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Oral Piercings: What You Should Know
Oral Complications Associated with the Piercing of Oral and Perioral Tissues and the Corresponding Degree of Awareness among Public and Professionals: A Systematic Review
By Seyed Ali Mosaddad Seyed Ali Mosaddad Scilit Preprints.org Google Scholar View Publications 1, 2 , Sahar Talebi Sahar Talebi Scilit Preprints.org Google Scholar View Publications 3, Maryam Hemmat Maryam Hemmat Scilit Preprints.org Google Scholar View Publications 1, Mohammadreza Karimi Mohammadreza Karimi Scilit Preprints.org Google Scholar View Publications 1, Alireza Jahangirnia Alireza Jahangirnia Scilit Preprints.org Google Scholar View Publications 4, Mostafa Alam Mostafa Alam Scilit Preprints.org Google Scholar View Publications 5, Kamyar Abbasi Kamyar Abbasi Scilit Preprints.org Google Scholar View Publications 6, Mohsn Yazadaniyan Mohsn Yazadaniyan Scilit Preprints.org Google Scholar View Publications 4, Ahmed Hussain Ahmed Hussain Scilit Preprints.org Google Scholar View Publications 7, * , Hamid Tebyaniyan Hamid Tebyaniyan Scilit Preprints.org Google Scholar View Publications 8 and Reza Abdollahi Namanloo Reza Abdollahi Namanloo Scilit Preprints.org Google Scholar View Publications 9, *
This study systematically reviews the literature to evaluate the potential relationships between oral/perioral piercing and consequent oral complications in the corresponding society. The second objective was determining public/professional sectors’ awareness of the subject. This research followed PRISMA and Cochrane guidelines for conducting systematic reviews and searching scientific databases, including PubMed, Scopus, Cochrane, and Google Scholar, until April 2023. Cross-sectional, cohort, and case–control studies in English were deemed eligible. The methodological quality of the included studies was assessed using proper quality assessment guidelines. Of the 965 initial articles retrieved, 34 were considered suitable for qualitative synthesis after screening procedures and removing duplicates and irrelevant records. There appears to be an imbalance between the general public’s low and dentists’ high awareness. This draws attention to the shortage of professional and societal knowledge-sharing and education initiatives. Women were more than twice as likely as men to have oral piercings. Piercing usage had a low incidence among a cohort of students with a mean age of 16. Merely circumstantial evidence has indicated a plausible correlation between oral and perioral piercings and the emergence of secondary bacterial and fungal colonization, particularly periodontopathogenic bacteria and Candida albicans. Furthermore, several adverse consequences have been observed linked to various piercings—such as lip and tongue piercings. These include caries, gingivitis/periodontitis, dental fractures, enamel chipping/cracks, plaque buildup, bone loss, bleeding, inflammation, and swelling. Given the risks involved and the complications that might impair oral health, the prevalence of oral piercings is alarming. As a result, public health authorities need to firmly support initiatives to raise awareness of the risks associated with oral/perioral piercings. For piercers to enhance their expertise in this field, professional training is necessary because there is a shortage of knowledge on the possible adverse effects of piercings.
The Risks Associated With Oral Piercings
Piercing is a body ornamentation that different civilizations have accepted since the past as a manifestation of self-expression [1]. Today, body piercing is widely noticed among people, especially young people [2, 3]. People with body piercings stated aesthetics, personal preference, and fit with the subculture as the main reasons for piercings [4]. Information sources available to individuals generally fail to provide information about health risk factors or other health-related issues [5, 6]. The incidence of body piercing has been reported to range from approximately 17 to 70% in different individuals [7, 8]. Oral piercings may be placed in various combinations on the lips, tongue, cheeks, or uvula (Figure 1). Oral piercing is unsafe, has positional and systemic hazards, and is associated with various complications [9]. Abnormal tooth wear, grinding, cracking, and gingival recession are late complications [10]. In addition, infection, abscess, and endocarditis can be considered severe systemic complications of oral piercing, which may even be life-threatening [11].
The tongue and lips were the two anatomical areas of the mouth where piercings were most frequently seen, and women were more likely than males to acquire oral piercings [12]. Gingival recession was mentioned as the most common complication. The central mandibular incisors reported the highest incidence of periodontitis and gingivitis. The frequency of tooth fracture was observed more in people with tongue piercing. Complications such as swelling and local inflammation after the piercing operation were among the injuries mentioned in the case reports that could threaten life. In addition, long-term piercing may cause gingival recession and tooth fracture [13]. There have been few systematic reviews or/and meta-analyses on the topic, each focusing on different aspects of oral/systemic health [14, 15, 16]. Their research primarily relied on case reports, which, due to their focus on individual patients, have limited statistical power. However, the dependability of the research was diminished by several investigations’ low quality and substantial heterogeneity across the studies [14, 15, 16]. In light of these apparent complications, clarifying how these injuries develop in oral piercing cases is necessary [17]. Therefore, this review aimed to systematically evaluate the literature for information on complications due to oral piercing.
Figure 1. Different locations for oral piercing include (A) the lingual frenulum, (B) the lower lip, (C) the body of the tongue, (D) the upper labial frenulum, and labret piercing [15].
