What is Oral Piercing?

Oral piercing can cause pain, swelling, infection, drooling, taste loss, scarring, chipped teeth, and tooth loss. Most dentists discourage oral piercing due to the many risks involved. If you do decide to get an oral piercing it is important to understand the regulations, associated problems and proper maintenance.

What should I know before getting an oral piercing?

Regulations on piercing vary from state to state, so it is important to be careful and find a professional who is prepared to answer any and all questions. They should use a fresh needle every time and sterilize all needles and instruments in an autoclave, which uses extreme heat to sanitize the instruments, to avoid serious infections such as HIV or Hepatitis. Also, make sure that they use the right kind of metal, such as surgical-grade stainless steel. Some people have allergic reactions to certain metals, which can lead to further complications.

What problems can the piercing cause?

Fractured teeth are a common problem for people with an oral piercing. People chip teeth on the piercing while eating, sleeping, talking or by chewing on the jewelry. It is possible for the fracture to go deep into your tooth, which may require a root canal or extraction.

Are there serious complications?

While it is not unusual for the tongue to swell after being punctured, in some cases the swelling indicates infection. When that happens, it is possible the swelling will cut off your breathing. In rare cases, doctors may pass a breathing tube through a patient's nose until such an infection passes. Also, rubbing of the barbell on the gums excessively can cause the gums to recede. Any infection can be serious and it is necessary to see a dentist at the first sign of a problem.

How do I maintain my piercing?

It takes three to four weeks for an oral piercing to heal. Unless complications occur, you will be able to remove the jewelry for short periods of time without the hole closing. Dentists suggest removing the jewelry to protect your teeth every time you eat or sleep. The piercer will place a larger, starter "barbell" in your tongue to give it enough room to heal when your tongue swells. If you decide to keep the piercing, after the swelling goes down, get a smaller barbell which will be less likely to get in the way of your teeth and more difficult for you to chew on.

Keep it clean

• Use an antiseptic mouthwash after every meal and brush the jewelry the same as you would your teeth.

• After your tongue has healed, take the piercing out every night and brush it to remove any unseen plaque.

• Consider removing the piercing before eating, sleeping, or strenuous activity.

 

So You Want to Pierce Your Tongue?

Oral piercing can cause pain, swelling, infection, drooling, taste loss, scarring, chipped teeth and tooth loss. Most dentists discourage oral piercing because of these risks.

Regulations vary in each state, so be careful if you decide to get any kind of piercing. Make sure that you ask the person performing the piercing about care after the piercing, possible side effects, cleanliness and anything that may concern you. If they are not prepared to answer your questions in a clear, professional manner, go somewhere else.

Chipped teeth

Fractured teeth are a common problem for people with oral piercings. People chip teeth on tongue piercings while eating, sleeping, talking and simply chewing on the jewelry. The fracture can be confined to the enamel of your tooth or may go deep into your tooth, which may require a root canal or extraction.

Swelling

It is not unusual for the tongue to swell after being punctured, but in some cases the tongue swells so much that it can cut off your breathing. In rare cases, doctors may pass a breathing tube through a patient's nose until the swelling subsides.

Infection

The tongue is covered with bacteria, so any infection can be serious. See your dentist at the first sign of a problem. Dentists are learning that oral infections can lead to infections in other parts of the body. Your mouth has high levels of bacteria. When you puncture any part of the oral cavity, these bacteria may find its way into your bloodstream. Bacteria can reach your heart and cause a variety of health problems.

There is also a risk of contracting blood-borne infections such as human immunodeficiency virus (HIV) and hepatitis. Ask the person performing the piercing what they do to prevent the spread of these serious infections. Does the piercer use a fresh needle for every piercing? Some may reuse needles to keep down the cost of the piercing. Make sure they completely sterilize all needles and instruments in an autoclave, which uses extreme heat to sanitize instruments.

Allergic reactions

Make sure that the piercer uses the right kind of metal, such as surgical-grade stainless steel. Some people have allergic reactions to certain metals, which can lead to further complications.

How do I maintain my piercing?

Once your tongue has been pierced, it will take four to six weeks to heal. The piercer will place a larger, starter 'barbell' in your tongue to give it enough room to heal when your tongue swells. If you decide to keep the piercing, make sure to get a smaller barbell after the swelling goes down, which will be less likely to get in the way of your teeth and more difficult for you to chew on.

Barring complications, you will be able to remove the jewelry for short periods of time without the hole closing. Some suggest that you remove the jewelry to protect your teeth every time you eat or sleep. Some parlors sell plugs that you can place in the hole, which should allow you to remove the jewelry for as long as necessary.

Keep it clean

Keep your piercing clean. Use an antiseptic mouthwash after every meal and brush the jewelry the same as you would your teeth. After the tongue has healed, take the piercing out every night and brush it as you would your teeth to remove any unseen plaque. Consider removing the piercing before eating, sleeping or strenuous activity.

To Pierce or not to Pierce

Have you thought about chipped teeth, drooling, gum damage, nerve damage, taste loss, tooth loss or infection? The problems that can arise from an oral piercing might surprise you.

Fractured teeth are a common problem for people with tongue piercings. People chip teeth on tongue piercings while eating, sleeping, talking and chewing on the jewelry. The fracture can be confined to the enamel of your tooth and require a filling, or it may go deep into the tooth; in which case, a root canal or tooth extraction may be necessary.

