Intra-oral and peri-oral piercing

Oral Piercing is a practice that is gaining acceptance in the western world as a sign of individuality, marginality, decoration, or group membership. In a recent large-scale survey among Israeli young adults, more than half of the study population was not aware of any of the complications of oral piercing. Pain, bleeding, edema, inhalation, dental and gingival trauma, allergic reaction, contact lesions, impaired mastication, deglutition, and speech, are all potential complications of intra-oral and peri-oral piercing. Piercing can induce local as well as distant site infection and inflammation such as Ludwig's angina, endocarditis and cerebellar abscess. Moreover, Piercing is recognized as a potential vector of viral transmitting. Nevertheless, not all piercers have adequate knowledge in infection control techniques. With the increase number of patients with pierced intra and peri-oral sites, dentists should be prepared to address issues, such as potential damage to the teeth and gingival, and risk of oral infection that could arise as a result of Piercing, as well as provide appropriate guidance to patients contemplating body piercing that involve the oral sites. Since common knowledge is poor, patients should be educated regarding the dangers that may follow Piercing of the oral cavity.     

Formation of mucogingival defects associated with intraoral and perioral piercing: case reports

BACKGROUND: The authors provide clinical findings in five patients wearing oral jewelry to illustrate the risks of experiencing periodontal injury associated with body piercing involving intraoral and perioral sites. They also present a literature review of other adverse dental and medical consequences attributed to oral piercing. CASE DESCRIPTIONS: Five young adult patients with tongue and lip piercing sought dental care. Each patient exhibited some degree of gingival recession and mucogingival defects in proximity of their oral jewelry. Three of these patients had probing depths ranging from 5 to 8 millimeters in the affected areas. CLINICAL IMPLICATIONS: Intraoral and perioral jewelry may be associated with the development of significant mucogingival deformities. Because severe attachment loss can develop even when gingival recession is minimal, it is critical that patients with oral piercing routinely undergo comprehensive periodontal assessment. The authors urge clinicians to educate patients about the potential risks regarding the practice of oral piercing.     

Oral and dental complications of intra-oral piercing

Abstract –  The present study assessed the prevalence of oral piercing among young adults and revealed the types and rate of complications following oral piecing, as well as the awareness of the complications. The study included 400 consecutive patients, who randomly arrived at a military dental office. Before dental examination, patients were requested to fill out a questionnaire regarding oral piercing, their awareness of its complications, and the occurrence of complications related to piercing. Intra-oral examination included special attention to piercing-related complications, such as tooth fractures, gingivitis, bleeding, infections, gingival recessions, etc. A total of 389 patients, 210 (54%) males and 179 (46%) females agreed to participate (97.3% response rate), with an average age of 20.08 ± 1.1 years. Of the participants, 79 (20.3%) reported having at least one type of oral piercing; lingual piercing was the most common. Swelling and bleeding after piercing were reported by 41 (51.9%) and 36 (45.7%) participants, respectively. Among the participants, 225 (57.8%) were unaware of the dangers of intra-oral piercing. Clinical examination revealed 15 fractured teeth in 11 (13.9%) participants with piercing. Gingival recessions were observed in 21 (26.6%), mostly in the mandibular incisor area. Dentists should be aware of the increasing number of patients with pierced intra- and peri-oral sites and to provide appropriate guidance to patients who contemplate body piercing involving oral sites.     

Oral piercing and oral trauma in a New Zealand sample

Abstract –  This study investigated the periodontal and dental trauma resultant from tongue and lip piercings in a convenience sample of 43 adult dental patients. Patients underwent an intra-oral examination followed by the administration of a questionnaire. Each patient was examined for lingual or buccal recession of the upper and lower incisors as well as the extent of abnormal toothwear or trauma on these teeth. Following bivariate analyses, regression analyses were conducted to test the study hypotheses and derive adjusted estimates for the dependent variables. Of the 43 individuals who participated (93.0% females; mean age 21 years; age range 14–34 years) 76.7% had a tongue piercing, 34.9% had a lip piercing, and 11.6% had both. Only four had had their piercing procedure provided by a doctor or dentist. Postpiercing complications were reported by 34.9%. Most of those with a labial piercing (80.0%) had 1+ labial site with gingival recession (GR), and almost one-third of those with a tongue piercing had at least one lingual site with GR. Age was a significant predictor of the prevalence of lingual recession, with the odds of having lingual recession increasing by 1.17 (95% CI 1.01, 1.35) for every year older than 14. Age was the only significant predictor of the number of lingual sites with recession, but was not a predictor of the prevalence of labial recession or the number of affected sites. There were no significant associations between piercings and abnormal toothwear or trauma. These findings suggest that oral piercings are associated with localized gingival recession, and that the providers of such procedures should ensure that, as part of the informed consent process, prospective patients are informed of the likelihood that their periodontal health may be compromised.     

