Oral Piercing Jewelry Can Increase Risk for Tooth Loss, Researchers Report

Having one's tongue, lips or cheeks pierced and ornamented with jewelry might be hip and socially desirable, but those mouth
adornments could produce undesirable results for the teeth and gums.

According to the cover story in this month's Journal of the American Dental Association (JADA), these undesirable results include increased risk for recessed gums, loose teeth and even tooth loss. Additional consequences could include chipped or fractured teeth, pain, infection, and inflammation or nerve damage at the piercing site.

"Wearing oral piercing ornaments, even over relatively short periods, may result in significant deformities to gingival tissue (gums) that might not respond satisfactorily to surgery and, in fact, may lead to tooth loss," writes lead author, John K. Brooks, D.D.S., clinical associate professor, University of Maryland Dental School, Baltimore.

The JADA article references the most commonly pierced oral sites as the tongue and lip at 81 percent and 38.1 percent, respectively. Tongue piercing may damage gum tissue behind the lower front teeth, while lip piercing may injure gum tissue in front of the lower teeth, according to the article.

In the article, the authors present five case reports of young adults with intraoral and perioral piercing jewelry and the health of their gums adjacent to the jewelry.

In each of the cases, the subjects exhibited some degree of gum recession and gum injury near the site of their oral jewelry. Three of the patients had probing depths or pockets (spaces between teeth and gums) around the teeth that ranged from 5 to 8 millimeters, which may indicate moderate to severe periodontitis. Probing depths indicate the amount of attachment loss or depth of pockets that have developed between the gums and teeth. When the attachment loss is severe, the teeth can loosen, fall out or require removal by a dentist.

In one case report, a healthy 19-year-old woman wore a barbell-like piece of jewelry through her tongue. The tongue had undergone piercing approximately 12 months earlier. The periodontal examination revealed a probing depth of 6 mm around tooth No. 25 (bottom mid-front tooth).

However, upon examination five months later, there was gum recession and the probing depth increased to 8 mm, with the tooth's prognosis classified as guarded.

"Because severe attachment loss can develop even when gingival recession is minimal, it is critical that patients with oral piercing routinely undergo a comprehensive periodontal assessment," writes Dr. Brooks.