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.

Oral piercings: what implications do these have on our oral health?

This systematic review aims to explore the literature surrounding awareness of oral health implications following oral/perioral piercings, and evaluate potential oral complications following these piercings. DATA SOURCES: Searches were carried out across scientific databases including PubMed, Scopus, Cochrane and Google Scholar for all studies published until April 2023. STUDY SELECTION: Primary research including cross-sectional, cohort, and case-control studies that met the inclusion criteria were included in the systematic review. This criteria included papers that measured public/professional awareness, periodontal/peri-implant complications, microbiological analyses, general and hard/soft tissue complications, and frequency of complications. Exclusion criteria including those not published in English, all in vitro and in vivo research, case reports, interventional studies, correspondence, comments, letters to the editor, and editorials. DATA EXTRACTION AND SYNTHESIS: Data was extracted from 34 studies which met the inclusion criteria. A data collection form was used to collate the extracted information on bibliographic details, research methodology, patient demographics, piercing types, health assessments, research findings, and conclusions. The risk of bias in the selected studies was also assessed. RESULTS: The study demonstrates a large disparity between the public's and dental health professionals' awareness of oral health complications following oral/perioral piercing. The results also show that piercings are more common in women than men, and that piercings have been linked to several adverse consequences including both hard and soft tissue injury, and the type of complication commonly relates to the position of the piercing. CONCLUSIONS: Oral piercings have been linked to several oral health complications including caries, plaque accumulation, gingivitis/periodontitis, dental fractures, bleeding, inflammation and swelling of the surrounding soft tissues. Public knowledge of these risks is limited, and therefore public health authorities should implement and support initiatives to raise awareness.

Extensive Keloid and Hypertrophic Mixed Scarring Pattern in Ear Lobes of a 14-Year-Old African Female: A Case Report.

Background Massive earlobe scarring/keloid formation can occur after ear piercing in individuals of African descent. Case report: A 14-year-old African girl with pierced ears in childhood presented with two progressively growing and disfiguring tumors on both earlobes. The maximum diameter of each lesion was 5.5 centimeters, and the weight of each lesion was approximately 20 grams. Histologically, there was a mixed pattern of keloid and hypertrophic scarring. Discussion: Massive keloids can occur after ear piercing in childhood. It is unclear why some individuals develop these massive keloids.

Whole blood donor return rates after deferral for tattooing or body piercing-Survey across blood donation services: The BEST collaborative study.

BACKGROUND AND OBJECTIVES: To protect transfusion recipients from transfusion-transmissible infections, blood donors are deferred from donating after recent tattooing or piercing. To explore to what extent and how this deferral impacts donor availability, we performed an international study to investigate how many donors were deferred for a recent tattoo or piercing and how many of these donors returned to donate. MATERIALS AND METHODS: We surveyed blood centre members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative and the European Blood Alliance Donor Studies Working Group on their numbers of donations, tattoo and piercing deferrals, and return rates in the year 2017. RESULTS: Eight blood centres participated. Overall, deferral rates were lower for repeat donors compared to new donors. Repeat donors were more likely to return than new donors. Women and young donors were more often deferred than male and older donors. Men were more demotivated by tattoo or piercing deferral, resulting in lower return rates compared to women. Return rates differed greatly between blood centres. CONCLUSION: Tattoo and piercing deferrals lead to missed donations and result in lower return rates. However, the numbers vary largely internationally, probably due to cultural and policy differences. Shortening deferral periods after tattooing or piercing may reduce the impact on donor availability, which should be investigated in single-centre studies.

A novel surgical technique for prevention of self-sucking in cattle and buffaloes: tongue piercing.

