Close to half. That is roughly how often gum recession turned up in people with lip or tongue piercings across the studies pooled in a systematic review by Hennequin-Hoenderdos and colleagues (International Journal of Dental Hygiene, 2016). Tooth damage, mostly chips and cracks, was also common, particularly with tongue piercings. None of this means every piercing will harm your teeth, but the risk is real and builds the longer the jewellery stays in.
Two piercings, two different patterns of wear
Where the damage shows up depends on where the jewellery sits.
A tongue bar rests behind the lower front teeth. Every time you talk, eat or move your tongue, the lower ball can knock against the inside surfaces of those teeth, and the bar can press on the gum behind them. Over time this tends to cause chipped edges on the inner side of the lower incisors and recession of the gum on their tongue side. Back teeth and existing fillings can be chipped too, often from biting down on the top ball by accident.
A lip stud or ring sits on the outside, so the inner disc rubs against the front surface of the gum below the lower front teeth. The pooled data in that review found gum recession in about half of people with lip piercings, along with tooth damage in about a quarter.
Lost gum does not grow back
Recession is the complication that matters most over the long term. Once the gum has worn down and exposed the root, it does not regrow by itself, even if the jewellery comes out. Exposed roots can be sensitive to cold, are softer than enamel and more prone to decay, and in advanced cases the bone support around the tooth can be affected. The lower front teeth have thin gum and bone to begin with, which is part of why they are vulnerable.
Taking the jewellery out stops the rubbing and usually halts further loss from that cause. Where recession is significant, a periodontist (a registered gum specialist) or a dentist may discuss gum grafting to cover the root. Results vary with the depth of recession and the health of the area.
Chips can be cosmetic or can reach the nerve
Small chips in enamel are often smoothed or repaired with tooth-coloured filling material. Deeper cracks can be harder to treat and may need a crown, and a crack that reaches the pulp can lead to root canal treatment or, occasionally, losing the tooth. Habitually clicking a bar against the teeth or biting on it during concentration speeds this up. If you notice a sharp edge, a new sensitivity, or pain on biting, our article on cracked tooth syndrome describes what to look out for.
The first fortnight carries the infection risk
A fresh oral piercing is a wound in an environment full of bacteria. Swelling, tenderness and some bleeding are expected for the first several days. Tongue piercings in particular can swell enough to make speaking and swallowing awkward. Spreading redness, pus, fever, increasing pain after the first few days, or swelling that makes breathing or swallowing difficult need prompt medical or dental care. Rarely, serious infections and nerve injury have been reported.
Other day-to-day effects people notice include more plaque collecting around the jewellery, changes in speech, and extra saliva at first. Jewellery can also come loose and be swallowed or, more seriously, inhaled.
Lowering the risk if you keep your piercing
Not having an oral piercing avoids these problems entirely. For people who choose to keep one, a few changes reduce contact and wear:
- Once the initial swelling has fully settled, ask your piercer about a shorter bar, which moves around less.
- A smaller ball, or one made from a softer material such as acrylic or bioplast rather than metal, may reduce chipping, although the evidence is limited and recession can still occur.
- Avoid playing with the jewellery or clicking it against your teeth.
- Check the ends are tight each day so they do not loosen and get swallowed.
- Take it out for contact sport and wear a mouthguard.
- Keep the jewellery and the area clean, and clean between your teeth every day.
Why regular check-ups matter more with a piercing
Recession and small chips are often painless in the early stages, so they can progress unnoticed. At a routine visit, a dentist or OHT can record the gum level next to the jewellery, photograph the area and look for early cracks, then compare at the next visit. Catching changes early leaves more options. You will usually be asked to remove oral jewellery before X-rays, because metal blocks part of the image.
Elsewhere on our blog we cover bleeding gums when brushing, the safety of tooth gems and tooth jewellery, and lumps such as mucoceles on the lip, which can follow minor injuries to the inside of the lip.
What people ask about oral piercings
Will my gum recover if I take the piercing out?
Removing it prevents further rubbing, but gum that has already receded does not grow back by itself. Larger areas of recession may be treated with a graft.
Is a lip piercing kinder to the teeth than a tongue piercing?
Not really. The pooled studies found similar rates of recession for both. They simply affect different surfaces of the lower front teeth.
How long before damage appears?
Infection problems show up in days. Recession and chips usually develop over months to years, and the risk rises with how long the jewellery has been worn.
Having your teeth and gums checked
If you have an oral piercing and notice shrinking gum, a chip or new sensitivity, book a check-up with one of our dentists or OHTs. You can see what is available on the current deals page or read about routine care with a general dentist.
This article is general information and is not a substitute for an individual assessment by a dentist.