An unusual cause of gingival recession: oral piercing

Wearing so-called jewelry in uncommon sites, termed as body piercing, is gaining increased popularity. There also seems to be a significant increase in oral piercing mainly in the lip and/or tongue. We report a case of multiple oral piercing sites and localized gingival recession as an adverse consequence. Furthermore, based on the medical characteristics of the case, we also emphasize the necessity and importance of professional dental/medical consultation before oral piercing.     

Oral piercing: dental considerations and the legal situation in Spain

Body piercing has become increasingly popular in Western countries, especially among young people. However, not everyone is aware of its potential risks, which may develop local and systemic complications shortly after, or long after the piercing procedure. Given that the oral cavity is one of the most frequent sites for piercing placement, the aim of this paper is to familiarise the oral healthcare professional with oral piercing and its possible sequelae in order to educate patients prior to and after piercing practices and address any complications that may arise.     

Oral and perioral piercings in Tshwane

Oral and perioral piercings have recently become very popular and many patients present at dental clinics and practices with jewellery inserted into the oral and perioral tissues. It is imperative that oral health care professionals become familiar with this practice, become aware of its sequelae, and are able to provide oral health education regarding oral hygiene and care of the piercing. The present study investigated the sites of oral piercings, complications associated with piercings, plaque control procedures practised by piercees, and the attitude and behaviour of piercers towards infection control and prevention of complications after a piercing. A convenience sample was used and 126 piercees and 10 piercers completed a self-administered questionnaire. Of the 126 participants (107 females and 19 males), 88.10% had a tongue piercing, 19.84% had a lip piercing and 7.94% had both. The most common immediate post-procedure sequelae were pain (69.05%), swelling (52.38%) and difficulty eating, speaking and swallowing (70.63%). Long-term complications were reported by 17.56% of the sample, and included chipping of teeth, gingival recession, lesions on the tongue and palate, painful gums, and sensitivity of teeth. Oral health professionals need to be aware of the risk of damage to soft and hard tissue, and their role in informing patients about the potential risks, if consulted before a piercing.     

Oral and perioral piercing: a unique form of self-expression

A comprehensive review of oral and perioral piercing is presented. This contemporary phenomenon has many implications for the piercee and for the oral healthcare professional. Oral and perioral piercing, which have become prevalent recently, both have historical antecedents. The implications of piercing are described in detail including sites at the tongue, lips, cheeks, frenum, and uvula. Complications occurring immediately after, soon after, and long after the piercing are detailed with special emphasis on the possible deleterious effects on hard and soft oral tissues. Suggestions are provided for patient education including a pamphlet for downloading. Appropriate jewelry selection is described and accompanied with a video clip demonstrating removal of jewelry during the dental appointment and a suggested technique for keeping the piercing hole patent while the jewelry is out. Reviewing this information should educate the oral healthcare professional to be prepared for the patient presenting with an oral or perioral piercing.     

Microbiological findings at tongue piercing sites – implications to oral health

Abstract: Background: Body piercing enjoys a widespread popularity among juveniles and young people. The tongue is the most commonly pierced oral site. Tongue jewellery, however, can damage the teeth and periodontium and may provide an ideal environment for microorganisms. The aim of this report was to investigate if and in case in which amount periodontopathogenic organisms can be found at tongue piercing sites. Methods: Patients with tongue piercings visiting the authors’ dental office for a dental check‐up volunteered. A questionnaire was used to collect data on the type of material used in the piercing, the time the device was in place, oral and piercing hygiene practices and smoking habits. The dental examination included an oral hygiene index and the periodontal screening index. From the surface of the piercing jewellery adjacent to the tongue perforation, microbiological samples were collected and analysed for the presence of 11 periodontopathogenic bacteria. Results: A total of 12 patients with tongue piercing were asked and examined. Their tongue piercings had been in place between 2 and 8 years. The microbiological analysis showed an increased or substantially increased concentration of periodontopathogenic bacteria in all cases. It became obvious that the longer a piercing had been in place, the more pronounced was the shift from bacteria with a moderate periodontopathogenic potential to bacteria with a high periodontopathogenic potential. Conclusion: Tongue piercing provides a potential reservoir for periodontopathogenic bacteria.     

