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Oral jewelry can cause dental havoc

Your teenage daughter wants to get a piercing—on her lower lip. A recent business school grad is concerned he’ll be turned down for a job—because of the gold grills on his teeth. A local receptionist is finding she has to repeat things twice. Could it have anything to do with the new stud in her tongue?

Piercings and grills may sound like fun and look cool. However, the appeal of oral jewelery, especially among young people, can cause problems.

“Many risks and complications can occur with these procedures including chipped teeth, decayed teeth, receding gums, pain, swelling, infection, nerve damage and excessive bleeding,” says Dr. Kevin Walsh, a dental surgeon in Windsor, NS.

In addition, oral jewelry can be swallowed—or cause someone to choke. It can also lead to speech impediments, difficulty chewing, and changes to your bite. Metal allergies are also a concern.

Serious problems can start before any jewelry is even in place on the tongue, cheek, lip, teeth or uvula (the fleshy extension that hangs above the throat). The person performing the procedure may not be regulated or have proper training or equipment including effective sterilization techniques. “Transmission of Hepatitis B and HIV/AIDS is a concern,” says Dr. Walsh.

Dr. Walsh recommends anyone considering oral jewelry start by having a conversation with their dentist to discuss the pros and cons of their specific situation. The next step is to make sure that the person performing the procedure is properly trained and has a clean working environment with a sterilizer. “If you are having a piercing, seek out a provider who is a member of the Association of Professional Piercers and who adheres to acceptable standards of health, safety and training,” he says.

All body piercings bring a risk of infection, but the mouth has a large variety of bacteria, which carries an even higher risk of infection. Depending on what you have done, your provider should tell you how to reduce the risk of infection and other complications. “During the healing stage, for example, care should be taken to avoid any foreign objects that could harbour bacteria such as gum, tobacco, and fingernails,” says Dr. Walsh.

Once the jewelry is in place, proper oral health care is essential. This includes regular cleaning around the area, removing the jewelry at night, and using an antiseptic mouth rinse.

With tongue piercings, a longer bar is often used initially to account for swelling. “This should be changed after the tongue heals to a shorter bar less likely to cause damage to the teeth and gums,” says Dr. Walsh.

It’s important to “ensure the removable portion is tightened daily to decrease the chance of swallowing any part of the jewelery.”

There are other steps you can take to reduce the risk of problems. Plastic balls on tongue piercings, for example, will not chip teeth as easily as metal ones. People can also react to some metals; inert non-toxic metals, such as stainless steel, 14K gold, niobium and titanium, are less likely to cause a reaction. Grills that fit well and are removable usually cause fewer problems than grills where the teeth are modified or the grill is cemented to the teeth.

Many complications can take years to occur. One study of 52 adults with tongue piercings found no fractured teeth or gum complications if the jewelry had been present for less than two years. After this time, however, more than half had receding gums, and after four years nearly half had fractured teeth.

“Teens...often rely on peers for advice on decision-making. It is less likely their friends who have not had their piercings for long will have experienced any ill-effects,” says Dr. Walsh.

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