear the truth about the damage consuming alcohol can do to your body. If you want a VERY good reason and motivation NOT to drink alcohol. Read or listen to these articles from start to finish because the journey is quite revealing.

Step into a pill sized submarine with me as we travel alongside a sip of alcohol through the human body.

This is the first in what will be a series of articles which follow ethanol around the body observing its effects on the body in detail. In these entries we will follow alcohol through the body from top to bottom and investigate how it impacts each region both directly and indirectly and explore any interesting points and facts along the way, interesting or possibly scary. This might be a big one. Strap in as we initiate the shrinking ray to get our vessel down to size and let’s go.

We buckle our seats and our mini sized sub is plopped into the glass of alcohol, engines on, down periscope hold on to your butt.

The drink is tipped into the MOUTH, swish, swish, hold on tight…

The drink sits in the mouth cavity and gets swirled around in there as we ride the wave in our little submarine. Depending on the strength of the alcohol you threw back, you might feel a warm burn in the mouth, this is because ethanol activates receptors in our body which usually tell the brain something is hot, alcohol just happens to have the ability to fire these receptors off as heat would and as well as this it is believed some of the burning sensation occurs due to a rapid inflammatory response caused by the alcohol. You will understand why that may be the case soon.

The ethanol in the alcoholic drink immediately gets to work on our body even when it is just in the mouth. In-fact while many people ignore the mouth as a potential trouble area regarding alcohol, nothing could be further from the truth. Think about this, the alcoholic drinks we consume are at their strongest and purest as they enter the mouth, imagine, a shot of 40%alc/vol liquor, that is 40% strength ethanol swishing around our mouth straight up with no further dilution. Any strength is potentially damaging but wine and above, that is 10% and up is particularly capable of causing substantial damage.

Ethanol is one of few substances which can effectively separate the cells which make up the lining of the mouth and penetrate them. These cells form a barrier to protect the mouth and are called epithelial cells, collectively these can be called the oral mucosal lining and these epithelial cells either cop the damage themselves or they make way for damage underneath. The epithelial cells could be considered the tough and protective or if necessary, the sacrificial barrier at the front line, they are the poor souls set out front in a fight who are likely to take the first round of impact in an attack and in the mouth they separate our deeper cells from the outside world.

Imagine a brick wall, the bricks are your cells which line the surface of the inside of the mouth protecting everything underneath, imagine it rains on this brick wall and the grout between the bricks is totally fine with normal rain and it does its job to protect everything underneath, the rain washes off the wall with no impact. The epithelial cells which line our mouth just like the wall are fine with most substances we consume and they do their job to protect the cells underneath. Or consider the epithelial cells the front line in a medieval war, this front line has toughened fighters who hold heavy armour and shields. These soldiers can almost always fend off an attack which is good because the soldiers behind them who they protect have barely any armour, they are not equipped to fight and regroup like the armoured epithelial soldiers are, they need the protection of this front line of tough armoured epithelial soldiers. Use whichever comparison you feel works for you, wall or soldiers. The wall is resistant so the water from the rain just washes over without damage being caused, or the soldiers bat away the attacking force with no unusual effort but now imagine we have a big downpour of strong acid rain, the acid is able to eat away the grout and work its way between the bricks then as it passes through it is allowed to damage the important contents behind or at the base of the wall. If you prefer, imagine the toughened soldiers protecting the less capable army behind them are attacked by a line of heavy cavalry, giant warhorses covered in armour steaming along at full speed, the front line of your army are tough and skilled and armoured but they have no hope in defending against a charging war horse, the war horse is alcohol. The horses smash through the front line and wound the protective line of soldiers or penetrate the protective barrier they form, allowed then to wreak havoc on the under armoured and under prepared army behind.

Your epithelial cells are literally like a wall in your mouth, or like a protective line of soldiers. They are packed close together to protect the cells of your mouth underneath from whatever you put in your mouth, the cells underneath are more vulnerable to damage. ALCOHOL can PENETRATE this natural wall of cells we have in our mouth as well as cause them unusually large amounts of damage! Alcohol is the acid rain, alcohol is the attacking heavy cavalry. The ethanol penetrates between the cells and irritates and damages your tissues underneath like a crashing horse breaking through, like a worm burrowing a passage through where there should be none or like acid eating away at a surface until it opens a hole up. This is simply put, not good. Feng et al in 2013 found in studying specimens who died of “chronic alcoholism”, quote “The findings of this study show that drinking alcohol over an extended time may lead to carcinogenic changes in oral mucosa.” This study also revealed that in about half of those studied they observed widespread NECROTIC points through the mucosa of the mouth, necrotic/necrosis means death of living tissue! They also found common examples of nerve bundles damaged in the mouth cavity mucosa and blood vessel damage (1).

