Impact of oral piercings on periodontal health - A systematic review

AIM

Evidence on the impact of oral piercings on periodontal conditions is scarce. Thus, the aim of this systematic review was to evaluate the influence of oral piercings on periodontal health.

MATERIALS AND METHODS

A systematic literature search was performed for studies published by 6 June 2023, using three electronic databases and a hand search. Clinical trials including ≥10 patients wearing ≥1 oral piercing and presenting data on probing pocket depths (PPDs) were considered. Primary outcomes were PPD, and secondary outcomes included clinical attachment loss (CAL), gingival recession, bleeding on probing (BOP), and plaque score (PI). A synthesis of results, using a vote-counting method, was applied.

RESULTS

From 131 titles identified, eight studies, published between 2007 and 2022, were included. Out of these were six cross-sectional studies and two case series. A total of 236 lip piercings and 236 tongue piercings in overall 408 patients were analyzed. In patients with tongue piercings, teeth adjacent to the piercing showed increased PPD (3 of 5 studies), more CAL (3 of 4 studies), more gingival recessions (4 of 4 studies) and a higher BOP (2 of 3 studies) compared with control teeth. In patients with lip piercings, teeth adjacent to the piercing demonstrated more gingival recessions (3 of 4 studies) compared with control teeth. Time since piercing placement was associated with localized periodontal destruction in patients with tongue and/or lip piercings (4 of 7 studies).

CONCLUSIONS

The available evidence from eight studies suggests negative effects of tongue piercings on several periodontal health parameters of adjacent teeth, while gingival recessions were frequently detected in patients with lip piercings.

Knowledge and Awareness of Oral and Perioral Piercing and Its Complications Among the Population in Riyadh

Background and objective Body piercing was a cultural custom associated with religious or ceremonial rites in antiquity. Currently, it has grown in popularity among teenagers and young people as a form of self-expression. Young adults are now frequently seen with body and oral piercings, which can cause several complications. Patients with intraoral piercing often present with poor dental and periodontal health, as well as various complications and side effects. The general public is often poorly informed about the risks they are exposed to after intraoral piercing and the strategies for minimizing them, and even healthcare professionals often have limited knowledge of the risks and complications that may arise after this procedure. To the best of our knowledge, no published data assessing the knowledge of oral and perioral piercing among the population living in Riyadh City, Saudi Arabia are currently available. In light of this, we conducted this study to assess the level of awareness and knowledge of oral piercing and its complications among the population living in Riyadh city and evaluate the correlation of nationality, sex, age, and socioeconomic status (educational level, area of residence, and income) with the level of individual knowledge. Methods This was a cross-sectional observational study with a sample size of 1,099. A confidence interval (CI) of 95%, a standard deviation of 0.5, and a margin of error of 5% were employed to determine the sample size. A structured questionnaire was used as the study tool and was distributed in several residential areas in Riyadh, such as North, South, Middle, Eastern, and Western Riyadh City. The data collection was performed using simple random sampling via electronic questionnaires distributed to participants living in Riyadh. Results A total of 1,054 individuals completed the survey. Of these, 95.6% were Saudi nationals. Approximately 85.5% of the participants (n = 901) were women, 52.4% were aged 20-29 years (n = 552), and most participants (62.9%, n = 663) had a low monthly income (<5,000 Saudi Riyals); in terms of residence, the highest number of participants were from the northern region of Riyadh (37.1%, n = 391). Most participants had heard of or seen an oral or perioral piercing (89.1%, n = 939). However, very few of them had received an oral piercing themselves (10.7%, n = 113) or had a family member with an oral piercing (18.7%, n = 197). Participants reported that the most commonly observed site for oral piercing was the lip (29.8%, n = 314), and teenagers were the most common age group with oral piercings (76.3%, n = 804). Regarding the adverse effects, most participants reported being aware of the negative consequences of oral piercing in the mouth (72.2%, n = 761). Sex and age were the only factors that showed a significant association with participants' level of knowledge. Women were significantly more knowledgeable and had higher scores (ß: 0.41; 95% CI: 0.13, 0.69) than men (p<0.05). Additionally, participants aged 20-29 years had significantly higher knowledge scores (ß: 0.39; 95% CI: 0.15, 0.63) than younger participants (p<0.05). Conclusions Based on our findings, participants' knowledge and awareness about oral piercing is adequate in general. However, there should be more efforts to educate the people of Riyadh about the complications of these piercings as well as raise awareness about proper oral hygiene methods.

Oral Piercing: A Pretty Risk-A Scoping Review of Local and Systemic Complications of This Current Widespread Fashion

Piercing insertion is a common practice among people of all ages for different reasons (e.g., esthetics, culture, religion). In the oral cavity, the jewel can be placed in the lips, cheeks, tongue, and frenulum. The presence of an oral piercing could cause local and systemic complications in the short term. In the long term, irreversible damage may occur to the hard and soft tissues of the oral cavity. Different authors in the past have produced publications focusing on this issue. This study analyzes 10 published articles sourced from online databases according to the PRISMA flowchart. These articles were chosen from the 501 suitable papers initially found. PubMed, Web of Science, and Scopus were used as the online databases for searching for papers that matched the topic, using the keywords "complication" and "oral piercing". The purpose of this review is to describe and analyze all possible complications related to the presence of a piercing in the mouth. Local and systemic complications are related to the presence of plaque and localized pathogenic micro-organisms that can spread via the bloodstream, although they rarely occur in patients without predisposing conditions. Maintaining proper oral hygiene and frequent check-ups are essential to avoid the onset of complications.