Dental Issues Tongue Piercing Can Cause And How To Avoid Them
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane Handbook for Systematic Reviews [18, 19] were followed in this investigation. The protocol of this study was registered at the Open Science Framework (https://doi.org/10.17605/OSF.IO/MXKDC (accessed on 12 September 2023)). The central question of this research was: What are the oral health-related complications associated with oral piercings? The secondary research questions focused on the level of awareness regarding oral piercings-associated complications among public/health care professionals and their microbiological profile.
The guidelines used for the search strategy are consistent with existing procedures for conducting systematic reviews. The four electronic databases, including PubMed, Scopus, Cochrane, and Google Scholar, were used to find papers that met the study’s criteria. In addition, electronic databases were searched from the inception until April 2023. The search terms used are presented in Supplementary Table S1.
The present study centered on the potential hazards posed by chemical, mechanical, and microbial factors in the context of piercing procedures and the awareness level regarding piercing-associated adverse effects among professionals/the public. The investigation analyzed primary research that presented evidence of these outcomes categorized into four main domains: public/professional awareness, periodontal/peri-implant complications, microbiological analyses, general and hard/soft tissue complications, and frequency of complications. The piercings in our definition encompassed those in the lips, cheeks, teeth, gingiva, buccal region, frenulum, uvula, tongue, and oral mucosa. The study incorporated case–control studies, cohorts, and cross-sectional studies, covering adolescent and adult populations and encompassing a wide range of piercing types. No limitations were imposed based on demographic factors such as age, height, weight, sexual orientation, race, or prior medical history. The studies included in the analysis were published from the beginning of the research field until April 2023. Articles written in English were included. In contrast, the analysis excluded all in vitro and in vivo research, case reports, interventional studies, hypotheses, correspondence, comments, letters to the editor, conference abstracts, editorials, and studies focused on exploring the association between oral piercings and general health risks.
Snake Eye Tongue Piercings: Everything You Need To Know
Following the articles’ retrieval from the database search, they were imported into the Endnote reference management software. The assessment of studies for potential eligibility was conducted by evaluating their title and abstracts for inclusion. Two authors (S.A.M and S.T.) independently assessed the title and abstract of each record to ascertain their suitability for inclusion in the review. Any disagreements between reviewers were resolved involving a third author (A.J.). Subsequently, the studies that satisfied the predetermined eligibility criteria underwent a thorough evaluation by scrutinizing the entire text document to ascertain their adherence to the established inclusion criteria. The review process is presented in Figure 2. The inter-reviewer reliability between the evaluators for the literature screening stage was determined using Cohen’s Kappa coefficient. Based on the frequency of precise agreements amongst reviewers, the kappa value (к) was calculated.
Using established categories mutually agreed upon by all authors, specific information from each eligible record was extracted (Table 1). Bibliographic details, research methodology, patient demographics, piercing types, health assessments, research findings,
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane Handbook for Systematic Reviews [18, 19] were followed in this investigation. The protocol of this study was registered at the Open Science Framework (https://doi.org/10.17605/OSF.IO/MXKDC (accessed on 12 September 2023)). The central question of this research was: What are the oral health-related complications associated with oral piercings? The secondary research questions focused on the level of awareness regarding oral piercings-associated complications among public/health care professionals and their microbiological profile.
The guidelines used for the search strategy are consistent with existing procedures for conducting systematic reviews. The four electronic databases, including PubMed, Scopus, Cochrane, and Google Scholar, were used to find papers that met the study’s criteria. In addition, electronic databases were searched from the inception until April 2023. The search terms used are presented in Supplementary Table S1.
The present study centered on the potential hazards posed by chemical, mechanical, and microbial factors in the context of piercing procedures and the awareness level regarding piercing-associated adverse effects among professionals/the public. The investigation analyzed primary research that presented evidence of these outcomes categorized into four main domains: public/professional awareness, periodontal/peri-implant complications, microbiological analyses, general and hard/soft tissue complications, and frequency of complications. The piercings in our definition encompassed those in the lips, cheeks, teeth, gingiva, buccal region, frenulum, uvula, tongue, and oral mucosa. The study incorporated case–control studies, cohorts, and cross-sectional studies, covering adolescent and adult populations and encompassing a wide range of piercing types. No limitations were imposed based on demographic factors such as age, height, weight, sexual orientation, race, or prior medical history. The studies included in the analysis were published from the beginning of the research field until April 2023. Articles written in English were included. In contrast, the analysis excluded all in vitro and in vivo research, case reports, interventional studies, hypotheses, correspondence, comments, letters to the editor, conference abstracts, editorials, and studies focused on exploring the association between oral piercings and general health risks.
Snake Eye Tongue Piercings: Everything You Need To Know
Following the articles’ retrieval from the database search, they were imported into the Endnote reference management software. The assessment of studies for potential eligibility was conducted by evaluating their title and abstracts for inclusion. Two authors (S.A.M and S.T.) independently assessed the title and abstract of each record to ascertain their suitability for inclusion in the review. Any disagreements between reviewers were resolved involving a third author (A.J.). Subsequently, the studies that satisfied the predetermined eligibility criteria underwent a thorough evaluation by scrutinizing the entire text document to ascertain their adherence to the established inclusion criteria. The review process is presented in Figure 2. The inter-reviewer reliability between the evaluators for the literature screening stage was determined using Cohen’s Kappa coefficient. Based on the frequency of precise agreements amongst reviewers, the kappa value (к) was calculated.
Using established categories mutually agreed upon by all authors, specific information from each eligible record was extracted (Table 1). Bibliographic details, research methodology, patient demographics, piercing types, health assessments, research findings,
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