BACKGROUND: Self-sucking is an abnormal behavior lead to important economic losses for dairy farms. The objective of this study was to evaluate tongue piercing as a novel technique to prevent self-sucking in cattle and buffaloes. The study was carried out on 26 cows and 4 buffaloes suffered from self-sucking. Tongue piercing was achieved by the application of an implant in the midline of the tongue and anterior to the frenulum linguae. With a follow up period of 6 months. RESULTS: This implant produced mechanical disruption of the affected animals ability to curl their tongues, in a U- shape manner, subsequently it was impossible for these animals to cup their tongues and suck its own teats. Slight swelling around the piercing site of the tongue was observed among all animals on the first 3 days after surgery. No other complications have been reported. CONCLUSION: Tongue piercing is an effective, rapid, easy, minimally invasive technique to prevent self-sucking among cattle and buffaloes, moreover, the technique was more widely acceptable by the owners than other traditional and surgical methods.

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.

Postmortem Diagnosis of Invasive Disseminated Aspergillosis After Tongue Piercing.

ABSTRACT: Severe fungal infections caused by highly invasive fungi such as Aspergillus are not easy to diagnose and often have a poor prognosis. In these cases, the nonspecific symptoms may make clinical diagnosis challenging, and consequently, the autopsy and postmortem histological investigations acquire a crucial role. We report the case of a young man in good health who died of septic shock 3 weeks after having had a tongue piercing. Intravitam investigations did not identify the etiology of the rapidly fatal infectious condition. The autopsy revealed flaccid organs of uniformly diminished consistency with abscesses and granulomatous foci with central necrosis. Histological examination showed the presence of septate mycotic hyphae, with a dichotomous 45-degree bifurcation, typical for Aspergillus , in all the examined organs, including the tongue. The molecular identification confirmed the presence of Aspergillus fumigatus. The observed macroscopic framework and the laboratory findings made it possible to diagnose pseudomembranous invasive tracheobronchial aspergillosis and to attribute the death to fatal invasive disseminated aspergillosis. The consistency and concordance of all the findings in our possession led us to suspect the practice of piercing as the triggering cause of the man's pathology.

Ear-piercing complications in children and adolescents.

QUESTION: Ear piercing is one of the most common forms of body modification seen in children and adolescents presenting to my office. Parents of my younger pediatric patients inquire about potential post-piercing complications and risk factors associated with earlobe infections. What guidance should I give them? Also, are there any specific post-piercing complications to consider for older pediatric patients seeking second piercings in the upper cartilage area? ANSWER: Piercing the earlobe or auricular cartilage continues to be a popular procedure among children and adolescents. Despite its widespread practice, improper aseptic piercing technique, insufficient training, and trauma to the soft tissue during high-pressure piercing (eg, use of spring-loaded ear-piercing instruments) can increase one's susceptibility to infections, bleeding, and microfractures. Other post-piercing complications include embedded earrings, keloids, hypertrophic scarring, and cutaneous hypersensitivity. Early recognition and treatment of infections and perichondritis secondary to transcartilaginous piercings can prevent the progression of severe ear deformities requiring reconstructive surgical interventions.

Basal cell carcinoma invasion of an ear piercing.

Basal cell carcinoma (BCC) development in the context of a piercing is a rare phenomenon, reported in the literature in only six instances. We present a 55-year-old woman with nodular BCC involving her auricular piercing and extending clinically onto the posteroinferior right ear lobule and right post-auricular crease. Histological analysis revealed spread of the BCC through the piercing onto the anterior lobule, with evidence that the cancer utilized the piercing as a low resistance pathway for this microscopic invasion. This case is, to our knowledge, the first report of microscopic BCC present within an auricular piercing itself. Chronic inflammation related to repeated trauma from the embedded jewelry may have played a role in its formation. A piercing may provide a path of least resistance for BCC tumor cells to invade, providing a nidus for recurrence. Careful histological examination with possible complete excision of the piercing is prudent to prevent cancer return.

Cutaneous B-Cell Pseudolymphoma (Lymphocytoma Cutis) of the Earlobe: A Poorly Recognized Complication of Ear Piercing in Children.

