Oral piercings and habit shaping

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  Posted by: Dental Design      12th December 2024

Once a form of rebellion and iconic with punk culture, piercings have become a common part of modern lifestyle, joining tattoos as a mostly accepted method of self-expression.[i]

Oral piercings, including those of the lips, tongue and frenulum, are a large part of this, and whilst the latest statistics for piercing prevalence in the UK date back to 2008 – where around 9% were at the tongue, and 4% at the lip[ii] – it’s not unusual to see many individuals with the accessory adorned in everyday life, and especially so in the dental chair.

Patients with a peri-oral or oral piercing need to work closely with their dentist to ensure that the accessory does not negatively impact their oral health. The range of potential complications is extensive, and appropriate steps must be taken to minimise negative impacts.

Dental professionals, alongside professional piercers, are best placed to deliver this advice and recognise the red flags for issues before they rapidly snowball.

Parafunctional problems

It’s important to recognise that by introducing a piercing to the oral cavity, whether buccally or lingually to the dentition, individuals put themselves at risk of experiencing abrasion against the enamel and dentine. Restorations and prosthodontic appliances are also at risk, meaning patients may need to spend further time and money on retreatments.

In one study, problems such as tooth abrasion, chipping and fracture – which occurred in 25% of cases – were likely to be connected with a patient’s tendency to play with the jewellery.[iii] This activity can be advised against by the dental professional, but may become an unconscious habit that is difficult to break for the individual. In any case, patient awareness is fundamental.

Playing with the piercing is not only a risk for destruction and damage to tissue, but a disruption of occlusion too. Holding a piercing between teeth for extensive periods has been described as a cause for tooth migration and diastema development, another issue that is of detriment to function and aesthetics.iii Whilst abrasion, chips and fractures may require minimally invasive restorative care at a minimum, or endodontic care in the most extreme circumstances, this new problem enters the realm of orthodontic care. It may take patients months before the issue is resolved, dependent on how far tooth migration has progressed.

A patient could also be at risk of developing temporomandibular joint disorder after receiving an oral piercing. One study into older adolescents found the presence of an oral piercing was associated with headaches and muscle tenderness on palpation, with more than half of the assessed group presenting moderate-to-severe clinical dysfunction according to the Helkimo index.[iv] Whilst other factors may be present, the new parafunctional actions, such as playing with the piercing, or impacts a piercing has on an individual’s occlusion can be significant causes for concern.

Build healthy habits

Dental professionals need to advise against the potentially unhealthy habit of biting on and pushing any intraoral jewellery, and reiterate the need for a diligent oral hygiene routine.

Increased plaque accumulation on the teeth close to a piercing has been observed as an especially common issue. One study found that a week after the insertion of the piercing, 30% of patients had accumulated plaque at the treatment site.[v] Larger ‘shanks’ (the elements that protrude through the piercing site) have been noted to result in increased plaque and tartar, which can be the cause of infections at the treatment site.[vi]

Many piercers will be unable to sufficiently warn patients of the responsibilities that come with the addition.[vii] This includes adequate cleaning of both the piercing site and the surrounding dentition. Without this, patients may be at a greater risk of developing other well-known oral health problems, such as gingival recession near the piercing site.

Make a difference

 Dentists need to be able to recommend effective oral hygiene solutions on top of twice daily cleaning with a toothbrush, toothpaste and mouthwash. A WaterpikTM Cordless Advanced water flosser could be an ideal solution, as it can remove up to 99.9% of plaque in treated areas,[viii] including at the gumline and interdentally. Patients will find the Cordless Advanced is 50% more effective than traditional dental floss at improving gingival health,[ix] too. With a range of pressure settings, patients can find a mode that is comfortable and effective for them.

Oral piercings are a common form of self-expression with a lot of required upkeep. Patients need to understand the importance of diligent oral hygiene, but also how newfound parafunctional habits could damage their dentition in a variety of ways. Luckily, dental professionals have a fantastic opportunity to offer support in every appointment.

For more information on WaterpikTM water flosser products visit www.waterpik.co.uk. WaterpikTM products are available from Amazon, Costco UK, Argos, Boots and Tesco online and in stores across the UK and Ireland.

 

[i] Malcangi, G., Patano, A., Palmieri, G., Riccaldo, L., Pezzolla, C., Mancini, A., … & Inchingolo, A. M. (2023). Oral piercing: a pretty risk—a scoping review of local and systemic complications of this current widespread fashion. International Journal of Environmental Research and Public Health, 20(9), 5744.

[ii] Bone, A., Ncube, F., Nichols, T., & Noah, N. D. (2008). Body piercing in England: a survey of piercing at sites other than earlobe. Bmj, 336(7658), 1426-1428.

[iii] Kołek, E., Fijałkowska, M., & Antoszewski, B. (2019). Oral and body piercings–are there any complications?. Czasopismo Stomatologiczne, 72(5).

[iv] Mejersjö, C., Ovesson, D., & Mossberg, B. (2016). Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students. Acta Odontologica Scandinavica, 74(4), 279-284.

[v] Srebrna, A., Sutkowska, P., Szwaj, K., Puzio, N., Szałkowska, J., Strączek, A., & Thum-Tyzo, K. (2021). The impact of piercing on various aspects of oral health. Journal of Pre-Clinical and Clinical Research, 15(4), 204-207.

[vi] Plastargias, I., & Sakellari, D. (2014). The consequences of tongue piercing on oral and periodontal tissues. International Scholarly Research Notices, 2014(1), 876510.

[vii] Covello, F., Salerno, C., Giovannini, V., Corridore, D., Ottolenghi, L., & Vozza, I. (2020). Piercing and oral health: a study on the knowledge of risks and complications. International journal of environmental research and public health, 17(2), 613.

[viii] Gorur, A., Lyle, D. M., Schaudinn, C., & Costerton, J. W. (2009). Biofilm removal with a dental water jet. Compendium, 30(1), 1.

[ix] Rosema, N. A., Hennequin-Hoenderdos, N. L., Berchier, C. E., Slot, D. E., Lyle, D. M., & van der Weijden, G. A. (2011). The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol, 13(1), 2-10.

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