Inside Dental Assisting
Mar/Apr 2011
Volume 7, Issue 2

Look Before You Pierce: Need-to-Know Facts about Oral Piercing Complications

Valuable information to share with your patients who are considering wearing oral jewelry.

As oral piercings become more common, so do the complications associated with them. Although there is no comprehensive reporting on the number of patients affected, case studies and discussions among oral healthcare providers demonstrate a rising concern. By some estimates, up to 20% of oral piercings become contaminated, and 24% of pediatric dentists surveyed reported treating patients for oral piercing complications.1

Oral piercings include lip, tongue, cheek, or frenum. Because of the unique features of the oral environment, these locations require special attention during aftercare, both immediately and over the long term. Unlike other types of body piercings, oral piercings are under continual stress: bacteria in the mouth, contamination from food and drink, irritation from chewing, or touching with unsanitary hands.

Patients and oral healthcare providers need to be fully informed on how to prevent infection and injury. Inside Dental Assisting offers an overview of the current professional guidance on oral piercings; however, any individual considering oral piercing should consult with a qualified healthcare provider before proceeding.

Selecting a Piercer: Safety First

Regulations and licensing standards for piercers differ not only from state to state, but from county to country. Before visiting a piercer, check with the appropriate city, county, or state health department. Also, look for referrals and other signs that the business is well established and professionally run. Cost should not be the determining factor. The piercer should be willing to have a consultation in advance, explaining the procedure and verifying professional qualifications. The piercer should wear fresh protective gloves and use fresh sterile needles. The piercer should take a medical history and have an emergency medical kit on hand. The studio should have a separate room exclusively for piercing and another room with an autoclave to sterilize the equipment and jewelry. Written instructions should be provided to the client, and the piercer should be available for follow-up treatment and questions.2-4

The piercing establishment should offer a wide selection of hypoallergenic jewelry. Materials for oral jewelry include 14K or 18K gold, surgical stainless steel, titanium, niobium, biocompatible polymers, or glass. Cheaper materials, particularly nickel, may cause allergic reactions. In order to avoid injury to the patient, the jewelry must be professionally selected to be the appropriate length and width. Once the swelling has subsided, the original oral jewelry usually must be replaced with a tighter-fitting option.3-6

Aftercare: Attention to Detail

Healing time varies depending on the type of oral piercing. Follow the instructions provided by your oral healthcare provider or piercing professional. These instructions may include the following precautions,3,4,6,7 but will also vary according to individual patient circumstances.

Use an antiseptic, alcohol-free mouthwash or sterile saline solution after meals and before bedtime. Carefully rotate the jewelry to work the solution into the piercing. Brush jewelry at night with a new, soft-bristled toothbrush. Avoid alcohol, chewing gum, smoking, or chewing on foreign objects such as pencils. Avoid salty, acidic, or hot food. Do not go swimming. Do not take aspirin, which may promote excessive bleeding.

Be aware that manipulation of the jewelry with your hands significantly increases the potential for infection.8

Once the piercing is completely healed, remove jewelry before strenuous activity, such as sports. Some dentists recommend removing the jewelry during eating and sleeping to prevent tooth damage.1,6 Because oral piercings can close rather quickly, even after years, plugs or retainers are available to maintain the hole when jewelry is removed.

See your oral healthcare provider at the first sign of infection. Do not remove the jewelry or attempt to self-treat. Infections can become life threatening very quickly if not treated promptly by a professional.


1. Dentists tell athletes keep the mouthguard, take out the barbell. Academy of General Dentistry Web site. March 30, 2007. Available at: https://www.agd.org/public/oralhealth/Default.asp?IssID=321&Topic=O&ArtID=1298. Accessed February 16, 2011.

2. Association of Professional Piercers. Picking your piercer. Available at: https://www.safepiercing.org/wp-content/uploads/2009/03/APP_Picking_Web.pdf. Accessed February 1, 2011.

3. Mayo Clinic staff. Piercings: how to prevent complications. Mayo Clinic Web site. Available at: https://www.mayoclinic.com/health/piercings/SN00049. Accessed February 9, 2011.

4. Oral Piercing: A Fact Sheet. Colorado Department of Public Health and Environment. Available at: https://www.cde.state.co.us/cdeprevention/download/pdf/oral%20piercing%20fact%20sheet.pdf. Accessed February 17, 2011.

5. Association of Professional Piercers. Jewelry for initial piercings. Available at: https://safepiercing.org/wp-content/uploads/2010/01/APP_Initial_Web.pdf. Accessed February 1, 2011.

6. Balzac F. Oral piercing. Consumer Guide to Dentistry Web site. Available at: https://www.yourdentistryguide.com/piercing/. Accessed February 18, 2011.

7. Association of Professional Piercers. Oral piercing risks & safety measures. Available at: https://www.safepiercing.org/wp-content/uploads/2010/01/APP_OralRisk_Web.pdf. Accessed February 10, 2011.

8. ADA Statement on Intraoral/Perioral Piercing and Tongue Splitting. American Dental Association Web site. Available at: https://www.ada.org/1891.aspx. Accessed February 15, 2011.

9. Oral piercing: patient version. American Dental Association Web site. Available at: https://www.ada.org/3090.aspx. Accessed February 15, 2011.

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