CONSUMER ACCESS | Laura McKee Oral Piercing Teen fashion trend has dental implications Irs painrutand can lead to infections, potentially even causing death Iecan ‘cause a person to lisp and drool uncon- trollably yet people do ito “be cool." It costs money to have it performed and can nix someone's chances ofbeing hired for a respectable job. Despite that, ifs never been more popular. Ys, ip and tongue piercing isthe latest in youth rebellion, ‘A quick plance at any old National Geographic shows that body piercing has been practiced, atleast by some of us, since the beginning of recorded time. Fotinos S. Panagakos, DMD, PhD, of the University of Medicine and Dentistry New Jersey Dental School, said he believes body piercing goes back to ancient times when it was performed primarily for religious and euleual Until recently, for most people in the United States, body piercing was restricted to the ears. Inthe eighties, picrcing extended from the demure carlobe up and around the entre ear rim. In che 1990s, piercing began to include a Wider variery of body parts, including the lipsand tongue. “Iesa generational shing involving = younger crowed,” said Dr. Panagakos. “The ‘music, philosophy or lifestyle, 00s and piercing are more related to thar than rel- gious or cultural reasons," he sid Dr. Panagakos said he's seen oral piercings in males and females from their carly teens through thet 305 ‘According to Enich Mortis, a piercer in suburban Chicago, congue and lip piercing began “asan underground thing ‘with homosexuals in the 1970s.” Iewent ‘mainstream in the ealy 1990s. Me Morris said he pierces tongues or lips of about 30 people a week, which, including patient prep and afer-care instructions, takesan estimated 10 minutes. Relative beauty aside, oral piercings can cause numerous problems, a fac that Mr. Mortsis quick to acknowledge. “They can rub the enamel off your teeth and chip your teeth,” he said, adding ‘that he has no interest in having his oral ‘evity pierced “because I have a big issue with germs.” Ds: Panagakos said he has seen one ‘ase where a person with a tongue barbell used his tongue to push the jewelry against the bottom teeth, causing ‘bone loss and a periodontal infection, He alo has heard of cases of nerve damage and resulting loss of sensiivcy. ‘According co an American Dental ‘Association news release, oral piercings ‘an cause “pain, swelling, infection, increased salivary low and gingival injury.” In 1998, the ADA called oral piercing a public health hazard and passed a statement offically opposing the practice, blaming i for infection, srauma to teth, interference with chewing and speaking, hypersensitivity to metals, foreign debris in the pierced site and breathing difficulty. Likewise, the National Institutes of Health cited tongue and lip piercings asa potential vehicle for blood borne disease transmission, including hepatitis and the hhuman immunodeficiency virus. They also stated that secondary infections caused by the procedure can be serious, possibly even life threatening, The Hepatitis C Foundation recendy stated that body piercing has contributed tothe spread of Hepatitis C. Other serious risks of oral piercings include toxic shock syndrome, blood poisoning that can ence the body through the hole and spread throughout the body; swallowing the jewelry, blocking che airway aspirating in the lung or perforating the bowel; congue swelling, possibly blocking the airway: and excessive bleeding if the lingual arcery and vein ae hit. Justa the very fact of having a barbell inthe tongue or hoop inthe ear can puta person’ well-being a risk or dlamage a person’ health, so can the actual procedure of purting one there. “To date, many sates, including Alabama, Alaska and Arkansas, have no laws regulating how or where or who _must do the piercings. Acthe other end of the spectrum, some states, including July 2000 | AGD IMPACTMassachusetts and South Carolina, have ‘outlawed body piercing altogether inois, for one, requires that tartoo and piercing parlors be inspected yearly and forbids minors from undergoing che procedures without parental permission. ‘There has been progeess recently in ‘what many say isan underregulated field, According to one tatoo and piercing artist in Port Charlot, Florida, his state i on the forefront of safety afer just passing legislation requiring parlors tobe inspected by a physician for safety and sanitation before being ised a license. In addition, che law requires people wanting to provide body piercing to receive formal training. “Make sure patients understand the risks of having a foreign item in their mouth.” Fotinos S. Panagakes, DMD,PhD In mose states, however, minimal regulations exis. Me. Mortis sa he learned his ar through apprenticeship and has never had any setious problems in the year-and-a-halfhe's been doing it. ‘And while he serilizes his tongue clamps, the only equipment cha is reused, patrons cannot be certain tha the nedles used are clean or that the person in charge knows hhow to avoid major arteries. “Teshould be regulated the same as cutting hai. Haie is dead and you sil need a license,” Dr, Panagakos said. ‘So what’ dentist ro do? “IF youre asked by a patient, rll them not ro do is” said Dr. Panagakos. Buc ifapatientis determined, at leas try co have them find a safe place to hhave the procedure done, suid Richard A. Smith, DDS, clinical profesor in che Department of Oral and Maxillofacial Surgery at the University of California at San Francisco School of Dentistry. “But wouldnt discourage i,” he said, AGD IMPACT | July 2000 Dr. Smith, who co-authored the ticle “Piercing: Dental Implicati (Oral Piercing,” forthe Journal ofthe California Dental Asaciation it March 1997, added char although he has seen problems associated with piercings, he is ‘equally concerned with the fact that piercets are not allowed to use anes- thetics during the procedure. Finally, make sue patients under~ stand the risks oFhaving foreign item in theie mouth," Dr. Panagakos added. Patients who already have taken the plunge need to be educated on how to keep the hole clean and how to avoid damaging teeth or periodontal tissue. Mr ‘Morris summed up his precautions ‘quickly ling eliensto avoid straws, smoking illicit drugs and oral sex uni the hole has healed ‘completely: He provides cients with awtinten copy ofafer-care instrue- tions and encourages them to callor ‘come in ifany problems aise. But in an unregulated industry, there is no guarantee a newly pierced person will receive any instructions on care. What they ae told might be incomplete or «even inaccurate. Clearly dentists can fill of in the gaps. ‘The ADA offers the brochure “Heavy Metal: Is Tongue Piercing Really Cool?” for dentists who have patients who are considering being pierced as well as those who have already done so. Beyond that, denis ae lef having to deal with whatever the patent brings to the chair. the patents piered, che dentist must check forthe problems commonly associated with chat, all while avoiding the piece of jewelry, which is rarely removed. “Tes not that dificult. ust ‘work around i,” sid Dr Smith. 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