Oral Piercings: Implications for Dental Professionals
Course Number: 688
Aftercare for Piercings
The average healing period for oral piercings varies from 1-6 months with 2-4 months being more typical. Unexpected or exacerbated reactions or delayed healing may extend the healing beyond 6 months.9,22,25
A quality piercing establishment will give post piercing instructions both verbally and in writing. A comprehensive brochure has been produced by the Association of Professional Piercers (APP) and can be viewed and downloaded from their website, www.safepiercing.org. Highlights from the brochure include the following:
What to expect during the first 3-5 days:
Swelling
Light bleeding
Bruising
Tenderness
Light secretion of a clear serous fluid (not pus) that may form a crust on the jewelry
To reduce swelling:
Allow ice chips to melt in the mouth.
Use an over-the-counter non-steroidal anti-inflammatory drug (NSAIDS) according to package directions. This will help with pain control as well.
Don’t speak or move the jewelry more than necessary.
Sleep with your head elevated above your heart for the first few nights.
In case of bleeding:
For light bleeding, press the area with a clean cloth.
Seek medical help if the bleeding does not stop.
Cleaning:
Use an antimicrobial or antibacterial mouth rinse, preferably alcohol-free and hydrogen peroxide-free, or a saline rinse. Swish for 30 seconds 4-5 times daily, especially after meals and at bedtime. The saline solution should be sterile and isotonic. The only ingredients included should be water and 0.9% or 9mg/ml sodium chloride. Mixing your own solution is not suggested as mixing your own solution will commonly result in the product being far too salty and strong. This can over dry the piercing and interfere with healing.
Wash hands thoroughly prior to cleaning or touching the jewelry or surrounding area.
Apply a saline soaked gauze 2-3 times daily for 5-10 minutes, rinsing carefully afterwards to remove any residue.
While showering, use a small amount of mild soap to clean the jewelry and the piercing. Once a day for no more than 30 seconds is recommended. Rinse thoroughly to remove any soap residue.
Dry carefully with a clean disposable paper product. Reusable items can harbor bacteria. Woven cloth items could snag the jewelry and cause injury.
Maintain good oral hygiene by daily gentle but thorough brushing and flossing.
Infection:
Signs of infection may include:
Yellow or green discharge – white or clear is normal.
Thick, dark tissue that builds up around the piercing site.
Increased redness, pain, swelling, bleeding, or any tearing.
Low grade, persistent fever.
If you suspect an infection:
Seek professional care.
Keep quality jewelry or insert plastic in place to encourage drainage.
Removing the jewelry will allow surface healing that could trap the infection and result in an abscess.
Eating:
Avoid:
Alcohol.
Salty, spicy, acidic foods.
Very hot foods.
Hard or sticky foods – mashed potatoes, oatmeal, etc. can stick to the mouth and jewelry.
Take small bites and take time to get used to eating with the piercing.
Cold foods and beverages are soothing and help reduce swelling.
With a tongue piercing, keeping the tongue level in the mouth can reduce the possibility of the jewelry getting caught between the teeth.
For cheek and lip piercings, don’t open the mouth too wide as the jewelry can catch on teeth.
Wearing jewelry:
After the swelling has subsided, it is essential to change the original, longer jewelry to shorter jewelry to avoid damage. This change usually occurs during healing and should be done by a professional piercer.
With clean hands or a disposable cloth, regularly check the threaded ends of the jewelry and retighten as necessary.
Carry clean, spare jewelry in case of breakage or loss.
The professional piercer can recommend a non-metal alternative in the event the jewelry needs to be removed temporarily for a medical or dental procedure.
Do not remove the jewelry for an extended period of time unless closure of the piercing is desired. Even piercings that have been healed for years can begin to close. With this partial closing, replacing the jewelry could result in re-piercing and the associated post-piercing issues.
Should you desire to permanently remove the jewelry, continuing caring for the piercing site. This should minimize scaring. Excess scarring can be unaesthetic, collect food debris or cause pain when the scar is pressed.
What to avoid:
The use of aspirin or NSAIDS for 7 days after the piercing, if heavy bleeding is present.
Playing with the jewelry. Cracks and fractures of the teeth caused by clicking, tapping, or rubbing the jewelry on the teeth occur so frequently the Academy of General Dentistry (AGD) calls them ‘wrecking ball fractures.’
All tobacco products.
Recreational drug use.
Chewing gum, fingernails, pencils/pens, earpieces of glasses/sunglasses, and other foreign objects that can harbor bacteria.
Sharing cups, plates and eating utensils.
Public water sources such as pools, lakes and hot tubs.
Hydrogen peroxide or makeup/personal care/beauty products.
Antibacterial/antibiotic ointments as they are heavy, block air circulation, attract/retain dirt/debris and are not shown to positively affect healing or scar development.