Oral Piercing

American Academy of Pediatric Dentistry - Council on Clinical Affairs

Policy Statement on Intraoral and Perioral Piercing, May 2000

Piercing has oral health implications and the use of intraoral jewelry on piercings of oral and Perioral tissues has been gaining popularity among adolescents and young adults. Oral piercings involving the tongue lips, cheeks and uvula have been associated with several conditions. Theses pathologic conditions range from scar formation and tooth fracture to metal hypersensitivity reactions and infection. Un attended infection sites can lead to tissue hyperplasia and airway obstruction. Unregulated piercing parlors and techniques have been identified by the National Institute of Health as a possible vector for disease transmission (i.e. hepatitis, tetanus, tuberculosis) and as s cause of bacterial endocarditis in susceptible patients.

The American Academy of Pediatric Dentistry strongly opposes the practice of piercing intraoral and Perioral tissues and use of jewelry on the intraoral and Perioral tissues due to the potential pathological conditions and sequelae associated with theses practices.

References:
1. Management of Hepatitis C and Infectious Disease. NIH Consensus Conference Statement 105. Section 5 paragraph 2. March 24-26, 1997
2. ADA Statement on Intraoral/Perioral Piercing. ADA Position Statement. October 4, 1999.
3. R. Boardman and R.A. Smith; Dental Implications of Oral Piercing. Journal of the California Dental Association. 25-3 March 1997. Pp 200-207.
4. Tongue Piercing - A Dangerous Fashion. FDI World 5/99. Pp 6-7

Oral Piercing - The culture, process, and results

Body decorating by tattoos and piercing is one of the most prevalent forms of self-expression in many societies. While tattoos have been popular in some groups for years, oral piercing is becoming more popular with our teens and young adults.

The appeal of tongue and Perioral piercing is that it is different, a conversation piece, and something that make the individual stand out as one who defies society. Many do it at the spur of the moent, just for fun. Others do it as a group activity.

The technique is done in piercing parlors that are not controlled for infection control and vary in the care of the piercer. The client may rinse with a liquid that is supposed to be antiseptic, like a mouthwash, the tongue is examined and the piercer and client mutually decide the location of the hole. Either the area is marked with a dye, or a clamp type device with a hole in it is placed on the tongue. No anesthetic is used. If a topical is used, it is an over the counter preparation and is minimally effective on the surface only. A large hollow needle is shoved through the tongue. It is extremely painful, and many individuals who have had it done would not have it done again. Of course there are those who are very pain tolerant. The tongue bar is placed through the needle and a ball is screwed on the bottom. The needle is removed and another ball is screwed on the top. Initially a long barbell is placed as the tongue swells up a lot initially, a few weeks later a shorter barbell is placed. Softer food and a liquid diet is indicated initially.

One has to be careful with what they eat and learn how to chew differently than before so one doesn't bite down on the ball. The tongue has to completely learn how to function differently. A depression is formed on the surface of the tongue, and playing with the ball can bruise the palate. Also the ball can rub against the gums and cause recession and tooth loss. Many molar teeth are cracked when biting down, and front teeth are chipped and weakened due to playing with the bar. A fractured tooth may often require a crown and root canal treatment costing up to $1800 per tooth. Fixing a smaller chip on a tooth can cost between $250 and $500.

The barbell needs to be taken out periodically to clean the plaque off the bar to prevent infection. Many people who have tongue piercing have the bar removed due to discomfort, dental complications, or to get a job. There are many who don't feel Perioral and tongue piercing is professional and will not hire a candidate with piercings.

Center for Pediatric Dental Care * 1560 Beacon Street * Brookline, MA 02446 * 617-731-KIDS (5437)