Oral piercings, involving the placement of decorative jewelry in the tongue, lips, cheeks, or frenulum, are increasingly popular, especially among teenagers and young adults. Common jewelry forms include barbells or hoops, with the lips and tongue being the most frequently pierced locations. However, this practice is associated with various local and systemic complications. Immediate complications after tongue piercing include infection, pain, swelling, and bleeding. Late and chronic complications involve traumatic damage to teeth, restorations, gingival tissues, local tissue overgrowth, and persistent difficulty with oral function.
The American Academy of Paediatric Dentistry (AAPD) warns about potential risks such as increased dental plaque levels, gum inflammation, tooth decay, impaired articulation, pain, infection, scarring, tooth fractures, hypersensitivity reactions, localized periodontal disease, Ludwig’s angina, hepatitis, nerve damage, bacterial endocarditis, and even life-threatening complications like airway obstruction. Unregulated salons and piercing techniques have been identified as possible vectors for infectious diseases transmission.
Oral hygiene among individuals with oral piercings is notably worse than in a control group. These individuals have a higher risk of tartar formation, enamel fractures, and non-carious cavities. Complications within teeth and periodontium are common, with habits like playing with piercing jewelry leading to local inflammation, gingival recessions, and dental hard tissue defects. Tongue piercing, in particular, increases the risk of periodontal disease due to the presence of potentially pathogenic bacteria.
There is a prevalence of tooth damage, gingival recessions, and clinical signs of inflammation in individuals with oral piercings. Different types of piercings (lip, tongue) affect various teeth, with molars most threatened by tongue piercings. Tongue piercing is more harmful to the periodontium than lip piercing, increasing the likelihood of periodontal disease. The length and diameter of the jewelry also correlate with the severity of oral changes.
Complications extend to oral mucosa, with lichenoid changes, metallosis (rare condition characterized by the deposition and build-up of metal debris in the soft tissues of the body associated with metal-on-metal (MOM) prosthetic devices) stretch marks, tears, hypertrophic scars, and keloids being common abnormalities. Cytological tests reveal the presence of metal particles, and exposure to metal ions may lead to hypersensitivity reactions, contact allergy, and potentially lichen planus, posing a risk of squamous cell carcinoma. Local complications such as Ludwig's angina may also occur.
The role of dentists is crucial in preventing and treating complications related to oral piercings. Dentists should recognize changes in the oral cavity associated with piercings, provide hygiene instructions, prevent bad habits, and advise on removal if necessary. The overall lack of awareness about the consequences of oral piercings is highlighted, and dental professionals are seen as pivotal in educating and preventing complications. The increasing popularity of oral piercings raises concerns due to associated complications, emphasizing the need for educational and preventive efforts, especially among dental students who may have peers as patients.
Srebrna, A., Sutkowska, P., Szwaj, K., Puzio, N., Szałkowska, J., Strączek, A., Thum-Tyzo, K. (2021). The impact of piercing on various aspects of oral health. J Pre Clin Clin Res., 15(4), 204-207. https://doi.org/10.26444/jpccr/145032
Oral Piercing/Jewelry- more information from American Dental Association
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