Lip and Tongue Piercing: Experiences and Views of General Dental Practitioners in South Lancashire

Oral manifestations arising from oral piercings: A systematic review and meta-analyses

OBJECTIVE

The aim of this study was to perform a systematic review of oral manifestations arising from oral piercings.

STUDY DESIGN

Literature was searched through January 2022 in PubMed, Scopus, Embase, Web of Science, Cochrane Library and Virtual Health Library, OpenGrey, and Google Scholar to address the question, "Is there an association between oral piercings and oral alterations, complications, or lesions?" Quality was assessed using the Joanna Briggs Institute appraisal tools. Meta-analyses were performed, and certainty of evidence was assessed through Grading of Recommendations Assessment, Development and Evaluation (GRADE). Reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

Fifty-four studies were included, with 15 achieving good methodological quality. Periodontal and tooth damage were the most reported, followed by soft tissue/mucosal injuries, speech disorders, chewing, soft plaque, and saliva. Pain was the most reported complication, followed by infection, swelling, bleeding, inflammation, allergy, and adornment aspiration. Meta-analyses revealed that 33% of participants with piercings had gingival recession (GR) (event rate [ER] = 0.329). In participants with piercings, ER values for nonspecified dental damage (NSDD), tooth chipping, wear/abrasion, and dental fracture (DF) were 27% (ER = 0.270), 22% (ER = 0.219), 34% (ER = 0.344), and 34% (ER = 0.338), respectively. Certainty of evidence was very low.

CONCLUSIONS

Alterations, complications, and lesions were associated with oral piercings and adornments, of which GR, DF, and NSDD were the most prevalent.

Health risks for body pierced community: a systematic review

OBJECTIVE

Body piercing is defined as the penetration of jewellery into openings made in different body areas. In the last decades, it has become increasingly common in the general population. The aim is to analyse the available literature about complications from body piercing for contributing to raise the awareness towards this issue and to plan and perform appropriate prevention interventions.

STUDY DESIGN

This is a systematic review.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to perform this systematic review; the protocol was registered with PROSPERO [CRD42020177972]. PubMed, Scopus and Web of Science were searched from database inception to April 2020, and articles in English language reporting a proven association between piercings and health risks were included, and their quality were assessed by adequate quality assessment tools.

RESULTS

A total of 4748 studies were found, and after duplicates removal and screening, 84 articles were included. Studies dealing with microbiological effects reported these complications both locally and at distant sites as a result of the spreading of the primary site infection: mastitis, endocarditis, glomerulonephritis, cephalic tetanus, viral hepatitis, HIV, cerebellar brain abscess and toxic shock syndrome. In addition, bleeding, gingival recession, dental injuries, contact dermatitis, granulomatous dermatitis, keloid, fibroma and basal cell carcinoma were reported.

CONCLUSIONS

Health authorities should promote educational campaigns to spread the knowledge on health risks related to piercings. Besides, piercers are often not adequately aware of all the possible adverse effects due to piercings because their professional training differs among countries. It is therefore advisable to provide periodical upgrade of their education in this field.

Body piercing in England: a survey of piercing at sites other than earlobe

OBJECTIVES

To estimate the prevalence of body piercing, other than of earlobes, in the general adult population in England, and to describe the distribution of body piercing by age group, sex, social class, anatomical site, and who performed the piercings. To estimate the proportion of piercings that resulted in complications and the proportion of piercings that resulted in professional help being sought after the piercing.

DESIGN

Cross sectional household survey.

SETTING

All regions of England 2005.

PARTICIPANTS

10,503 adults aged 16 and over identified with a two stage selection process: random selection of geographical areas and filling predefined quotas of individuals. Results weighted to reflect the national demographic profile of adults aged 16 and over.

MAIN OUTCOME MEASURES

Estimates of the prevalence of body piercing overall and by age group, sex, and anatomical site. Estimates, in those aged 16-24, of the proportion of piercings associated with complications and the seeking of professional help.

RESULTS

The prevalence of body piercing was 1049/10,503 (10%, 95% confidence interval 9.4% to 10.6%). Body piercing was more common in women than in men and in younger age groups. Nearly half the women aged 16-24 reported having had a piercing (305/659, 46.2%, 42.0% to 50.5%). Of the 754 piercings in those aged 16-24, complications were reported with 233 (31.0%, 26.8% to 35.5%); professional help was sought with 115 (15.2%, 11.8% to 19.5%); and hospital admission was required with seven (0.9%, 0.3% to 3.2%).

CONCLUSIONS

Body piercing is common in adults in England, particularly in young women. Problems are common and the assistance of health services is often required. Though serious complications requiring admission to hospital seem uncommon, the popularity of the practice might place a substantial burden on health services.

An investigation into the practice of tongue piercing in the South West of England

OBJECTIVE

To investigate the prevalence and range of complications following tongue piercing.

METHODS

A survey of individuals with tongue piercings ('piercees') and tongue piercers was undertaken in the South West of England. One hundred and twenty-three piercees completed a self-administered questionnaire and 22 piercers took part in an interviewer-led questionnaire.

RESULTS

The mean age of an individual having a tongue piercing was 19 years old. Almost all the subjects reported problems following piercing; early problems were mainly due to tissue trauma, whereas later, ingestion of jewellery and tooth fracture were common events. A minority (7%) of piercees required the advice of a healthcare professional following tongue piercing. The majority of piercers reported adequate cross-infection measures and enquired about their clients' health prior to piercing. However, only one piercer was aware of the risk of bacterial endocarditis following tongue piercing. Most of the piercers reported that they would advise their clients to attend an Accident and Emergency department if a serious complication ensued.

CONCLUSION

Tongue piercing may be associated with significant short-term and long-term morbidity, including tooth damage. Although the majority of piercers interviewed reported adequate cross-infection controls, knowledge of the medical risks associated with tongue piercing varied widely.

Orofacial Piercings: Perceptions of Dental Practitioners and Piercing Parlours

Objectives

To identify the advice given by piercing parlours prior to orofacial piercing and to determine how many dental practitioners see complications from orofacial piercings.

Method

Administered questionnaire to 19 piercing parlours and postal questionnaire to 400 dental practitioners in southeast Wales.

Results

Ninety-nine per cent of 227 dental practitioners in south-east Wales had treated patients with orofacial piercings, over three-quarters had seen a patient for a complication caused by the piercing, and over half (N=120) had treated a patient for a complication of piercing. Tongue (N=225) and lip (N=209) piercings were most frequently seen and the most commonly occurring complication was fractured or cracked teeth (N=176). Almost all practitioners wanted more information on orofacial piercing and its sequelae. All 19 piercing parlours in south-east Wales warned clients about pain following piercing and 18 mentioned swelling; only four discussed possible damage to teeth and none discussed the risk of airway obstruction.

Conclusions

Despite the concerns of dental and medical professionals orofacial piercing remains popular and the complications it causes are frequently seen by dental practitioners. There is a need for literature to assist both dental practitioners and piercers in advising and safeguarding patients.