Alcoholism is a primary cause of sialadenosis, which is an asymptomatic, bilateral enlargement of the parotid glands . Alcoholic sialadenosis has been shown to occur only when there is some form of liver disease present as well. In fact, alcoholic sialadenosis takes place in 30 to 80 percent of patients with cirrhosis . Other than being aesthetically displeasing, the parotid swelling is asymptomatic, which can cause patients to delay treatment. Other indications of alcohol abuse include, Breath and Body Odor of Alcohol and Tobacco.
Tobacco is considered an indication because many alcohol users are also heavy tobacco users.
Tremor of the hands, tongue or eyelids can further be an indication of withdrawal from alcohol. Ranka and Kharat state, alcoholics are difficult to manage. They miss their appointments, do no cooperate in treatment aspect and leave the course midway. Therefore, most intra-oral manifestations only provide an indication of alcohol abuse. In the alcoholic, periodontal infection is not uncommon.