"Every time you swallow, the barbell hits the teeth, causing constant irritation that can result in mouth ulcers," says Academy of General Dentistry spokesperson Manuel A. Cordero DDS, FAGD.

Infections are also common. Dentists are learning that oral infections can be linked to other infections. "The tongue is covered with bacteria," Dr. Cordero said. "The moment the tongue is punctured, bacteria are introduced into the blood. When that happens, bacteria can travel to the heart and cause a variety of serious problems."

If you decide to pierce your tongue, take care of it. Once the tongue has been pierced, it takes four to six weeks to heal. Barring complications, the jewelry can be removed for short periods of time without the hole closing. Always remove the jewelry every time you eat or sleep.

To avoid serious infections such as HIV or hepatitis, make sure the piercer sterilizes everything in an autoclave, which uses extreme heat to sanitize surgical instruments. Ask the piercer questions about after-care, cleanliness, equipment and other concerns.

Clean your piercing with an antiseptic mouthwash after every meal and brush the jewelry the same as your teeth to remove plaque.

Dentists Tell Athletes Keep the Mouthguard, Take Out the Barbell

Perhaps more than most people, athletes view their bodies as their temples. Seeking to emulate their professional heroes, a growing number of high school and younger athletes are adorning those temples through oral piercings.

But oral piercing and tongue jewelry place athletes at risk for serious medical and dental consequences, according to the Academy of General Dentistry (AGD), an organization of general dentists dedicated to continuing dental education.

"For years, we have been urging athletes to wear mouthguards when they are playing," says AGD spokesperson Bruce DeGinder, DDS, MAGD. "Now we have to tell them to take the barbell out of their tongues."

According to an article in the March/April 2002 issue of General Dentistry, the Academy's peer-reviewed, clinical journal, one out of every five oral piercings results in infection from contaminated puncture wounds. Athletes are more likely than most people to develop infections because the increased blood flow and breathing rate involved in vigorous exercise, as well as the increased chance of bleeding from a contact injury, can spread infection more quickly.

And the dangers don't stop with infection. In a survey, 24 percent of pediatric dentists reported that they had treated patients with complications resulting from oral piercing. Common problems include bleeding, airway restriction and chemical burns from the use of postpiercing care products. After the piercing is healed, damage to teeth and gums is common.

Suzann P. McGeary, DDS, lead author of the report, says the risks are even higher for athletes. "The athlete who participates in contact sports may be particularly susceptible to airway restriction because an impact may dislodge the tongue jewelry, which could be inhaled. It also could be swallowed, which could cause injury to the gastrointestinal tract."

Damage to teeth by tongue jewelry is another danger intensified by participating in contact sports. "We have seen so many cracks and fractures in teeth caused by clicking, tapping or rubbing the jewelry on them that it has gotten its own name – the wrecking ball fracture," says Dr. DeGinder. "The danger of this is much higher on the playing field." According to Dr. McGeary, the jewelry can also injure the gums and other soft tissue, as well as interfere with proper salivary functioning, conditions that decrease the body's defenses against infection and disease.

Dr. DeGinder's first suggestion regarding oral piercing is, "Don't do it."

Mixing tongue jewelry and a mouthguard is a particularly bad combination, says Dr. McGeary. "The jewelry may interfere with the mouthguard and cause increased salivary flow and gagging or inhibit breathing or speech."

"Remove the tongue jewelry – not the mouthguard," says Dr. McGeary.

A Fatal Fad? Tongue Studs Cause More Problems Than Chipped Teeth

Wearing a tongue stud puts people at risk for chipped teeth, recessed gums and nerve damage. However, most people don't realize that getting an oral piercing also places them at risk for developing a fatal infection, such as Ludwig's angina or endocarditis, according to a report in the May/June 2004 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal.

Ludwig's angina, a bacterial infection of the floor of the mouth, occurs after a tooth infection, mouth injury, oral surgery or oral piercing. After getting an oral piercing, the mouth has an open wound that allows bacteria to travel through the bloodstream. Bacteria can cause the floor of the mouth to rapidly swell, which can block the airway or prevent the swallowing of saliva.

Endocarditis occurs when bacteria travels into the bloodstream through the piercing hole and infects the heart. People with a history of heart defects are at risk for endocarditis. At the dentist's office, a medical history is taken that helps the dentist determine who is at risk, and those patients are given antibiotics prior to certain dental procedures in order to avoid this potentially fatal problem.

"Some body piercers are unlicensed, and most are not members of the medical profession," says William J. Dunn, DDS, MAGD, ABGD, author of the study. "Because of this, health histories are not recorded or reviewed, emergency medical kits are not available, antibiotics are not prescribed and postoperative care is not available."

Postoperative care can also help identify these serious infections before they become fatal. "People are told to expect some swelling from a tongue piercing, but if they don't receive follow-up care, they may not be aware of abnormal swelling," says AGD spokesperson Melvin K. Pierson, DDS.

Unclean piercing equipment can cause other infections, such as hepatitis. Also, if a patient is not instructed to avoid touching the piercing, they might spread infections with their own fingers.

"I don't recommend piercing," says Dr. Pierson. "Because of the risks associated with this unregulated procedure, if someone is considering an oral piercing, they should discuss it with their medical or dental professional."