Rooted in ancient history, with cultural and religious significance, body piercings have become increasingly popular in Canada as a form of self-expression, individuality, spirituality, and adornment.
Of particular relevance to dental professionals are the intraoral and perioral locations for piercings, including the tongue, lip, cheeks, labial and lingual frenula, and uvula. As dental professionals, it is our responsibility to educate and inform our patients about the various oral health risks and complications these piercings can result in if they are not properly cared for. Communicating these risks to patients requires tact, empathy, and a clear understanding of the potential consequences.
Before addressing the risks and complications, it is important to acknowledge the perspective of the patient. Many individuals choose to get piercings as a form of self-expression or cultural significance. Understanding and respecting their reasons can help establish trust and open communication.
Approach the conversation with empathy and non-judgement. Phrases like, “I understand you’re interested in getting an oral piercing as a form of self-expression. I want to make sure you’re aware of the potential risks so you can make an informed decision,” will show the patient you respect their autonomy while also voicing your concerns.
Educating patients about the specific risks of oral piercings should include the following touchpoints:
- Risk of hemorrhage: During the piercing process, blood vessels may be torn causing blood loss (at times serious), prolonged bleeding, hematomas, and disturbed wound healing.
- Nerve damage and numbness: Piercings can damage a number of different nerves in the oral cavity, leading to permanent or temporary numbness or loss of sensation in the tongue or lips.
- Increased risk of infection: Piercings create entry points for bacteria, leading to the potential for both localized or systemic infections. Systemic infections can potentially result in rare but extremely serious complications, including endocarditis, cerebral brain abscesses, and Ludwig’s angina.
- Damage to teeth and gums: The initial mucosal trauma of piercings can cause pain and swelling of the involved tissues, resulting in functional problems with chewing and/or swallowing. Longer-term complications can result in gingival recession and/or periodontal attachment loss, as well as hard tissue trauma, including abrasion and tooth fracture.
- Interference with oral function: Even after pain and swelling has subsided, piercings may still affect speech, chewing, and swallowing, causing daily discomfort.
- Aspiration: Though rare, it is possible to accidentally aspirate a small piece of oral jewellery should it come apart or break. Oral piercings, most commonly tongue piercings, can also cause complications in patients who need to be intubated in emergency scenarios.
Despite the risks involved, many patients will opt to get an oral piercing or will present in your office after the fact. In these cases, it is important to remain open-minded and continue to help guide your patients. Recommend jewellery that is hypoallergenic, such as stainless steel, 14-karat gold, niobium, or titanium. Soft rubber ends and acrylic screw caps can offer more hard/soft tissue protection and should also be suggested, especially for tongue piercings. Emphasize the importance of proper care and maintenance of the piercing, including regular check-ups, as well as seeking prompt treatment for any signs of infection of potential complications.
By communicating openly and honestly, we can build supportive relationships with our patients while providing the knowledge they need for making informed oral health decisions.
