Warning for Teens: Teeth and Jewelry Don't Mix

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Dr. Liran Levin, a dentist from the Department of Oral Rehabilitation, School of Dental Medicine at Tel Aviv University has found that about 15 to 20 percent of teens with oral piercings are at high risk for both tooth fractures and gum disease. Resulting tooth fractures as well as periodontal problems, he says, can lead to anterior (front) tooth loss later in life.

High rates of fractures due to piercings are not found in other age groups, and cases of severe periodontal damage in teens without oral piercings are similarly rare, says Dr. Levin, who conducted the study with partners Dr. Yehuda Zadik and Dr. Tal Becker, both dentists in the Israeli Army.

Their initial study was done on 400 young adults aged 18-19, and the results were published in the well-known peer-reviewed journal Dental Traumatology in 2005. A new review by Drs. Levin and Zadik published in the American Dental Journal in late 2007 is the first and largest of its kind to document the risks and complications of oral piercings, drawing on research from multiple centers in America and across the world.

Ten percent of all New York teenagers have some kind of oral piercings, compared to about 20 percent in Israel and 3.4 percent in Finland. Dr. Levin warns teens to think twice before getting an oral piercing, as it can lead to easily preventable health complications and, in some (rare) cases, even death.

Premature Frontal Tooth Loss

"There are short-term complications to piercings in low percentages of teens, and in rare cases a piercing to the oral cavity can cause death," Dr. Levin says. "Swelling and inflammation of the area can cause edema, which disturbs the respiratory tract." He warns that the most common concerns ― tooth fracture and periodontal complications ― are long-term.

"There is a repeated trauma to the area of the gum," says Dr. Levin. "You can see these young men and women playing with the piercing on their tongue or lip. This act prolongs the trauma to the mouth and in many cases is a precursor to anterior tooth loss."

During the Israel-based study, the researchers surveyed teens both with piercings and without, asking them a number of questions about their oral health, their knowledge of the risk factors associated with piercings, and about their piercing history, before conducting the clinical oral exams.

Ironically, Dr. Levin notes, those youngsters who opted for oral piercing were very concerned about body image, but seemed to be unaware of the future risks such piercings can cause.

The Doctor's Practical Advice to Teens and Parents

Bottom line, the best advice for teens is to "try and avoid getting your mouth pierced," says Dr. Zadik. If your teen is insistent, he says, then it's essential that piercing tools are disposable, and that all other equipment is cleaned in an on-site autoclave to help reduce infection.

After the procedure, the area should be rinsed regularly with a chloroxidine-based mouthwash for two weeks. Thereafter, avoid playing with the piercing and clean it on a regular basis. Calculus deposits on the piercing may form over time and should be removed by a dentist. Checkups should be made regularly.

"Teenagers are not easy to manage," Dr. Levin commiserates, but his advice to parents is simple: "Try where possible to dissuade your teen from getting a piercing. They will thank you when they are older."

Tel Aviv University