Complications of oral piercing: a review of the literature and two case reports

The practice of piercing has been used since ancient times, and nowadays is coming back in fashion among adolescents and young adults. Teenagers wearing oral piercings are frequently observed during routine examination, and there are, also, recurrent harmful consequences attributed to the devices. Unfortunately, piercings are usually placed by unlicensed individuals, lacking the appropriate anatomical knowledge, and therefore unable to provide sufficient information regarding the potential risks, especially when compared to the ones known by the patients. In this regard, the relevant legislation is frayed both vertically (that is within the framework of State and Regional competences), and horizontally (within the competences between the various regions). With the present study, through an accurate review of the literature and the description of two case reports, we underline the importance of informing both the patients and the dental professionals about the dental consequences undergoing the application of piercing. Both patients examined presented the common complications related to the application of piercing. The aim of this study is to underline the importance of being informed for both the dental professional and the person who undergoes piercing about its consequences for the whole oral system as well as the possible risks of infections and complications. We want to underline the key role of the dentist as a promoter of prevention of oral disorders as well as being able to deal with the possible complications which may occur.

Piercing and Oral Health: A Study on the Knowledge of Risks and Complications

The aim of the present study is to verify the knowledge of risks and complications of oral piercings, and to observe the main complications associated with piercings, using a sample from central Italy of patients wearing intraoral piercings. Through piercing and tattoo studios selected randomly in Rome, Latina and Campobasso, and a tattoo and piercing convention in Latina, a group of 387 individuals with oral piercings were selected and asked to complete an anonymous questionnaire. After filling in questionnaires, 70 individuals of the 387 selected agreed to be visited to allow the observation of the integrity of their teeth and gums (especially close to the oral piercing), oral hygiene conditions, piercing cleaning, bad habits and gingival recession. Among the respondents, 46.8% said they had not been informed about these risks, 48.5% claimed not to clean the piercing, 70.6% stated that they had not been made aware of gingival problems that can arise, 60.4% subjects stated that they were not informed about the complications of piercings concerning teeth, 52.8% had insufficient oral hygiene conditions, 42% showed signs of generalised gingivitis, 20% had 3–4 mm recessions and 22% had tooth fracture(s) due to piercing. From this study, it emerged that oral piercings can represent a risk to oral health and that there is a widespread lack of awareness of the complications and correct methods of maintaining oral piercings. Periodic checks by both dentists and dental hygienists, for patients with oral piercings, could play a decisive role in preventing, intercepting and treating the complications that they can cause.

Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students

OBJECTIVE

The use of chewing-gum and piercing has become common among adolescents and might result in increased oral muscle activity and overloading. Aim To investigate the frequency of oral piercing and parafunctions in relation to symptoms of temporomandibular disorders (TMD) among adolescents.

MATERIALS AND METHODS

One hundred and twenty-four third level high school students, living either in a city or in a small town, enrolled in either science or media programmes, were included. The students completed a questionnaire regarding different parafunctions and symptoms of TMD. A clinical examination of the temporomandibular system and estimation of the tooth wear was performed in 116 students.

RESULTS

Chewing-gum was used by 86% of the students (25% with a daily use) and 14% had an oral piercing. The science students used more chewing gum than the media students (p = 0.008), while the media students had more piercings (p < 0.001). Symptoms once a week or more were reported with 39% for headache, 18% for clicking, 7% for facial pain and 6% for difficulty to open wide. Girls reported more headaches (p = 0.007) and more severe symptoms (p = 0.003), had more medical consultations and used more analgesics (both p < 0.05) and had more clinical signs (p = 0.01) than boys. Girls had more oral piercings and used more chewing gum than boys (both p < 0.05). The media students had more sick leave (p < 0.01) than the science students. Chewing-gum use was associated with headache (p < 0.01), with difficulty to open wide (p < 0.05) and with tenderness of the temporomandibular joints and muscles (both p < 0.05). Oral piercing was associated with headache and muscle tenderness (both p < 0.05) and daily nail biting with headache (p < 0.05) and tooth wear (p = 0.004).

CONCLUSIONS

There is an association between use of chewing gum, nail biting, oral piercing, and symptoms of TMD.

Pilot study in Lazio Region

OBJECTIVE

Specific regulations about education and training for body piercing licensure courses have to be considered due to the great increase in oral piercing practices. The aim of the present survey was to assess the local and systemic risk awareness in the practice of oral piercing and their prevention in a sample of Italian piercers.

MATERIALS AND METHODS

An anonymous 20-item questionnaire was administered to 30 body licensed piercers in a small town of central Italy. Licenses certificates were issued by Lazio Region after the completion of an approved training program for standard body piercing including 90 hours of course and a final examination as provided by regional law. The questionnaire surveyed on oral cavity anatomy, local and systemic risks as result of oral piercing, piercing maintenance and need of a dental visit.

RESULTS

Response rate was 66.6%. Only 20% of respondents was aware about oral cavity anatomy and none had knowledge about tongue and gums anatomy. Only 10% enlightened the need of a dental visit and 30% was aware about piercingrelated temporary paralysis. The piercing maintenance was habitually proposed only by 40% of respondents.

CONCLUSION

The study participants showed a low level of awareness regarding the potential health risks of oral piercing. Poor knowledge of anatomy and local and systemic risks and poor awareness of the importance of piercing maintenance explanation.