Background: Cutaneous pseudolymphoma (CPL) refers to a group of benign, reactive processes that mimic cutaneous lymphoma and are associated with a variety of triggering immune stimuli, including arthropod bites, drugs, and foreign bodies. In children, most cases of CPL are due to a variant of Borreliosis that is specific to Eurasia. Cutaneous pseudolymphoma secondary to ear piercing has only been documented in adults. Case Reports: We present the clinical and pathological findings of cutaneous Bcell psuedolymphoma in two adolescent patients (11-year-old female and 15-year-old male) secondary to ear piercing. Conclusion: Our report expands the clinico-pathological spectrum of CPL associated with ear piercing by documenting its occurrence in children.

Sociocultural overview and predisposing factors of body art in a health promotion perspective: survey on a sample of Italian young adults.

Background: The body art (tattoos, body piercing and other aesthetic practices) is increasing at global level and involves different aspects of public health, from epidemiological feature to cultural and psychosocial determinants and regulatory issues. The study is aimed at estimating the prevalence of tattooed and pierced in youth, focusing on emerging profiles. Study design: A cross-sectional study has been conducted on 575 students at the first year of degree courses of an Italian University. Methods: Students were asked to fill an online questionnaire. Logistic regression models were evaluated in order to identify predictive factors and determinants of practice (tattoos, piercing, body art). Results: The 41.9% of participants underwent at least one body art intervention, with a higher prevalence in females. Multivariate logistic regression suggested an association of body art practice with type of school and university course, as well as lifestyle characteristics (smoking, alcohol abuse). In addition, the intention to undergo to body art intervention in the future appeared significantly higher in women and more frequent in apparently 'protected' categories such as medical students and non-problematic alcohol users. Conclusions: The study confirmed the importance of the surveillance and social and behavioural research on body art practice and suggested different health promotion perspectives, such as early intervention towards adolescents and late intervention towards young adults belonging to lesser risky population groups.

Effect of tongue piercing on periodontal and peri-implant health: A cross-sectional case-control study in adults.

OBJECTIVES: The authors hypothesize that periodontal and peri-implant inflammatory parameters are poorer in adult patients with tongue piercing compared with controls. The aim was to assess the influence of tongue piercing on periodontal and peri-implant health status in adults. METHODS: Test and control groups comprised of individuals with and without tongue piercing, respectively. A questionnaire was used to collect information about gender, age, duration of tongue piercing and implants in function, jaw location of the implant, reasoning for wearing the tongue ornament, and oral hygiene and ornament cleaning habits. Full-mouth and peri-implant plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing depth (PD) and marginal/crestal bone loss (MBL and CBL, respectively) on mesial and distal surfaces of teeth/implants were recorded. The material (plastic or metal) from which, the bar and ball-ends of the ornament were fabricated was also recorded. A p < 0.01 was considered statistically significant. RESULTS: Forty-eight and 49 individuals were included in the test and control groups, respectively. There was no difference in PI, GI, PD, CAL and MBL (mesial and distal) among individuals in the test and control groups. In the test group, peri-implant PI (p < 0.01), GI (p < 0.01), PD (p < 0.01) and mesial (p < 0.01) and distal (p < 0.01) CBL were significantly higher in the anterior mandible compared with implants in other jaw locations. In the control group, there was no difference in peri-implant PI, GI, PD and CBL around implants placed in both jaws. CONCLUSION: Wearing tongue piercings could increase the risks of periodontal and peri-implant diseases particularly in the mandibular anterior segment.

Do oral piercings cause problems in the mouth?

