OBJECTIVE: To measure the presence and severity of dental disease, as assessed by physicians, among consecutively hospitalized alcoholic and nonalcoholic medical patients. DESIGN: Descriptive cross-sectional study. Patients who had Michigan Alcoholism Screening Test (MAST) scores > or = 8 were identified as being alcoholic. Nonalcoholic patients were defined as individuals with MAST scores < or = 4. These patients were matched with alcoholic patients for gender and age (+/- 5 years). The decayed, missing, and filled teeth (DMF) score and its components were used as a measure of dental disease. SETTING: General wards of internal medicine of a 1,000-bed urban teaching hospital in Lausanne, Switzerland. RESULTS: Among patients aged 20-75 years, the mean DMF score was higher among alcoholic patients than among nonalcoholic patients (26 vs 23, respectively; p < 0.001). This difference was greater among patients aged 20-39 years (20 vs 14, respectively) than among those aged 60-75 years (29 vs 27, respectively). The positive association between alcoholism and dental disease (crude odds ratio, 2.24; 95% CI, 1.15-4.31) remained after sequential stratification for several confounding factors. CONCLUSION: The study suggests that dental disease is frequent and severe in hospitalized medical patients and that alcoholism is an independent predictor of its severity. Routine assessment of dental disease by the physician is important for medical inpatients, especially among those who are alcoholic.