ORAL piercings are piercings of the tongue, lips or cheek. In recent years, oral piercings have become a form of self-expression.

As with pierced ears, the metal jewellery used in oral piercings come in different styles, including studs, barbells and rings. However, piercing your tongue, lips or cheek involves greater health risks than piercing your ears. Before having any part of your mouth pierced, you should seek advice from your dentist.

Risks involved with oral piercings

The potential risks of oral piercings include:

• Infection: Our mouths contain millions of bacteria, which can lead to infection after an oral piercing. Handling jewellery once it has been placed in the mouth also increases your chances of getting an infection.

• Prolonged bleeding: If a blood vessel is punctured by the needle during piercing, the result can be difficult-to-control bleeding and serious blood loss.

• Pain and swelling: Pain and swelling are common symptoms of oral piercings. In extreme cases, a severely swollen tongue can actually close off the airway and restrict breathing.

• Chipped or cracked teeth: contact with oral jewellery can fracture teeth. Teeth that have restorations, such as crowns or caps, can also be damaged if the jewellery strikes them.

• Injury to the gums: Not only can metal jewellery injure soft gum tissue, it can cause the gums to recede. In addition to looking unattractive, recessed gums leave your tooth root more vulnerable to decay and periodontal disease.

• Interference with normal oral function: Jewellery in the mouth can cause excessive saliva flow, impede your ability to pronounce words correctly, and cause problems with chewing and swallowing.

• Blood-borne diseases: Oral piercings have been identified by the National Institutes of Health as a possible factor in transmitting hepatitis B, C, D, and G.

• Endocarditis: Oral piercing carries a risk of endocarditis, an inflammation of the heart valves or tissues. The wound created during oral piercing provides an opportunity for oral bacteria to enter the bloodstream, where they can travel to the heart.

Managing patient with oral piercing

Most often, a patient who presents with an oral piercing will not require any special considerations by the oral health care team during routine treatment. However, sometimes removal of oral jewellery is indicated.

During exposure of radiographs, it is often necessary to ask the patient to remove his or her oral jewellery. For panoramic radiographs, all jewellery should be removed above the neck. Cheek and labret jewellery should be removed for exposing periapical and bitewing radiographs due to their location in relation to film placement and the tube head.

In some cases, oral jewellery must be removed under local anaesthesia, with the administration of a mandibular block. When the tongue is anaesthetised, patients should be cautioned that there is increased possibility for tooth damage or accidental biting of the tongue until the anaesthesia has completely worn off.

How long do oral piercings last?

As long as your mouth stays free of infection and your oral piercings do not interfere with normal function, they can stay in your mouth indefinitely. Just be sure to see your dentist at the first sign of pain or problems, in addition to your regular check-ups.

Because of the risks involved, even after the initial wound has healed, such as damage to the teeth or jewellery that becomes loose and gets ingested, your safest bet is to avoid oral piercings altogether.

Dr Sharon Robinson DDS has offices at the Dental Place Cosmetix Spa located at Shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 630-4710 or visit the website www.dentalplace4u.com