Oral piercings and jewellry are not a new phenomenon. In many cultures over the centuries, the piercings and the jewellry design were signs of social status, wealth, and even position with a family order. While they sometimes fell out of favour, oral piercings have surged in popularity in North America since the latter part of the 1980s.

This has led many to wonder what effects, if any, oral piercings have on dental health. For some people, the answer is none at all. Others have developing conditions or found themselves at greater risk for certain types of dental issues. If you are thinking of getting any type of oral piercing or already have one, here is some information that you can put to good use.

Understanding the Different Types of Oral Piercings

Oral piercings may be place in any area of the oral cavity. Currently, there are several types of oral piercings that are popular among various age groups:

• Tongue Piercing: The piercing can be placed anywhere along the surface of the tongue. One of the more popular options involves using a piece of jewellry that is shaped somewhat like a barbell. The result is two round studs that in the top of the tongue. In fact, the design is sometimes referred to as a barbell piercing.
• Uvula Piercing: This piercing may involve a single stud, or a bar design similar to those used for the tongue. Considered a more discreet placement, it’s only possible to see the piercing when the person opens his or her mouth widely.
• Inside Lip Piercing: A piercing may also be placed along the inside of the upper or lower gum. The jewellry may be a single stud, a ring, or a custom design of the person’s choosing.
• Gum Piercing: This involves piercing the gum tissue and inserting some type of ring or stud. Typically, the placement is along the base of the gum, under the area where the tooth root would reside. A popular option is to tattoo the gum tissue and strategically place one or two studs or rings within the tattooed area.

There are variations on these types of oral piercings. The options are usually limited only by the imagination of the person who wants the piercing and skill of the artist who will manage the process.

The Popularity of Oral Piercings and Jewellry in North America

Body piercing is nothing new. Females of different ages have long used ear piercing as a form f body ornamentation. In recent years, pierced ears have become increasingly common for men in western cultures. During the last couple of decades, oral piercings have become less of an underground fashion statement and more mainstream

While there is evidence that people in multiple age groups are opting for body art, including oral jewellry, there are several studies indicating that people between the ages of 18-29 are more likely to be interested in this form or ornamentation. Those in the 30-49 age range follow next.

Overall, there is more acceptance among each age group in terms of others having body and oral ornamentation. As with those who choose to get oral piercings, it’s the 18-29 age group that is the most accepting of piercings for all genders. The level of acceptance tends to decline with older individuals.

This trend is not limited to North America. In the United Kingdom, particularly Great Britain, the last couple of decades have seen an increased interest in body and oral piercings. In some areas of the UK, attempts to prevent piercings by individuals under the age of 16 or 18 take the form of local statutes, regulations by professional organizations, and even laws.

In Canada, many provincial associations as well as laws in certain jurisdictions require that people who want tattoos or piercings to be at least 18 and present a valid form of identification. There are exceptions made for people who are at least 16 and have formal permission from a parent or legal guardian.

Do the Major Dental Associations in North America Have Official Positions?

Both the American Dental Association (ADA) and the Canadian Dental Association (CDA) as well as some dentists in Mississauga, Barrie, Toronto and North York have published official positions on the connection between oral piercings and dental well being. The position issued by the CDA focuses on both potential risks as well as recommendations for those who already have piercings.

The CDA Position on Oral Jewellery lays the groundwork for the remainder of the document in the opening paragraph:

“Body art is increasing in popularity within a largely unregulated industry. It includes tattooing, body piercings and oral jewellery, which consists of soft tissue piercings and/or objects attached to teeth. All body piercing presents a level of risk of infection. Because of the presence and variety of bacteria in the oral cavity, oral piercings are considered to have higher risk and are therefore, strongly discouraged.”

People who are considering oral piercings would do well to learn more about the potential compromises to dental health. While it’s true that not everyone with a piercing will develop a dental issue, understanding the risk and what can be done to minimize it is important.

The Risk of Gum Infection

There are studies indicating that people with tongue piercings have as much as a 26% increase in the risk of developing a gum infection. Much of this has to do with the bacteria that can collect at the piercing site and then transfer to the gum tissue proper. Depending on the placement of the piercing on the tongue, it may come in direct contact with the gums constantly. When that happens, the transference of a greater amount of bacteria to the gum surface and possibly at the site where the teeth protrude from the gum is increased.

What About Infection at the Piercing Site?

The piercing site itself is cause for concern. The potential for the piercing to become infected increases when the individual is less than diligent with dental hygiene. Some signs that the piercing is infected include discoloration, a sensation of hardness in the soft tissue of the tongue, and increased sensitivity to hot and cold beverages.

Is It Possible to Crack a Tooth If You have a Piercing?