Aim This systematic review and meta-analysis aimed to synthesise the current evidence for the association of oral piercings with oral complications.Data sources Research published before January 2022 was identified from the Cochrane Library, Virtual Health Library, Web of Science, Scopus, PubMed, Embase, Google Scholar and OpenGrey databases. Experts in the field were approached via email to request access to relevant ongoing studies and unpublished results.Study design Two independent reviewers determined the eligibility of studies based on the predefined inclusion criteria. Where the outcome was unclear, a third reviewer was consulted to reach consensus. Using the Joanne Briggs institute criteria for critical appraisal, 15 studies achieved good methodological quality.Meta-analysis was conducted to determine the event rate of gingival recession and damage to teeth in participants with oral piercings and to determine odds ratios of these outcomes in participants with oral piercings compared to those without.Results In total, 54 studies published between 2000-2021 met the inclusion criteria, providing a total sample of 27,963 piercings covering various anatomical sites: tongue (39 studies), lip (29 studies) and other sites, such as oral frenula or cheek (11 studies).Meta-analysis showed that there was a 34% prevalence of dental fracture (DF) in participants with oral piercings and this was 34% for tooth wear, 33% for gingival recession (GR), 27% for non-specified dental damage and 22% for tooth chipping. A significant association was found between oral piercings and the presence of GR and DF, with a seven-fold and three-fold increased risk, respectively, when an oral piercing was present. Reporting bias was not observed and evidence certainty for these outcomes was low.Conclusions The presence of oral piercings is associated with an increased risk of gingival recession and dental fracture.

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.

Accidental Insertion of a Piercing Needle in Tongue.

ABSTRACT: Tongue piercing causes various complications, including bleeding, pain and infection and it cause potential life-threatening complications. An 18-year-old woman presents with losing a needle in mouth. She attempted to perform tongue piercing using piercing needle by herself at home, and it was lost in mouth. The patient showed speech difficulty, but no active bleeding and edema of the floor of mouth. Computed tomography showed approximately 50 mm needle like structure in tongue. General anesthesia was performed with nasal intubation using video laryngoscope. The surgeon found the needle could be hold in the tongue by fingers. The needle in the tongue was holding by left fingers, and 10 mm skin incision was made by right hand. The needle tip was pushed to the incision line and it was removed. There was no bleeding immediate after needle removal. She could speak immediate after surgery. Two days after surgery, the patient discharged with no complications.

Perichondritis due to a herpes zoster Infection after an Ear Piercing: a Case Report.

Nowadays piercing has become one of the most popular fashionable and cultural customs and people of all ages are interested in this cosmetic procedure. One of the common sites of piercing is ears which, like any other piercing, can bring about many complications like infection, inflammation, allergic reaction, keloid formation, and traumatic tearing. In this paper, we report a case of perichondritis due to Staphylococcal secondary infection to a primary herpes zoster infection following ear piercing.

[Second ear piercing for aesthetic purposes and appearance of pathological scars in negroids: About 172 observations in an endemic area of keloids]. / Deuxième piercing auriculaire à but esthétique et apparition de cicatrices pathologiques chez les négroïdes : à propos de 172 observations dans une zone endémique de chéloïdes.

This is a transverse and retrospective descriptive study carried out on a quantitative and qualitative component on pathological scars after a second ear piercing for aesthetic purposes in a Negroid female population from an endemic area of keloids. For a period of 10 years (from January 1, 2010 to December 31, 2019), we observed 172 patients with pathological ear scars after a second piercing for aesthetic purposes including 65.7% of female students and 22.1% of students. Clinically, we had 143 (83.1%) patients with keloids and 29 (16.9%) with hypertrophic scars. The average age of the second piercing was 22.62 years; 98 (57%) patients had single lesions on the pierced ear and 74 (43%) multiple lesions; 168 (97.7%) had no family history of pathological scars. Our patients from an endemic area of keloids did not develop pathological scars during the first piercing but all develop pathological scars after the second piercing. Several risk factors could be accused: heredity, environment, race, age, gender, wearing of poor-quality jewelry, infection, disruption of the healing process caused by the first piercing, mechanical tension caused by the new ornamental object. However, none of these assumptions has been verified. In the meantime, we do not recommend that at risk negroid subjects, originating from areas with high endemicity of keloids, a second ear piercing for aesthetic purposes.

Hidradenitis Suppurativa Influences Tattooing Practice in Women.

