- The Washington Times - Tuesday, October 22, 2002

Body piercing, an ancient tradition, is experiencing a renaissance and has become a hip sign of youth. Most of the time, it comes without any major health implications. But area dentists and doctors say they sometimes treat damaged teeth and gums as well as local infections due to mouth piercings.
"We're now seeing kids who are piercing their lips, their tongue, their cheek, even their uvula," says Dr. George Acs, a pediatric dentist and spokesman for the American Academy of Pediatric Dentistry. The uvula is the fleshy mass of tissue suspended from the center of the soft palate.
One of the most common problems with body piercing, including different forms of mouth piercing, is the risk of infection. Sometimes the area around the tongue piercing swells due to infection, which can have life-threatening consequences.
"It can block your airways, and you can actually choke," Dr. Acs says.
Dr. Michael Hopper, a pediatrician at Inova Alexandria Hospital, says localized infection occurs about 25 percent of the time with ear piercing, and slightly more with mouth piercing. The level of bacteria is higher in the mouth.
It takes about six weeks before a piercing is completely healed, and it is during this time that the risk for infection is at its highest, Dr. Hopper says.
This kind of infection is local and caused by the bacteria that is already on the skin or in the mouth, such as streptococcus and staphylococcus.
In some cases, the local infection, if it's serious and persistent, needs to be treated with antibiotics, Dr. Hopper says.

There is also a risk for more systemic infections if the piercing isn't done properly. But this risk is much smaller, Dr. Hopper says.
"A potential problem is that the kid does it on his or her own or at a tattoo/piercing parlor that does not adequately clean the tools, and the child could be infected with hepatitis," he says.
If a teen-ager were to ask him about piercing, Dr. Hopper says he would advice against it, but then again "most kids wouldn't ask their doctor for advice on body piercing."
Dr. Hopper advises those who have already decided that they want to get their tongue or other body part pierced to make sure the piercer uses disposable equipment.
"If the person doing the piercing is using non-disposable equipment, just make sure they are sterilizing it," he says.
At Black Enque, a tattoo and piercing parlor on Capitol Hill, piercer Walmberto Gudiel uses only disposable equipment.
"The jewelry is sterilized, too," Mr. Gudiel says. "And we use only stainless steel."
Mr. Gudiel says he sometimes gets calls from clients whose tongues have started swelling after piercing.
"I usually tell them to use mouthwash and chew ice to keep the swelling down," he says.
Mr. Gudiel says he has never had to refer a client to a doctor.
Most piercings are done without producing a word of complaint, he says.

Aside from infections, dentists often see effects on teeth from tongue and other mouth piercings.
"Probably the most mundane effects of tongue piercing is that it's pretty easy to fracture a tooth," Dr. Acs says.
When a tooth is fractured meaning it's cracked or chipped it may need a filling, much like a cavity does.
You can actually lose a piece of the tooth from mouth jewelry, Dr. Acs says. "If the damage is severe and the tooth's nerve dies, the patient will need a root canal."
One common indication that a nerve has died is when a single tooth becomes discolored. As the nerve dies, it becomes unable to fight off bacteria, which is why it has to be cleaned and filled to prevent any regrowth of bacteria.
"When you traumatize the tooth, there is always a risk that the nerve is going to die," Dr. Acs says. "That can happen three days after the trauma occurs, or three years. You never know."
Teeth that have had root canals may become fragile.
"The tooth becomes brittle because it's not getting any blood supply anymore," he says.
Sometimes a crown is placed on the tooth to prevent further breakdown.
Other problems surrounding mouth piercings include chewing and speech problems.
"I have never met anyone with a tongue piercing who doesn't have a speech impediment," says Dr. Tawann Jackson, a dentist with a private practice in Southeast. "They definitely have problems with articulation."
Dr. Jackson says mouth piercing is actually changing the face of dentistry a bit: The fractures caused by tongue studs are different from regular cavities because they start on the side (toward the tongue) and go in toward the center of the tooth, instead of starting at the top of the tooth and going down to the center.
"You really see some unusual fractures of the teeth," she says. "You also have worry about how you use the drill."
Some patients develop an allergic reaction to the metals in the jewelry. The culprit often is nickel.
The allergic reaction can lead to inflammation of the gums, which makes it much harder to keep the teeth clean, Dr. Acs says. The inflammation and inability to clean the teeth thoroughly can create plaque.
He says that as far as the chewing problems go, some of his patients actually take the stud out while they eat.

While they are not proponents of body piercing, dentists and doctors are less adamant about piercing than they are tattoos.
"If they were to ask me, I would say 'no,'" Dr. Hopper says. "I would say 'no' because there are no medical benefits to piercing."
But if he had to choose between tattoos and body piercing, he would choose the latter, he says.
"We strongly discourage kids from getting tattoos," he says. "One advantage is that you can remove the earring, nose ring or tongue stud, which is much easier than removing a tattoo and it will heal eventually."
Parents feel the same way, says Sikethia Dillingham, manager of Black Enque.
"Parents seem to prefer body piercing to tattoos, because they are less permanent," Ms. Dillingham says. "You know how teen-agers change their minds all the time."
As the body piercing trend continues among young people, doctors and dentists keep informing their young patients about the health consequences.
"I don't want to limit someone's self-expression, but from a health aspect, there is nothing beneficial about it," Dr. Acs says. "Any dentist will tell you, 'No filling is the best filling.'"

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