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ORAL PIERCING RISKS & SAFETY
MEASURES
The Association of Professional Piercers
would like to present a number of facts in order that consumers,
health care workers, and other concerned parties may properly
educate themselves about oral piercing before making any
decisions or judgments. A well-informed and discerning consumer
is subject to far fewer dangers than one with incomplete
or inaccurate information.
When properly performed, the piercing procedure
itself takes only a few seconds, and involves minimal discomfort
and often no blood. Healing is ordinarily rapid and is commonly
uneventful.
Most of the concerns about oral piercings
center on one of three areas:
- Fear of an unsafe procedure
- Potential for damage to teeth and oral structures
- Risk of infection
These potential hazards are generally easily
controlled when the following steps are taken.
PIERCER
To reduce risks of an unsafe procedure,
you must first select the right piercer, one who:
- Has appropriate training; is skilled, experienced,
clean and professional;
- Practices safe piercing technique and cross-contamination
control;
- Works in a hygienic environment that conforms to relevant
local and/or state regulations;
- Follows OSHA Bloodborne Pathogens standards;
- Has obtained all applicable licenses and permits;
- Spore tests autoclave (sterilizer) regularly and can
provide documentation;
- Uses appropriate sterile instruments and jewelry,
and sterile disposable needles;
- Takes the time to verbally instruct in proper care
guidelines and provides written instructions;
- Is available for follow-up and questions post-piercing,
so any developing problems can be resolved before damage
occurs.
See CHOOSING A PIERCER or download the
PDF of the brochure for additional details and information.
JEWELRY
The potential for structural damage from
tongue and oral piercing can be dramatically reduced by
wearing appropriate jewelry. Complications may result if
the jewelry is inappropriately sized, improperly placed,
or poorly manufactured. Things to consider:
- Correct style of jewelry for the particular anatomy
and piercing placement;
- Jewelry accurately sized to the area -The initial,
longer jewelry that allows for usual swelling should
be replaced with a shorter piece after swelling has
dissipated, as this has less chance of negatively impacting
the teeth and other oral structures.
- Surgical implant grade jewelry -See the accepted APP
Minimum Jewelry Standards for detailed jewelry material
and design specifications.
- Balls made of acrylic can be worn on tongue barbells
to further minimize the risk of damage to the teeth.
- Check that threaded ends are on securely. Tighten
them each day to insure jewelry stays in place.
- A smaller ball can be worn on the underside of the
tongue to reduce contact with the sublingual portion
of the oral cavity.
- Piercees should be strongly cautioned that playing
with the jewelry excessively is frequently the cause
of reported tooth and gum damage and should be avoided.
PLACEMENT
Proper placement is absolutely critical
to the health and comfort of the piercee.
Traditional placement for a tongue piercing:
Along the midline of the tongue, essentially in the center
of the mouth;
Often approximately 3/4" or so back from the tip of
the tongue;
Commonly placed with the top a little further back than
the bottom (This allows the top of the jewelry to lean slightly
back, away from the teeth, and towards the higher part of
the upper palate where there is more room in the mouth);
Usually placed just in front of the attachment of the lingual
frenulum (web under the tongue).
Traditional placement for lip or cheek
piercings:
- Should be placed relatively perpendicular to the
area to avoid having the jewelry rest at a sharp angle.
- Position should be chosen so that the jewelry rests
in a neutral spot within the mouth.
- Post should be shortened to fit snugly once healing
is done to minimize contact of jewelry with the gums
or teeth.
- Place cheek piercing no further away from the mouth
than the first molars to avoid parotid gland and ducts.
- A strong light can be used to check the selected placement
for vascularity and enervation (blood vessels and nerves).
AFTERCARE
The risk of exposure to infection can be
controlled during the piercing procedure by the use of sterile
tools, jewelry and needle, and a thorough understanding
and implementation of aseptic technique. Entirely vital
for avoiding infection during healing is the cooperation
of the piercee in caring for the piercing properly.
- The piercer must thoroughly explain aftercare protocol,
including providing written and verbal guidelines detailing
the use of antimicrobial alcohol-free mouth rinses and
sea salt rinses.
- Don't share plates, eating utensils, cups, and such.
- Replace your toothbrush and make sure to keep it extra
clean during healing.