This effect of penetrating the epithelial barrier allows the ethanol to cause damage to our cells and active oxidation may damage our DNA as the ethanol passes through and allows other carcinogens and contaminants to damage underneath. This point is key. When alcohol is in our mouth and causing this damage and penetration, it is not only the ethanol which is causing the harm alone, the damage and permeability it creates allows more entry and damage by other compounds which would usually be stuck behind the front line barrier which our epithelial cells create and this is simply put, not good. When our mouth is opened up to additional carcinogens we again increase the risk of cancers developing, take for example the well established statistic whereby alcohol plus smoking combined allows for greater risk of cancer than alcohol alone or smoking alone, this is because the noxious agents within the cigarette smoke is then allowed to cause additional damage as alcohol clears a path for it to affect the cells of our mouth cavity. So while drinking though common, is precisely the worst time you could smoke. Smoking aside, there are actually known carcinogens present within some alcoholic beverages aside from the ethanol itself, some more than others, however this is the same story, any harmful compounds within the drink aside from the ethanol itself are then allowed to pass and do more damage than they would otherwise be able to due to the work the ethanol does on the barrier cells of our mouth, oh how wonderful. Our body does its best, but we were are not able to ingest alcohol without causing damage, not even at the entry point, our mouth. (1)

The risk has been present and known for a very long time. Look at another quote from research by Feng and Wang 2013. “previous researchers have confirmed that the most important risk factors in the development of oral cancer are smoking and alcohol”. So smoking, that might not surprise you but alcohol?? I think they left that off the label. You see the ethanol (alcohol) penetrates the lining of the mouth and irritates the cells underneath, irritates, damages and destroys. Add repeat bouts as we tend to do as drinkers and the repeated irritation eventually causes tissue damage and eventually other big problems such as mouth or throat cancer can occur, not definitely, not with certainty, BUT the risk absolutely increases due to alcohol. (1) Seriously, does that shock you? Were only talking about the mouth so far and the science is in, we know through many studies that the, most, important risk factors in development of oral cancer are smoking, sure, and ALCOHOL!

If we drive our little submarine around with a floodlight on and we take a close look at the lining of the mouth we might see several changes to the mouth lining due to alcohol, we might see gaps developing between the protective lining, like bricks in the wall missing which allow harmful substances to irritate underneath. We might also see these protective cells atrophy, atrophy means wasting/shrinking, so our brick wall might include shrunken, broken and undersized bricks which also allow harmful substances in. We will see with our floodlight “dysplastic changes with keratosis and increased number of mitotic figures” what this means is very basically put, change in the cells of the mouth that are very undesired in nature, dysplastic cells are often pre-cancerous, keratosis is thickened lining layers. Look at it like this, when we shine our floodlight around the damaged areas of the mouth it would be comparable at a cellular level to seeing a warzone in the worst affected areas, the walls are bomb blasted and have big holes in them with protruding sparking wires and water pipes spraying water everywhere, this represents the cells being damaged by the ethanol and carcinogens in alcohol drinks damaging and destroying the otherwise healthy cells deeper in the mouth cavity. The immune systems then kicks in, there is inflammation growing in the damaged areas, so the brick layers and the tradesmen are rolling in to patch up the damage and they do a great job, we heal quite well but we keep blasting the inside of the mouth with metaphorical bombs as we drink more and more and the repair job can be a little hacked when we overdo it to the point where we build up scar tissue and thickened lining like a badly braced wall or a hole that has just been patched too many times. This may sound dramatic, not really, the destruction to our cells is very real, we are just lucky our bodies have such a great ability to heal but this does not last forever and sometimes instead of heal the DNA is damaged and the cells divide in a way we would consider very bad, we simply can not ask our body to repair again and again from repeat damage, there is a point where these cells change for the worse. we also see the salivary glands become swollen and overactive though it has been uncertain why this change occurs to now.

Aside form this the after effects of drinking have huge effects on the health of the mouth too, dehydration causes gum irritation and dryness, healing ability becomes impaired and our increased consumption of bad foods and sugars directly impacts dental health while people under the influence of alcohol then in turn have a tendency to clench and grind causing jaw joint problems and dental wearing. The horrible acetaldehyde infuses into the saliva and this compound is a verified carcinogen, a horrible substance we create as we break down alcohol, but we will cover this in detail later (2). Nothing is working well. The well known fact is that alcohol consumption both during consumption and days after leads to poorer lifestyle choices commonly in the form of bad foods, sugar, nutrient devoid and calorie rich foods and other excessively processed goods come into the equation which contribute to early tooth and gum decay or disease. Alcohol consumption is a dentists nightmare, or a dentists new Porsche perhaps, depending on how you look at it.

Within the article I draw from, alcohol does cause damage and cancerous change in the mouth, as you will find out, the mouth is only one region prone to increased cancer risk through consuming alcohol.

I think we have seen all we need to see here in the mouth. (1) Lets get this submarine moving again, because I think were about to be swallowed and I also think we have scared ourselves enough for one small area, like I said, this may be a long and scary ride.

• MOUTH SUMMARY: Ethanol can penetrate the protective lining of the mouth allowing harm to come to the underlying cells. Long term exposure to alcohol is responsible for substantial damage and death to the cells of the mouth and may lead to cancers occurring.

