Oral Piercings [Complications, Treatment & Patient Education]

Oral piercing of the tongue, lip, cheek, or other soft tissues is a popular form of body art and self-expression. These piercings are most commonly seen in adolescents and young adults, with the tongue being the most frequent site for oral-piercing placement.

These lip and tongue piercings can lead to oral piercing complications, including potential risks to denture procedures.

Complications

Oral piercings can lead to numerous complications, including a decrease in immunoglobulins, particularly in blood clots, which can compromise the body’s ability to fight infection.

Further oral piercing risks include:

• Tooth fracture restoration
• Abrasion
• Tooth sensitivity
• Pulpal pathology
• Gingival recession
• Tooth mobility
• Electrogalvanism
• Pain
• Ulceration
• Penetration into tissues
• Hyperplasia
• Integration into tissues
• Rejection and migration
• Oedema leading to airway risk
• Inhalation
• Sialadenitis

Oral Piercings and Periodontitis

A study led by Professor Clemens Walter of University Medicine Greifswald, Germany, found that many individuals with oral piercings had deep pockets and gaps around their teeth, as well as receding and bleeding gums—symptoms indicative of periodontitis, or gum disease, which can result in tooth loss.

Professor Walter stated, “People with tongue and lip piercings should remove them to protect their teeth and gums from further damage.”

It is estimated that approximately 5% of young adults have oral piercings, with the tongue being the most common site. Women are around four times more likely to have an oral piercing than men. A systematic review, found significant evidence of the negative impact of piercings on oral health. The studies compared teeth and gums adjacent to the piercing with those elsewhere in the mouth.

Regarding tongue piercings:

• Three in five studies found deeper pockets around teeth next to the piercing.
• Three in four studies observed wider gaps.
• All four studies that examined patients for receding gums found this problem in those with tongue piercings.
• Two in three studies found bleeding gums.

For lip piercings:

• The main finding was receding gums, observed in three out of four studies.

The findings indicate that oral piercings, particularly those in the tongue, can have a detrimental impact on the surrounding teeth and gums. Damage from tongue piercings was especially pronounced around the bottom two front mandibular incisors, which play a crucial role in biting and chewing food.

Moreover, the risk of harm to both teeth and gums seemed to escalate the longer a tongue piercing or lip piercing was worn. This highlights the importance of considering the potential long-term effects of oral piercings on dental health.

Considerations for Patients with Oral Piercing

Remember, these mouth piercings come in various forms, such as studs, rings, hoops, and barbells, in the intraoral or perioral region. This can include the upper lip, lower lip, and the standard tongue piercing.

As stated, these piercings, especially those of the tongue and other intra-oral piercing sites, are associated with an increased risk of tooth fracture, chipping, wear or abrasion, gingival recession, and potentially traumatic lacerations. Additionally, individuals with oral piercings face a heightened risk of infection due to the vast number of bacterial species in the oral cavity.

Post-Piercing Care

If a patient comes to you within the first five days after receiving an oral piercing they can expect pain and swelling. To manage these symptoms, the use of an alcohol-free mouthrinse is recommended to cleanse the mouth and the site of the piercing.

Once the swelling subsides, it is important for patients to revisit their piercer to replace the initial, longer piece of jewelry with a shorter one. This adjustment helps to minimize damage or irritation to oral tissues. Ideally, the patient will remove the oral piercing due to its inherent risk and potential damage to teeth and gums.

Oral Hygiene Recommendations

To reduce the risk of oral infections post-piercing, individuals should maintain a rigorous oral hygiene regimen that includes:

• Brushing teeth twice daily with fluoride-containing toothpaste and a soft-bristle toothbrush.
• Regular use of floss or another interdental cleaner.
• Using an alcohol-free mouth rinse during and after the healing period.

Risks of Oral Jewelry

Research indicates that oral piercing objects, such as barbells, can serve as sites for plaque accumulation and higher concentrations of periodontopathogenic bacteria. Similar risks are associated with tooth gems, dental grills, and other oral jewelry, which can increase the risk of caries and periodontal infections over time, particularly when oral hygiene practices are insufficient.

Therefore, long-term wearing of oral jewelry is discouraged due to potential adverse oral health outcomes, including dental caries (from food particles and debris entrapment), enamel damage, chipped teeth, or periodontal inflammation.

Patients should exercise their best judgment when considering or pursuing such procedures to minimize the risk of adverse events or deleterious outcomes, such as insufficient infection control and instrument sterilization.

Oral Piercings and Dentures

Patients should be informed that oral piercings pose inherent risks for individuals with dentures. The presence of piercings can complicate the fit and comfort of dentures, leading to increased irritation and potential damage to both the dentures and the oral tissues.

Movement of the jewelry can cause abrasions and ulcerations, while metal piercings can interact negatively with the materials used in dentures, potentially causing electrogalvanism and discomfort. Clearly, the decrease in blood clots are also a primary concern for denturists, especially regarding implants and the healing phase.

General Recommendations

Patients with an oral piercing or split tongue should:

• Keep their piercing site clean.
• Avoid playing with oral-piercing jewelry.
• Monitor their oral cavity for signs of infection, such as swelling, pain, tenderness, or unusual discharges with an offensive odor.

All forms of intraoral or perioral jewelry, including tongue barbells, lip rings, or studs, should be removed before participating in athletic and other physical activities, particularly contact and collision sports, to prevent injury.

By following these guidelines, patients can better manage their oral health and reduce the risks associated with oral piercings and jewelry.

Deliver Excellent Patient Results With Stomadent

While oral piercings are a form of self-expression, they come with significant risks that can affect dental health. Proper education and preventive measures are essential to mitigate these risks.

At Stomadent Dental Laboratory, we prioritize superior patient results and support your education efforts. When you require denture products, our dental lab has a quick turnaround and excellent processes and services.

Ensure quality patient outcomes with Stomadent.