1. Consequences of Popular Lip and Perioral Jewelry on Periodontal Tissues Jacqueline Muñoz WLADH 1066 November 29, 2009

2. History of Lip and Perioral Piercings In ancient times, civilizations wore oral and perioral jewelry to symbolize courage, royalty, virility, or spirituality. Today, these facial adornments are a popular symbol of self expression and have become a fashion statement amongst adolescents and young adults.

3. Lip and perioral piercings are second in popularity, following tongue piercing. The jewelry is made of non-toxic, hypoallergenic material such as14-18K gold, titanium, stainless steel, niobium, tygon, acrylic, stone, wood, bone, and ivory. The jewelry is usually a labret stud, magnetic stud (most dangerous-risk of aspiration), unenclosed ring, or a barbell. http://s.bebo.com/app-image/7933963010/5411656627/PRO FILE/i.quizzaz.com/img/q/u/08/08/01/Piercing_by_larafairie.jpg

4. Variety of Lip and Perioral Piercings http://images.google.com/imgres?imgurl=http://www.desertsmiles.com/assets/lip.jpg&imgrefurl=http://www.desertsmiles.com/news/piercing.htm&usg=__opSZA OiDa8QJp0SFlPXKSZEMvg=&h=129&w=163&sz=4&hl=en&start=1&um=1&itbs=1&tbnid=O4UYGdFXx4E0SM:&tbnh=78&tbnw=98&prev=/images%3Fq %3Dlip%2Band%2Bperioral%2Bpiercing%2Bjewelry%26hl%3Den%26rlz%3D1T4GZHY_enUS238US240%26sa%3DN%26um%3D1 images%3Fq%3Dlip%2Band%2Bperioral%2Bpiercing%2Bjewelry%26hl%3 Den%26rlz%3D1T4GZHY_enUS238US240%26sa%3DN%26um%3D1 http://images.pennnet.com/articles/rdh/thm/th_203683.jpg http://en.academic.ru/pictures/enwiki/66/B7a8e9052925.jpg

5. Effects on soft and periodontal tissue: Gingival recession on the facial surfaces of the teeth which can extend into the mucogingival junction Narrow width of attached gingiva Bone dehiscence Soft tissue trauma and lesions Injury to the PDL Localized horizontal bone loss Chipped or broken teeth Temporary or permanent increase in salivation Infection and inflammation Interference with radiographic interpretation http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2606659/

6. Permanent Damage http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2606659/ http://jada.ada.org/cgi/content/full/134/7/837 2003http://jada.ada.org/cgi/content/full/134/7/837 http://jada.ada.org/cgi/content/full/134/7/837 2003 ://www.desertsmiles.com/assets/recession.jpg&imgrefurl=http://www.desertsmil es.com/news/piercing.htm&usg=_zUjwlYMANvR1I5y-fZY0sIbPQfY http://images.google.com/imgres?imgurl=http =&h=129&w=163&sz=5&hl=en&start=2&um=1 &itbs=1&tbnid=mI1aeO2BAroszM:&tbnh=78&tbnw=98&prev=/images%3Fq%3 Dlip%2Band%2Bperioral%2Bpiercings%26hl%3Den%26rlz%3D1W1GZHY_e n%26sa%3DN%26um%3D1 http://images.google.com/imgres?imgurl=http://image.listpipe.com/lp_lippiercing.jpg&imgrefurl=http://www.kochaesthetics.com/blog/%3Fcat%3D7&usg=__SmNWKt0PpffEcI2mon0yQtO7gYM=&h=191&w=235&sz=9&hl=en& start=49&um=1&itbs=1&tbnid=c2Aeicshcv3VNM:&tbnh=89&tbnw=109&prev=/images%3Fq%3Doral%2Bdamage%2B caused%2Bby%2Bpiercing%2Bjewelry%26ndsp%3D18%26hl%3Den%26rlz%3D1W1GZHY_en%26sa%3DN%26start%3D36%26um%3D1

7. Other Negative Effects of Lip and Perioral Jewelry Interfere with chewing food Collect plaque and accumulate calculus Possibility of ingesting jewelry exists Playing with jewelry can cause tissue trauma Tissue pigmentation at piercing site http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2606659

8. Risk of Disease Transmission Body piercing is unregulated Infection control standards are not followed Piercing is done by non-medical personnel Hepatitis B & C, Herpes Simplex virus, Epstein-Barr virus, Syphillis, T.B, or Candida albicans can be transmitted HIV transmission has not been documented

9. Recommendations Avoid lip and perioral piercings Educate patients on the negative outcomes of lip and perioral piercings ADA stands against lip and perioral piercings Maintain good oral hygiene habits Regularly remove and clean oral jewelry Routine dental examinations Routine physical examinations To repair periodontal tissue damage, gingival graft surgery is performed

10. References ADA Position and Statements. (2004). ADA statement on intraoral/perioral piercing and tongue splitting. Retrieved October 12, 2009, from http://www.ada.org/prof/resources/positions/statements/piercing.asp.http://www.ada.org/prof/resources/positions/statements/piercing.asp Andrian, E., Grenier, D., & Maheu-Robert, L. (2007, May). Overview of complications secondary to tongue and lip piercings. Journal of the Canadian Dental Association, 73(4), 327-331. Retrieved October 10, 2009, from http://www.cda-adc.ca/jcda/vol-73/issue-4/327.pdf. Bascones-Martinez, A., Campo-Trapero, J., Cano-Sanchez, Escudero-Castaño, N., & Perea- Garcia, M.A. (2008). Oral and perioral piercing complications. The Open Dentisitry Journal, 2, 133-136. Retrieved October 2, 2009, from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2606659. Brooks, J.K., Hooper, K.A., & Reynolds, M.A. (2003, July). Formation of mucogingival defects associated with intraoral and perioral piercing: case reports. The Journal of the American Dental Association, 134, 837-843. Retrieved October 10, 2009, from http://jada.ada.org/cgi/content/full/134/7/837. Downs, J.S., Gold, M.A., Murray, P.J., & Schorzman, C.M. (2007, October). Body art: attitudes and practices regarding body piercing among urban undergraduates. Journal of the American Osteopathic Association, 107(10), 432-438. Retrieved October 10, 2009, from http://www.jaoa.org/cgi/reprint/107/10/432.pdf. Soileau, K.M. (2005, April). Treatment of mucogingival defect associated with intraoral piercing. The Journal of the American Dental Association, 136, 490-494. Retrieved October 10, 2009, from http://jada.ada.org/cgi/content/full/136/4/490. Wikipedia. (2009). Lip piercing. Retrieved October 10, 2009 from http://en.wikipedia.org/w/index.php?title=Lip_piercing&printable=yes.http://en.wikipedia.org/w/index.php?title=Lip_piercing&printable=yes Wolfe, F.D. (2006, March). The perils of oral piercing. Registered Dental Hygienist Magazine. Retrieved October 10, 2009 from http://www.dentaleconomics.com/display_article/250008/56/none/none/Feat/the-perils-of-oral-piercing.http://www.dentaleconomics.com/display_article/250008/56/none/none/Feat/the-perils-of-oral-piercing