Alcohol-Induced Neuralgia / Neuropathy

Which prompted me to write about a rare and unique condition that I was discussing recently with a patient: Alcohol-Induced Neuralgia or Alcohol-Induced Neuropathy.

Patient A came in recently and when asked if they have any questions or concerns for us, Patient A replied, "Yes. Why do I get a stabbing pain in my TMJ area after two glasses of wine or beer? This didn't happen when I was in Italy, though." This is a symptom of Alcohol-Induced Neuralgia (Alcoholic Neuralgia/Neuropathy).

As defined by the National Institute of Health: Alcoholic Neuralgia is a condition characterized by sharp, stabbing or electric-shock-like jaw pain triggered by consuming alcohol. It is often linked to irritation of the trigeminal nerve or underlying neuropathic issues aggravated by alcohol. Alcoholic Neuropathy is nerve damage caused by chronic, heavy alcohol consumption and associated nutritional deficiencies. It causes painful burning, numbness, and tingling, primarily in the feet and hands.

Before I explain the science behind the connections between alcohol and jaw pain, let me quickly explain "jaw pain". Temporomandibular Disorders (TMD) are what doctors refer to the group of 30+ conditions that cause pain and dysfunction in the jaw joint and its muscles that control movement, the Temporomandibular Joint (TMJ). The pain can be felt in the jaw, ear area, neck and/or face. In addition to the pain, symptoms can be clicking, popping or locking of the jaw.

So if this is what the conditions are and their symptoms, what is the science behind all this? Well, the important connections to note between alcohol and TMD are:

• Increased Bruxism (teeth grinding/clenching): Alcohol can disrupt sleep architecture and trigger bruxism, which strains the jaw muscles.
• Inflammation: Alcohol can contribute to the inflammation in the TMJ which exacerbates any existing pain.
• Dehydration: As most of us already know, alcohol consumption dehydrates us. Dehydration worsens any muscle soreness, especially in this case in the face and jaw.

Now that we understand how and why Patient A experiences Alcoholic Neuralgia, let's try to demystify why this did not happen when they were drinking wine and beer in Italy.

My area of expertise is anything dental-related. I am not too familiar with the wine-making or beer-brewing processes. I can explain, though, that European regulations are stricter than in the US. This limits the additives, sulfites, and histamines in wine, for example. So simply based on the fact that wine made in Europe contains less impurities than wine made in the US, we can deduce that European-made wine is less likely to cause painful symptoms after consumption.

The purpose of this blog post is not to scare you away from drinking wine or to insinuate that European-made wine is better than US-made wine! I am simply doing something I am passionate about: researching, writing, publishing, sharing and educating my community here in Darien, and for those of you reading along, about the artistic and scientific connections between dentistry/oral health and culture.