A CDA Clinical Practice publication entitled “Tongue Piercing and Associated Tooth Fracture” cites the case of a young man who presented himself to the undergraduate clinic at the University of Alberta. The man was complaining of worn and chipped teeth, including some problems with upper and lower molars.

For the most part, the patient’s medical history was uncomplicated. Other than smoking, he appeared to have no chronic or ongoing medical conditions. His work did create some stress, which could contribute to the wear on his teeth. He appeared to practice good oral hygiene habits based on the amount of plaque and tartar present.

 It was only when he mentioned that he did wear a tongue jewellry that the fractures and wear on the enamel that the medical team began to see a pattern. The patient slipped the jewellry into position. When he moved his tongue, the jewellry came into direct contact with the teeth. This explained the damage that the team found on the incisal edges of teeth #12 and #31along with damage on the lingual surfaces of a a few other teeth.

The patient selected stainless steel jewellry for his mouth piercing Toronto, Unfortunately, the placement and the type of materials used for the jewellry had led to multiple fractures to the teeth.

Piercings and the Potential to Chip a Tooth

As it’s possible to crack teeth based on the placement and type of jewellry used for the piercing, there is some danger of chipping one or more teeth. While molars are often cited as the being at a greater risk, it is possible to chip incisors and even the canine teeth. While the use of dental crowns and possibly veneers will help, they will do little to prevent further damage to the other teeth. Even when the chipped area is filled in and the tooth is reinforced with a veneer, there is still the potential to crack or fracture the same tooth in the future.

Piercings and Gum Recession

Gum recession is a serious condition that can make it more difficult for the teeth to remain in place. Owing to the collection of bacteria that can occur when mouth piercings are present, it is possible to trigger a change in the gum tissue. A study conducted by Levin Liran and Adik Yehuda and published in October 2007 points out the potential effect of this type of ornamentation on dental health.

The paper, entitled "Oral Piercing: Complications and Side Effects," identified a 19% to 68% rate of recession of gingival tissue among patients who had tongue ornaments. A further analysis of the data used for the study indicate that patients with piercings that were closer to the edges of the tongue were at a higher risk for gum recession.

The Effect on Healing After Future Dental Procedures

Since the piercings can lead to a greater level of bacteria in the mouth, it should come as no surprise that the presence of the jewellry could slow the healing process. Patients who have piercings and especially those who decide to leave them in while recovering from a root canal, an extraction, or any type of oral surgery may find that it takes longer to heal.

Do the Risks Increase if I Get Oral Tattoos Along With My Piercings?

Piercings are not the only form of oral ornamentation that have increased in popularity. Tattoos along the gums and on the tongue are also increasingly accepted as a form of personal expression. If you opt for a tattoo to go along with your mouth piercing and choice of jewelry, the odds of developing some type of dental issue are much higher.

Much of this has to do with the type of ink used for the tattoo. For example, mercury sulfide is a common ingredient in the ink. This can lead to soreness, swelling and damage to the soft tissue in the mouth. It also leads to an increased amount of bacteria that is difficult to control using typical methods of dental hygiene. If you are thinking of a custom piercing that includes tattoos along with jewellry, talk with a professional about possible side effects and how to manage them responsibly.

Five Things You Can Do to Minimize the Risks

Obviously, the most effective way to avoid the risks associated with oral piercings is to decide against them. If you really want one or more piercings, there are things you can do to offset at least some of the risk. Most of these approaches are good for your dental health in general.

• Always have an annual dental exam. This will make it easier to identify any issues that are developing while they are still in the early stages. Prompt treatment is the best way to prevent damage to the teeth, tongue, and gums.
• Have teeth cleanings quarterly. During the cleanings, the dental professional will also look closely at the tissue surrounding the piercing site. A thorough cleaning by a professional helps to minimize the risk for infection.
• Choose something other than metal jewellry. There are attractive plastic options that are less likely to cause damage to the teeth and are equally easy to remove when you like. You reduce the potential for cracking or chipping the teeth while still enjoying the look.
• Observe a strict regimen for your daily oral hygiene. Brush after meals, floss regularly, and use a higher quality mouthwash that’s capable of reducing bacteria levels in the mouth. If you have a tongue piercing, remember that brushing the tongue as well as the roof of the mouth will help.
• Placement of the piercing is also important. If you are thinking of getting a tongue piercing, go for one that’s along the middle rather than closer to the edges. There’s less risk of the jewellry damaging the teeth. 

Choosing to invest in any type of oral piercing is a personal choice. Make sure you understand the potential risks and what you can do to keep that level of risk as low as possible. Select your jewellry with care and remember to take care of your teeth every day. In the long run, you will find that the piercing is something you enjoy and that your general dental health remains high.