Time for long-term change?

22 January 2021
3 min read

Kimberley Lloyd discusses why a teetotal lifestyle should continue beyond Dry January.

Every January, we’re used to the annual campaign encouraging us to go “dry” for a month, to balance December’s overindulgence and start the new year with good intentions. But at the end of 2020 we didn’t see crowds of people celebrating the party season in the usual way – with plenty of booze. Dry January is about an individual “resetting” their relationship with alcohol and, if they enjoy the benefits, they might be inspired to make permanent changes.

Trying to find facts
The true picture of how (and indeed, if) the pandemic caused the UK to re-evaluate its relationship with alcohol might never be known. We see the statistics, but not everyone is candid when discussing how much they drink and, although the guidance is clear – no more than 14 units per week – there is often confusion over what constitutes one unit. Converting drinks to units and coming up with a rather conservative figure is something many of us will relate to.

Then there is the matter of the “sober curious” movement, which has grown rapidly over the last few years. Dry January (and its sister, Sober October) have helped raise the profile of sobriety, often claimed as a lifestyle choice by “influencers” who use social media to post aspirational photos of themselves enjoying life without alcohol. There are several theories why sober living has enjoyed a surge of popularity among the young; one explanation is that they don’t want to be seen looking inebriated on Instagram. Certainly, if more young people are able to socialise without alcohol, this is a positive development. The de-stigmatising of a choice not to drink, rather than fulfil other people’s expectations of what constitutes a good night out, is also positive.

It could be argued that the UK has been in the grip of a mental health crisis for some time – in 2013, there were over 8m cases of anxiety reported, and one can only guess what that figure looks like now. Studies have made positive associations between alcohol misuse and anxiety disorders, particularly among adolescents and young adults. Outside clinical literature, there’s a name for the low that many feel when they’re hangover – hangxiety. You won’t find this term in a medical dictionary, but it does sum up how excessive drinking can lead to emotional, not just physical, symptoms. A disclaimer does apply to some parts of the “sober curious” movement that targets young people; many influencers are not medically trained and are speaking from experience only. That’s not to say there aren’t benefits to high-profile figures advocating an alcohol-free/moderated lifestyle, but a distinction between this and professional support must be made.

Alcohol and the pandemic
The last 12 months have given all of us plenty to worry about, and worry doesn’t mix well with alcohol. At the beginning of lockdown, many people admitted to drinking more, then decided to moderate, or stop completely, once they realised it wasn’t doing them any good. At the other end of the scale, the British Liver Trust reported a 500 per cent increase in calls since March 2020 (it should be noted, too, that figures for alcohol-related disease and deaths have been on the rise in the UK for the last few decades).

Where do we, as oral health professionals, fit in? Well, moderation is the ideal and patients should be encouraged to continue beyond 31 days. Too much alcohol isn’t good for body or mind and will negatively impact oral health. A 2010 study found that people who had four or more drinks a day had about five times the risk of developing mouth and pharynx cancers compared to people who never drank, it also indicated an increased risk for moderate alcohol consumption which counts as one drink a day.

Many alcoholic drinks are full of sugar and can lead to xerostomia increasing caries risk; also, certain drinks will stain teeth when imbibed regularly. Moderating alcohol intake is part of a healthy lifestyle that includes exercise and relaxation, a balanced diet and other preventive behaviours, like smoking cessation and cleaning the whole mouth properly using high-quality brushes – patients should try the premium-brand Tandex range. If you have a patient who feels they cannot moderate, and are regularly “problem” drinking, this will require a multi-agency approach to give them the support they need.

Alcohol has long been associated with a good time, which is why the campaign for month-long abstinence begins after the party season. But long-term moderation will make your patients feel so much better, physically and mentally, every day. If they’re in control of their intake, when restrictions have lifted and we can all enjoy being together again, they’ll be able to truly enjoy a drink as an optional extra, not the focus of their fun.

References available on request.