BACKGROUND: The reasons or the motivations that compel people to get a tattoo or a body piercing (BP) are plentiful and personal. Patients with chronic cutaneous or systemic conditions may be interested in getting tattooed or pierced. OBJECTIVE: To determine the frequency of body art practices in hidradenitis suppurativa (HS) and to evaluate the possible impact of HS in the decision-making process. METHODS: An anonymous specific paper-based questionnaire was prospectively offered to patients (≥18 years) consecutively managed for HS from September 2016 to March 2017 in a French specialized center. RESULTS: In total, 209 patients participated in the study, of whom 77 (37%) and 50 (24%) had tattoos and BP, respectively. These proportions were higher than those reported in the French population. HS prevented the decision to get a BP or a tattoo in 2 and 5%, respectively (fear of infection or healing difficulties). Fifteen patients (7%) got tattooed to hide a surgical HS scar (n = 5, 2%), to regain control over the pain or their bodies (n = 9, 4%), or to turn others' eyes away from HS lesions or scars (n = 1, 0.5%). HS severity influenced a proportion of patients who intended to get a new tattoo. CONCLUSION: HS is associated with a significant increase in body art practices.

Biocultural diversity in Late Pleistocene/Early Holocene Africa: Olduvai Hominid 1 (Tanzania) biological affinity and intentional body modification.

OBJECTIVES: The dentition of Olduvai Hominid 1 (OH1) exhibits an anomalous pattern of dental wear that was originally attributed to either intentional cultural modification (filing) or plant processing behaviors. A differential diagnosis of the wear and assessment of the biological affinity of OH1 is presented. MATERIALS AND METHODS: Macroscopic and microscopic observations of all labial and buccal tooth surfaces were undertaken to assess wear patterns. A multivariate analysis of mandibular morphology of OH1 compared to other Late Pleistocene, Holocene, and recent modern humans was used to ascertain biological affinity. RESULTS: The morphological variation of the OH1 mandible is closely aligned with variation in penecontemporaneous fossils from Africa and outside that of recent humans. The concave wear facets exposing dentin on the labial surfaces of all three preserved mandibular incisors is confirmed. Substantial loss of labial/buccal surfaces was documented on the surfaces of all in situ maxillary and mandibular canines, premolars, and molars ranging from distinct facets with well-defined edges, to blunting or "polishing" around areas of maximum buccal curvature. The wear on both the anterior and postcanine teeth closely resemble that caused by adornments ("labrets") worn in lower-lip and buccal facial piercings known from bioarchaeological and ethnographic contexts. The wear pattern suggests that the OH1 wore three facial piercings-two buccal/lateral and a medial one in the lower lip. DISCUSSION: Our findings suggest that the expression of social identities through intentional body modification is more diverse than previously documented elsewhere in Africa during the Late Pleistocene (i.e., ablation) and Early Holocene (i.e., ablation, chipping, and filing).

Necrotizing soft tissue infection of both ear lobules occurring concomitantly in a set of twins following non-aseptic ear piercing: a case report.

BACKGROUND: Necrotizing soft tissue infection of the ear following ear piercing is a very rare condition. It is easily misdiagnosed leading to reconstructive morbidities and mortality in neonates. High clinical suspicion is important for early diagnosis. Our knowledge, this is the first case reported in the literature in this unique initial presentation. We hope to heighten the awareness of necrotizing soft tissue infection of the ear following ear piercing to ensure early aggressive intervention. CASE PRESENTATION: We report a set of 19-day-old female twin neonates who developed bilateral ear sores following ear piercing in a primary healthcentre without adherence to surgical asepsis. Examination findings showed features consistent with necrotizing soft tissue infections of the ears. They were successfully managed with antibiotics and wound care. CONCLUSION: Necrotizing soft tissue infections is a very rare complication of neonatal ear piercing. It may occur following suboptimal aseptic procedure and a high index of suspicion is necessary to make this diagnosis to ensure early intervention and to forestall the potential reconstructive morbidities and mortality associated with late recognition. Adherence to basic aseptic surgical principles is the key to prevention of necrotizing soft tissue infections.