- Keep dirty fingers, pencils, sunglasses, and other
foreign objects away from the mouth and face.
- Avoid excessive talking, playing with the jewelry,
and all oral sexual contact during healing.
See ORAL PIERCINGS AFTERCARE or download
the PDF brochure for detailed care information.
WHAT ABOUT SWELLING?
Most piercees report little or no bleeding
and a minimum of swelling for a few days when the piercing
is performed properly and approved care guidelines are followed.
- Gently sucking on chipped or shaved ice can diminish
swelling during initial healing
- Elevation of the head above the heart while sleeping
(use several pillows) may minimize initial overnight
swelling
- The use of over-the-counter nonsteroidal anti-inflammatory
such as Ibuprofen taken according to package instructions
may limit the extent of initial swelling.
ISN'T THE MOUTH DIRTY?
Although often cited, this concern may
not be as valid as expected.The extremely short healing
time of the average oral piercing provides a much smaller
window of opportunity for exposure to external infection
than do many other common piercings. For instance, a tongue
piercing usually heals in 4 6 weeks, compared to 6 9 months
or longer for a navel piercing.
As the main 'entry portal' for any material
entering the body, the oral cavity is exposed to a variety
of toxins, bacteria, and other noxious substances on a near-constant
basis. Drinking or eating anything contaminated with disease-causing
microbes can potentially cause illness and infection. Breathing
air that contains airborne pathogens may lead to other types
of systemic disease. Why then are we relatively healthy
despite this continual microbial assault? The answer lies
in the design of the oral cavity and its defensive strategies.
Salvia contains numerous antimicrobial
factors that directly attack and deactivate harmful microbes.
Among them:
- Lysozyme
- Lactoferrin
- Salivary peroxidase
- Myeloperoxidase
- Agglutinins
- Immunoglobulins ('antibodies')
Because saliva is produced only within
the oral cavity, the mouth is at a distinct advantage over
other parts of the body when it comes to warding off infection.
Oral mucosa has an extremely high 'turnover rate' which
makes it one of the fastest healing sites in the body. This
fast turnover rate allows oral mucosa to maintain its structural
integrity by a system of continuous cell renewal in which
cells are produced by cell division, migrate to the surface
of the tissue, and replace those cells which are shed. Cellular
turnover rates for oral mucosa of the cheek is 25 days compared
to 52-75 days for skin.
Because the head and neck region houses
a highly concentrated system of veins, arteries and lymph
vessels allowing for rapid transportation of these anti-infective
agents, infectious agents can be attacked and dealt with
in a swift manner.
When a piercing in the oral cavity is performed,
infection rates are negligible when sterile equipment, proper
aseptic protocol and appropriate jewelry selection are combined
with conscientious aftercare. This requires the education
of both the piercer and the client, and with cooperation
can ensure a safe and successful experience.
INFORMATION IS THE KEY
Unsafe, unethical, and uneducated piercers
thrive in areas where complete, accurate information is
not made available to both the general public and those
who seek to protect them. Making oral piercings illegal
forces consumers who still seek them to patronize unregulated,
underground establishments. Only by supporting the dissemination
of accurate information and the efforts of conscientious
professionals can the risks of piercing truly be controlled.
To disparage the efforts of a burgeoning
profession without full and appropriate information is not
an accurate or helpful response. Since many individuals
still desire oral piercings and intend to get them, it is
far more constructive to provide accurate information and
specific guidelines on safe piercing procedure and how to
choose a practitioner.
The APP is a non-profit organization dedicated
to health, education and safety of piercers and the public.
We are a group of committed professionals who uphold an
extremely high standard of safety and hygiene. We support
the development of appropriate regulations and standards
to ensure the improvement of our art form and the continued
safety of our clientele.
For more information please contact the
Association of Professional Piercers (APP)
REFERENCES
1. Department of Cariology, Institute of
Dentistry, University of Turku (Finland): Salivary peroxidase
systems and lysozyme in defense against cariogenic microorganisms.
Lenager-Lumikari (1992)
2. Ten Cate AR: Oral histology: Development,
structure, and function (2nd ed). C.V. Mosby Company (St.
Louis). 1985
3. Staines N, Brostoff J and James K: Introducing
immunology (2nd ed). C.V. Mosby Company (St. Louis). 1994.
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