Oral piercings and your teeth

Reviewed by Dr. Samar Fadavi, DDS

Short answer: Tongue, lip and cheek piercings can chip or crack teeth, wear away gums and lead to infection or swelling. If you have one, choose smooth, well-fitted jewellery, keep it clean, avoid clicking it against your teeth and take it out for contact sports. Visit your dentist regularly so early gum recession or tooth damage is found before it becomes a bigger problem.

Oral piercings: a quick overview

Oral piercings are a popular form of self-expression. Common types include tongue piercings, lip piercings (including labret piercings below the lower lip), cheek piercings and piercings of the small fold of tissue under the upper lip, sometimes called a smiley. Each sits close to teeth and gums, and the mouth is full of bacteria, so oral piercings need more care than piercings elsewhere on the body.

Dentists are not here to judge. Our goal is to help you keep your teeth and gums healthy whatever choices you make. This guide explains the risks, how to care for a new piercing, how to choose jewellery that is kinder to your mouth, warning signs to watch for and what your dentist looks for at check-ups. It is general information for patients in Scarborough, the Danforth and East Toronto.

Risks to teeth

Chipped and cracked teeth

Metal jewellery is hard. Biting on a tongue barbell, clicking it against the back of the front teeth or playing with a lip ring can chip enamel and crack teeth. Cracks may start small and cause no pain at first, then grow until a piece breaks off or the nerve is affected. Back teeth and the inside surfaces of front teeth are most often damaged.

Wear on fillings and crowns

Repeated contact can chip porcelain crowns and veneers and wear or loosen fillings.

Sensitivity

Small chips and cracks can expose the inner layer of the tooth, leading to sensitivity to cold, sweets or biting. Our guide to different types of tooth pain explains what these twinges can mean.

Risks to gums

Lip and labret piercings often rest against the gums of the lower front teeth. Tongue barbells can rub the gums on the inside of the lower front teeth. Over months and years, this constant contact can wear the gum away, causing gum recession. Exposed roots are sensitive and more prone to decay, and lost gum tissue does not grow back on its own. In some cases bone loss around the front teeth follows. Our gum recession guide explains why this matters and how it is treated.

Health risks of the piercing itself

• Infection. The mouth contains many bacteria, and a fresh piercing is an open wound. Signs include increasing pain, redness, warmth, pus, a bad taste and fever.
• Swelling. The tongue swells after piercing, usually for several days. Severe swelling can make breathing or swallowing difficult and needs urgent care.
• Bleeding. The tongue has a rich blood supply, and piercing a blood vessel can cause heavy bleeding.
• Nerve injury. Rarely, a piercing affects a nerve and causes numbness or changes in taste or movement.
• Allergic reactions. Some metals, especially those containing nickel, can trigger allergy.
• Swallowing or inhaling jewellery. A loose ball can come off and be swallowed or breathed in.
• Speech and eating changes. Many people notice a lisp or extra saliva at first.
• Bad breath. Plaque and food can collect around jewellery. Our mouth odour guide has tips.

Before you get pierced

1. Have a dental check-up first. Healthy gums and treated cavities lower the risk of problems.
2. Choose a reputable studio. In Toronto, personal service settings such as piercing studios are inspected by public health. Look for a clean studio that uses single-use needles and sterilized tools, and ask how they sterilize equipment.
3. Ask about jewellery material. Implant-grade titanium or other body-safe materials lower the risk of allergy.
4. Plan around your schedule. Swelling and a lisp are common for the first days, so avoid getting pierced right before an important event, exam or performance.
5. Talk to your doctor if you have a heart condition, diabetes, a bleeding disorder or a weakened immune system, since infection risk is higher.

Caring for a new oral piercing

1. Rinse after eating. Use plain water, a saline rinse or a mouthwash without alcohol after meals and snacks.
2. Keep brushing. Brush your teeth and gently clean around the jewellery with a soft brush. Replace your toothbrush once the piercing has healed.
3. Use cold for swelling. Small sips of cold water or letting ice chips melt in the mouth can ease tongue swelling.
4. Eat soft foods at first. Choose foods like yogurt, soup, eggs and mashed vegetables, and take small bites.
5. Keep hands off. Touching or twisting the jewellery adds bacteria and slows healing.
6. Follow the piercer’s timeline. Tongue piercings usually take several weeks to heal, and lip piercings often take longer. Keep the original jewellery in until it is safe to change.
7. Swap to shorter jewellery once swelling settles. The longer starter bar is needed for swelling, but a shorter one afterward is less likely to hit your teeth. Your piercer can do this.

What to avoid

• Avoid clicking, biting or playing with the jewellery. This habit causes most tooth damage.
• Avoid alcohol, smoking, vaping and cannabis while healing. They slow healing and raise infection risk.
• Avoid kissing and oral contact until healed.
• Avoid very hot, spicy or crunchy foods during healing.
• Avoid sharing drinks or utensils.
• Avoid removing new jewellery too early. The hole can close quickly and trap infection.
• Avoid wearing jewellery during contact sports. Remove it or use a mouthguard as advised.

