Friday, October 9, 2009

Oral Piercing and its Complications

Oral piercing is the most happening fashion trend in youngsters now a days. A dentist should be well informed about such procedures as it is invasive in nature and is carried out without the use of anaesthetics. It involves the use of needles in order to create a hole in the following structures i.e. tongue(most common),lips, eyebrows, cheeks for inserting metals in the form of studs, rings or barballs. It can turn out to be dangerous as the various neural supplies of the tongue may get hampered while performing such procedures. This post will focus on some short and long term oral complications related to oral peircing

Short- term complications:

  1. Immediately after the operation certain complications may arise including:
  2.    Infection is the major concern after such procedure if the needle used are not properly sterilized and placed in antiseptic solutions. Life-threatning complications like the transmission of HIV and hepatitis viruses can take place.
  3.    Postoperative pain is present.
  4.   The tongue usually swells after piercing. In some cases it can be so massive leading to obstruction of airway and dyspnoea.
  5.    Aspiration of the inserted jewellery can take place thereby asphyxia and death of the person can take place.
  6.    Slight/excessive bleeding can occur depending on the severage of the blood vessels.

*        Long-term complications:
  1. Chipping and fracture of teeth occurs in due course of time due to constant trauma to teeth by the barbells and studs in tongue. Cracked tooth syndrome is a characterstic feature resulting in microscopic cracks in teeth making it difficult to masticate and is extremely painful. The tooth may have to be finally removed if it does not respond well to some splinting techniques.
  2. Neural deficiencies can arise due to incorrect piercing techniques like facial paralysis, ageusia/dysgeusia, disarticulation of speech, eye problems, loss of deglutition reflex etc.
  3. The gums and buccal mucosa experience continuous irritation from the jewellery which may lead to the following lesions in the oral cavity like irritational keratosis, frictional keratosis, lichenoid reaction, lichen planus, peripheral giant cell granulomas, fibroma, epulis fissuratum, carcinoma etc.
  4. There is a risk of infection due to foreign debris and bacteria accumulating in the pierced site.  
  5. Hypersensitivity and galvanism may occur due to interaction between other restorations in the teeth and allergy due to a particular metal in gums.
  6. Due to untreated or unknown infections the pain and swelling may exacerbate and take a different route to reach and create complications systemically like infective endocarditis etc.
Safety measures :
The risk of oral complications can be minimised by following these suggestions:
·         Oral piercing should be get done by a professional who is well aware of the anatomy of the oral cavity.
·         The place should be completely hygienic and disposable needles and gloves should be used. All the procedures should be carried out with sterilized instruments and accessory equipments.
·         Ice packs should be applied on the site of inflammation to reduce swelling and bleeding.
·         Immediate referral to a medical hospital should be done to avoid any systemic complications and ensure safety of the patient.
·         Blood tests should be performed before doing piercing to decrease the chance of inadvertent infections.
·          Generally pain subsides within 4-6 weeks of piercing, if it does not reduces seek medical advice.
·         One should prefer wearing plastic jewellery in place of metal ones to avoid potential damage to the teeth, gums, palate.
·         Remove all the inserted elements before sleeping and playing sports.
·         Once u are stabilized with the piercing, a must visit to a dentist to evaluate if the piercing has caused any trauma to the oral cavity in any way.