It has been reported over the past five years, that individuals with oral piercings may be at risk for acute gum disease problems. Typically, gum disease is diagnosed in adults over the age of 35, and is the leading cause of tooth loss in the United States. However, younger patients with oral piercings put themselves at risk for gum recession, bone loss around teeth, and ultimately tooth loss.
We have seen young patients in our practice over the past several years, who have had dramatic gum defects, bone loss and tooth mobility associated with oral piercings. These problems are localized to areas in close proximity to the jewelry. These patients have no other signs of gum disease in other sites, and they would not normally be classified as high risk for gum disease. Clearly, there is a detrimental affect of the oral piercing to the supporting tissues of the teeth.
Tongue piercings are a common culprit and most frequently affect the lower front teeth. The tongue-ring will cause trauma to the gum tissue while eating and speaking. In addition, many individuals with tongue rings develop a tongue thrusting habit that causes hitting of the ring against the lower teeth and gum tissues. This trauma allows the bacteria within the oral cavity to infiltrate the tissues and create an acute inflammatory condition. Ultimately, infection ensues and will cause irreversible bone loss which could result in eventual tooth loss.
Overall the general public has not been well informed of these risks. Most patients who present to our practice with piercing related periodontal disease, are completely unaware of the risks associated with this fashion trend. Fortunately, most patients when faced with the possibility of losing their front teeth at a young age, decide to discontinue the use of oral jewelry. Some patients have been told that if the jewelry is made of plastic instead of metal, that the risk of damage is eliminated. Figures 1 & 2 show a plastic style tongue ring that a patient was using recently until diagnosed with rapid onset recession (stripping of the gum tissue away from the teeth). Use of plastic jewelry definitely does not eliminate the risk of damage.
Figure 3 depicts the inflamed and infected gums of another patient following use of a tongue ring. I have included a surgical photo demonstrating the incredible destruction of the supporting bone. This patient was facing imminent loss of at least one tooth prior to treatment. Bone and tissue grafting helped recover some of the lost bone. With suspension of use of the tongue ring, this patient will have a fairly good prognosis. Others who are diagnosed later may not be as fortunate and will lose their teeth.
If you wear oral piercing jewelry, you should seek a periodontal screening examination to assess whether you have experienced any of these problems. If a family member or friend wears an oral piercing, please share this information and you may save someone you care about from disastrous fashion fallout.
This article first appeared in the 2010 February / March edition of the The New London Women’s Journal