Choosing jewellery that is kinder to your mouth

• Smooth, rounded ends are less likely to chip teeth than sharp or textured designs.
• The right length matters. A bar that is too long hits the teeth more often. Downsize after healing.
• Flat discs on the inside of lip piercings rest more gently against the gums than balls.
• Body-safe flexible materials are an option some people choose once healed, as they are softer on teeth.
• Check that balls are tight every day, with clean hands, so they do not loosen and get swallowed.

Signs of a problem

Call your piercer or doctor, or the clinic for tooth or gum problems, if you notice:

• Pain, swelling or redness that gets worse after the first few days.
• Pus, a foul taste or fever.
• Swelling that makes it hard to breathe, swallow or speak. Seek emergency medical care right away.
• A tooth that feels rough, chipped or sensitive.
• Gums that look like they are pulling back near the jewellery.
• Jewellery that is embedded, stuck or hard to remove.

Oral piercings and dental visits

Tell your dental team about any oral piercing. At a check-up, the dentist looks closely at the teeth and gums near the jewellery for chips, cracks and early recession. You may be asked to remove the jewellery for x-rays, because metal can block the view, and sometimes for cleanings or treatment so instruments can reach every surface. If you cannot remove it easily, let us know when you book. Our dental x-rays guide explains what each type of x-ray shows.

Treating damage from piercings

• Small chips can often be smoothed or repaired with tooth-coloured bonding.
• Larger cracks or breaks may need a filling, crown or, if the nerve is affected, a root canal. Our crowns and bridges page explains crowns.
• Gum recession may be managed by removing or changing the jewellery and monitoring, and in some cases with gum grafting.
• Infection may need cleaning, antibiotics as prescribed and sometimes removal of the jewellery.

Many people decide to remove a piercing once they see early tooth or gum damage. The hole usually closes, sometimes leaving a small scar.

Teens and oral piercings

Teens are often the age group most interested in oral piercings. Parents can help by talking openly about risks, choosing a reputable studio together if the decision is made, and making sure regular dental check-ups continue. Teens with braces should know that jewellery and brackets are a risky combination for both chipped teeth and broken appliances.

Breaking the clicking habit

Many people with tongue or lip jewellery play with it without noticing, especially when concentrating, stressed or bored. Over time this habit does the most damage. A few ideas can help:

• Notice when you tend to play with it, such as while gaming, studying or driving, and keep your tongue resting on the roof of your mouth during those times.
• Ask a friend or family member to point it out when they hear clicking.
• Switch to shorter or softer jewellery once healed, which makes clicking less tempting.
• Chew sugarless gum when you feel the urge, if you do not have a fresh piercing.
• Take the jewellery out at night if your piercer says it is safe, so you do not bite it in your sleep.

Sports, sleep and eating

A blow to the face during sports can drive jewellery into the gums or break teeth. Remove jewellery for contact sports when it is safe to do so, and wear a mouthguard. Some people bite down on tongue jewellery while sleeping, so check with your piercer about safe options for night time. When eating, take smaller bites and chew slowly so you do not bite the jewellery, and be careful with hard foods such as nuts, ice and hard candy.

If you decide to remove an oral piercing

Many people choose to take out an oral piercing after a few years, or after their dentist points out early gum or tooth changes. Removal is usually simple once the piercing is fully healed. Clean your hands, unscrew the ball or disc, and slide the jewellery out gently. Rinse with salt water for a few days while the hole closes. Most holes close within days to weeks, sometimes leaving a small dimple or scar. If the jewellery is stuck, embedded in swollen tissue or the area looks infected, do not force it. See your piercer, doctor or dentist for help.

When to see a dentist

Book a visit if:

• A tooth near your piercing feels rough, sharp, chipped or sensitive.
• Your gums near the jewellery look like they are receding.
• You have had an oral piercing for a while and have not had a check-up in the past year.
• You are thinking about getting an oral piercing and want a check-up first.

Call the same day if a tooth breaks or you have severe pain. Our emergency dentist page explains same-day care, and our family dentistry page covers regular check-ups.

Questions about oral piercings

Can a tongue piercing crack my teeth?

Yes. Biting or clicking metal jewellery against teeth can chip or crack them, especially the back teeth and the inside of the front teeth.

Do lip piercings cause gum recession?

They can. Jewellery resting against the gums of the lower front teeth can wear gum tissue away over time.

How long does a tongue piercing take to heal?

Usually several weeks, though full healing of the tissue takes longer. Follow your piercer’s timeline before changing jewellery.

Do I need to remove my piercing for dental x-rays?

Often, yes, because metal can block part of the image. Let us know if removal is difficult.

What jewellery is safest for teeth?

Short, smooth, well-fitted jewellery made from body-safe materials, with flat discs on the inside of lip piercings, is generally kinder to teeth and gums.

Is an infected oral piercing an emergency?

Swelling that affects breathing or swallowing, or fever with spreading redness, needs urgent medical care. Milder signs should be checked promptly.

Can I keep my piercing if my gums have started to recede?

Your dentist will explain how far the recession has gone. Often the first step is changing to shorter or flatter jewellery, or removing it, and monitoring the area closely at each visit.

Does an oral piercing affect my speech?

Many people lisp for a few days while swelling settles. Speech usually returns to normal, though some people notice small changes with longer jewellery.

Can I get an oral piercing with braces?

It is usually wiser to wait until treatment ends, since jewellery can chip teeth and damage brackets and wires.