Lip and tongue piercing: experiences and views of general dental practitioners in South lancashire.

PURPOSE OF THE STUDY: To ascertain the numbers of patients with pierced lips or tongues seen by dentists during routine consultations. The study also examined the provision of advice by dentists, and the nature of piercing-related complications. BASIC PROCEDURE: A postal questionnaire was sent to dentists in two Primary Care Trust areas in South Lancashire. MAIN FINDINGS: Sixty-four of the 106 questionnaires were returned, giving a response rate of 60%. Sixty-two dentists (96.9%) reported that they had seen patients with lip or tongue piercings during the previous 12 months and that they had seen a mean number of 2.8 patients with lip piercing and a mean of 9.0 patients with tongue piercing. A total of 56.5% of the dentists gave advice on oral hygiene and 79.0% on possible damage to the oral structures. Twenty-seven dentists (43.5%) said that their patients had oral health problems as a result of lip or tongue piercing. PRINCIPAL CONCLUSIONS: The dentists who responded to the questionnaire commonly saw lip and tongue piercings. All dentists should therefore be prepared to offer appropriate advice. A public health information leaflet available in all medical and dental practices would help to ensure that patients were better informed about body piercing and its complications.     

Oral piercings and their dental implications: a mini review

Oral piercing has become common in young adults in recent years. Adolescents are characterized by a compulsive tendency to distinguish themselves from the rest; differences in clothes, hairstyle, or "decorative" details are used to this effect, based on highly-diverse criteria. Dental health-care professionals need to be aware of the procedures and risks involved with oral piercings and the social and psychological reasons that lead people to engage in this practice, regardless of the risks. The present article addresses oral mutilation practices, specifically from the oral health perspective, as it is of concern to dental professionals due to the health risks and oral complications associated with such practices. The various oral ornaments, piercing sites, and their implications, orally, as well as systemically, have been discussed.     

Dental and oral complications of lip and tongue piercings

Piercing of the tongue and perioral regions is an increasingly popular expression of body art, with more patients coming in for a routine check-up with tongue and/or lip piercings. Several complications of oral piercing have been reported, some of which are life-threatening. In the present clinical survey the prevalence of both tongue and lip piercing complications in oral health was assessed in a group of 50 patients. The most common dental problem registered was chipping of the teeth, especially in association with tongue piercing. Gingival recession was seen as a result of lip piercing with studs. Post-procedural complications included oedema, haemorrhage and infection. Therefore, dentists and oral and maxillofacial surgeons should be given more authority to advise patients with oral and facial piercings or those who plan to acquire this type of body art.     

Oral piercing: the hole story

Oral and perioral jewelry is increasingly being viewed as an acceptable fashion statement in our society. Accordingly, dental professionals are being presented with questions by their patients as to the risks associated with this form of body piercing. This article reviews recommendations for individuals with, or contemplating, an oral piercing, common locations of piercings, risks associated with the piercing procedure, types of jewelry used, and post-piercing home care instructions. Current trends in the piercing industry will be discussed, and the recommendation made that dental professionals advocate for improved safety standards at body modification studios.     

Elective lip piercing and gingival recession: case report

Elective oral piercing as a form of ornamentation or self-expression appears to be gaining popularity in New Zealand and around the world. Several reports of the dangers associated with this practice appear in the dental and medical literature. This report presents a case of rapid, severe gingival recession in a previously periodontally-healthy young female, arising from trauma due to her lip piercing. The aetiology, diagnosis and treatment of her condition are outlined, as well as criteria for the dental community to consider when evaluating patients with facial piercing. The report highlights some of the dangers associated with oral piercing and raises questions concerning potential risk factors for such trauma.     

Orofacial piercings: perceptions of dental practitioners and piercing parlours.

