"Piercing the Human Mouth"

Oral piercing has seen a traumatic increase in recent years. The lips, cheeks, and the tongue are popular sites for oral piercing. There are several potential health hazards related to this practice. Perforation of the blood vessels of the tongue can cause bleeding and hematoma formations. Frequently swelling in the mouth develops after tongue piercing.
A major possible consequence of oral piercing is the compromise of the airway from trauma, tongue swelling, or obstruction by the jewelry in the mouth. Securing or providing an adequate airway or even endotracheal intubation can be challenging when a patient has a tongue barbell. If in an emergency the jewelry in the mouth is not able to be removed easily or expeditiously, emergency physicians and dentist must try and ensure that the jewelry is not loosened and aspirated or swallowed. It would always be indicated protocol to remove oral and nasal jewelry for non-emergency surgical procedures.
Chipping, cracking, or splitting teeth are the most common dental problem related to barbells in the tongue. When beaded jewelry is in the mouth it is possible for the jewelry to become trapped between teeth. The mouth has millions of bacteria present at all times and the risk of infection is obviously high. It would be recommend to use oral rinses like Listerine to reduce the bacteria amounts found in the mouth, and thus reduce the chance of oral infection. There have been reported cases of rapidly spreading oral cellulitis (Ludwig’s Angina) as a complication of tongue piercing. This cellulitis can impact a person extremely quickly, sometimes a matter of hours, and can lead to life threatening complications such as maintaining an adequate airway due to the enormous swelling in the throat area.
The information offered above describes the reasons for caution to be used when having oral piercing done in your mouth. Please contact your dental professional and explore the pro’s and con’s to oral piercing.

Dental Examinations

Without getting into a lot of technical detail, a radiograph is a special kind of picture taken of hard structures, such as bone or teeth, which demonstrates the density of the subject of the picture. The more dense the matter shown, the lighter the image will appear on the x-ray or radiograph. Conversely, the less dense the subject, the darker that part of the radiograph will appear. Caries, fractures of the bone or tooth, and many tumors of the bone are less dense than healthy tissues, and the darker on the radiograph.

There are three types of radiographs used in dentistry:

1. Panoramic - This type of radiograph is taken by a machine that rotates around the head while projecting the radiograph beam onto a long film, which is also rotating in a canister. The result is a picture of the entire lower face from the eye sockets to the chin. This type of radiograph is excellent for detecting tumors and irregularities of the maxillary sinuses and upper and lower jaws, including fractures, as well as offering the best view of the position of the third molars (wisdom teeth). In most cases, the detail of the remaining teeth themselves is not adequate for diagnostic purposes.

2. Periapicals – Literally meaning “around the roots” of the teeth, this film shows the roots and bone around 2-4 teeth per film, and has excellent detail for diagnosing abscessed teeth, bone and tooth fractures, and bone loss due to advanced periodontal disease.

3. Bitewings – Either two or four films, this set of radiographs is taken specifically to detect caries (decay) that occurs between the teeth. Bitewings plus 14 periapical images constitute a “Full Mouth Series” of radiographs.

For a complete dental examination adequate to diagnose a patient’s dental problems and potential future problems, all the above mentioned radiographs are necessary. The panoramic in most cases, does not provide sufficient detail to diagnose decay or bone loss due to periodontal (gum) disease. Conversely, the periapicals and bitewings do not expose areas of the jaws where tumors and fractures of the bone typically occur. Be advised that your dental insurance company may not agree that all types are necessary.

The frequency of prescribed radiographs is based upon the dentist’s assessment of your individual needs, including whether you are a new patient, adult, child, and pregnant females. Many dental offices are now using the new technology of digital radiography. Much like a digital camera, there is no film. Instead, a sensor is used to capture the image. Directly connected to the computer, the sensor transfers the image into the computer data bank to be retrieved whenever needed. The image can be made larger, smaller, darker, lighter-changed in many ways to enhance diagnostic ability. In communicating with specialists or other dental offices, the image can be electronically transferred or emailed in seconds. An advantage for the patient is that less radiation is required to create the image.

A planned course of treatment is only as good as the information obtained in the diagnostic examination. Caries between the teeth, root fractures, bone loss caused by gum disease, fractures of the bone and many cancerous and non-cancerous tumors of the bone would be impossible to diagnose without the use of dental radiographs.