• QUOTE: “Alcohol and its metabolite (breakdown product) acetaldehyde are both classified as a Group 1 carcinogens (cancer-causing agents). This is the highest carcinogen rating, equal to tobacco smoke and asbestos. Alcohol consumption is a risk factor for mouth, pharynx, larynx, esophagus, breast, bowel and liver cancers. The risk of developing these alcohol-caused cancer increases with the amount of alcohol consumed.” (9) So to repeat. alcohol. Group 1 carcinogen. Highest carcinogen rating. There simply is not any denying. So to the question, does alcohol cause cancer? Let me answer that question with another question, does a bear shit in the woods? Does the tin man have a sheet metal cock? You get it, yes, yes, yes. Known, verified, researched, confirmed, yes.

Sorry to be a downer Sobertown, sometimes we need to know what we are or have been doing to ourselves to drive in the importance of giving it up.

The good news is that if you stop, the damage stops, the risk factors lower eventually though this takes time, the healing begins and continues only after stopping. Research by Rehm et al in 2007 which centred on head and neck cancers found the following “In general, these studies have found that stopping alcohol consumption is not associated with immediate reductions in cancer risk. The cancer risks eventually decline, although it may take years for the risks of cancer to return to those of never drinkers.” (10) So, although risks take time to reduce, they do, but it does take time. Noting this study centres on head and neck, the fact is though, the damage has got to stop and regardless of risk factors reducing or not, continuing consumption will only worsen the future health risk. If you take one thing from this, it should be that alcohol is a verified GROUP 1 CARCINOGEN. This means alcoholic beverages are on the very same shelf in risk of cancer as ASBESTOS, SMOKING, HIV INFECTION, IONIZING RADIATION, PLUTONIUM, STRONG INORGANIC ACID MIST (11) and many more. These are all group 1 carcinogens and right there with them is alcohol. Class 1, group 1 carcinogen verified. You want reason to stay away from it, there you go. So Sobertown, what better reason or motivation to stop drinking.

Stopping is what Sobertown is here for.

(Stay tuned as we continue the journey and we travel from the mouth and down the esophagus to the stomach in the next fun filled explorative episode of your body on booze).

Sobertown. You can stop the damage. You can do it. You can lower the risk. You don’t have to get there immediately, and it is tough, but you have to keep trying and put in the work and it will stick. Remember, at Sobertown, you absolutely are not alone, you are not alone.

Thanks Sobertown. Remember to protect your soldiers, protect your wall. Now you know for sure that alcohol is a group 1 carcinogen it should serve as another good reason to give it up.

REFERENCE

(1): Feng L, Wang L: 2013. Effects of alcohol on the morphological and structural changes in oral mucosa. Pak J Med Sci. 2013 Jul-Aug; 29(4): 1046–1049.

(2): Dr. Shikha Goel Bansal: 2015. April 6th, 2015. Alcohol and Your Mouth. Taken from https://humanhealthproject.org/alcohol-and-your-mouth/#:~:text=Ethanol%20diffuses%20rapidly%20into%20saliva,sensation%20in%20the%20oral%20cavity.

(3): Samaneh Shirani, Neda Kargahi, Sayed Mohammad Razavi and Solmaz Homayoni. 2014. Epithelial Dysplasia in Oral Cavity. Iran J Med Sci. 2014 Sep; 39(5): 406–417.

(4) S Chari, S Teyssen, M V Singer: 1993. Alcohol and gastric acid secretion in humans. Gut. 1993; 34:843-847

(5): Guidelines to reduce your risk: Taken from https://www.health.gov.au>alcohol. 02/05/2021.

(6): Recovery Elevator Podcast: Episode 78. What I’ve learned about the stigma surrounding alcohol. Released 15/08/2016.

(7): Bode, Christiane & Bode, Christian J: 1997. Alcohol’s Role in Gastrointestinal Tract Disorders. ALCOHOL HEALTH & RESEARCH WORLD. VOL. 21, NO. 1, 1997.

(8): Shrubsole, M.J: 2008. Alcohol Drinking, Cigarette Smoking, and Risk of Colorectal Adenomatous and Hyperplastic Polyps. 167(9), DOI: 10.1093/aje/kwm400.

(9): Update July 20, 2020: Alcohol and the Digestive System. Taken from https://alcoholthinkagain.com.au/alcohol-your-health/alcohol-and-long-term-health/alcohol-and-the-digestive-system/. Taken 04/05/2021

(10): Rehm J, Patra J, Popova S. 2007. Alcohol drinking cessation and its effect on esophageal and head and neck cancers: a pooled analysis. International Journal of Cancer 2007;121(5):1132-1137.

(11): Known and Probable Human Carcinogens: American Cancer Society: Last Revised August 14, 2019. https://www.cancer.org/cancer/cancer-causes/general-info/known-and-probable-human-carcinogens.html. Taken on 05/05/2021.

The Sobertown Blog articles and recordings are created as a means of assisting others in achieving and maintaining sobriety and freedom from alcohol. Experiences, entries, research and article content are that of the author and should be applied in a safe manner deemed best by the reader and applied safely and if relevant with medical oversight. This is not medical advice and the author is not a medical doctor. No advice within is based on or crosses over with the authors profession or professional opinion as an AHPRA registered allied health practitioner or FA registered exercise professional.