OBJECTIVES: To identify the advice given by piercing parlours prior to orofacial piercing and to determine how many dental practitioners see complications from orofacial piercings. METHOD: Administered questionnaire to 19 piercing parlours and postal questionnaire to 400 dental practitioners in south-east Wales. RESULTS: Ninety-nine per cent of 227 dental practitioners in south-east Wales had treated patients with orofacial piercings, over three-quarters had seen a patient for a complication caused by the piercing, and over half (N=120) had treated a patient for a complication of piercing. Tongue (N=225) and lip (N=209) piercings were most frequently seen and the most commonly occurring complication was fractured or cracked teeth (N=176). Almost all practitioners wanted more information on orofacial piercing and its sequelae. All 19 piercing parlours in south-east Wales warned clients about pain following piercing and 18 mentioned swelling; only four discussed possible damage to teeth and none discussed the risk of airway obstruction. CONCLUSIONS: Despite the concerns of dental and medical professionals orofacial piercing remains popular and the complications it causes are frequently seen by dental practitioners. There is a need for literature to assist both dental practitioners and piercers in advising and safeguarding patients.     

Tongue piercing and insertion of metal studs: three cases of dental and oral consequences

"Body art" is a fashion that appears to be gaining popularity worldwide. There are many risks and potentially adverse results associated with tongue piercing. Pain (the procedure is performed without anesthetics), post-placement edema and the risk of prolonged bleeding, if the blood vessels are punctured during the piercing, and fracture of tooth structures, are but a few of the risks. The purpose of the present article is to describe the consequences of three cases of tongue piercing in which metallic barbell-shaped studs were inserted: the consequences include the fracture of tooth structure, caused by the device knocking against the teeth; and inflammation and edema occurred as a result of the piercing of the tongue.     

Prolonged bleeding following tongue piercing: a case report and review of complications

The number of adolescents and young adults undergoing intraoral piercing is increasing in the United States. Numerous articles have documented complications following intraoral piercing. This article presents a case of prolonged bleeding and reviews other documented sequelae following intraoral piercing. The article may serve as a guide to dental professionals whose patients seek advice regarding these procedures.     

Gingival recession due to trauma caused by a lower lip stud

Body piercing seems to be increasing in popularity, with more patients attending for their routine check-up having had a tongue or lip stud placed. Many complications have been documented, some of them, particularly involving tongue piercing, can be life threatening. There appears to be fewer problems associated with lip piercing; however this case study illustrates the damage that a lip stud can cause to previously healthy gingival tissue.     

Dental and periodontal complications of lip and tongue piercing: prevalence and influencing factors

Background: The aim of this study was to compare the prevalence of lip and tongue piercing complications and explore the effect of ornament time wear period, habits, ornament morphology and periodontal biotype on the development of complications. Methods: One hundred and ten subjects with 110 lip and 51 tongue piercings were assessed for abnormal toothwear and/or tooth chipping/cracking (dental defects), gingival recession, clinical attachment loss and probing depth of teeth adjacent to the pierced site. Piercing habits (biting, rolling, stroking, sucking) were recorded. Results: Wear time and habits significantly affected the prevalence of dental defects and gingival recession. Pierced site significantly affected dental defects prevalence, with greater prevalence for tongue than lip piercing. Wear time significantly affected attachment loss and probing depth. Attachment loss and probing depth did not significantly differ between tongue and lip piercings. Gingival recession was significantly associated with ornament height closure and stem length of tongue ornaments. Periodontal biotype was not significantly associated with gingival recession, attachment loss and probing depth. Conclusions: Dental defects prevalence is greater for tongue than lip piercing. Gingival recession is similar for tongue and lip piercing. Longer wear time of tongue and lip piercing is associated with greater prevalence of dental defects and gingival recession, as well as greater attachment loss and probing depth of teeth adjacent to pierced sites. Ornament morphology affects gingival recession prevalence.     

Oral piercing: complications and side effects

PURPOSE: To review current relative literature on oral piercing regarding its prevalence, complications and possible side effects An increasing number of patients present to their treating dental professionals wearing jewelry inserted into the peri-oral and intra-oral tissues. Since the literature is mainly confined to individual cases or a small series of patients, it is difficult to assess the magnitude of risks that face individuals with oral piercing. METHODS: The current study was based on scientific literature published in English regarding oral piercing. A Medline search, using the PubMed Bibliographic Index to identify clinical articles published between January 1992 and August 2007, found 11 articles on the prevalence of oral piercing, and/or on the prevalence of complications and side effects. RESULTS: Three studies reported the prevalence of oral piercing (ranging from 3.4% to 20.3%). Immediate post-operative complications reported were swelling and/or infections (24%-98%), pain or tenderness (14%-71%), and bleeding or hematoma. Jewelry-related complications mainly consisted of tooth fractures and wear (14%-41%) and gingival recessions (19%-68%).