A small crystal glued to a front tooth is usually low risk when it goes on a healthy tooth with a proper dental bonding material and the area is kept clean. Most of the trouble with tooth gems comes from three places: kits and glues that were never designed for the mouth, plaque that collects around the edge of the gem, and rough removal that scars the enamel underneath.
So the useful question is less "are tooth gems safe?" and more "how was this one put on, and how will it be looked after and taken off?"
How a tooth gem is attached
A flat-backed gem is stuck to the outer surface of the enamel with a bonding material, much like the adhesives used for tooth-coloured fillings and orthodontic brackets. Cleveland Clinic notes that a dentist usually does not need to change the shape of the tooth to place one, and no drilling or anaesthetic is normally involved. The gem sits on the surface rather than in the tooth, which is why it can later be removed and the area polished.
That only holds if the tooth underneath is healthy. A gem placed over early decay or a cracked area can hide a problem that keeps getting worse, so having the tooth checked first matters.
Home kits and non-dental glues carry the most risk
DIY kits sold online, and gems stuck on with nail or craft glue, are where the real problems appear. These adhesives are not made for use in the mouth, so you may be exposed to materials that were never meant to be there. Poorly bonded gems also fall off sooner, and a tooth that has not been checked and prepared properly can be damaged or decay under the gem. Cleveland Clinic's dental adviser recommends against DIY tooth gem kits, partly because there is no way to tell at home whether a tooth is healthy enough for one.
Plaque builds up around the edge
Any small ledge on a tooth gives plaque somewhere to settle, and a gem is no exception. If that edge is not cleaned well every day, the enamel around it can start to decay and the nearby gum can become red and puffy. This is a common longer-term problem, and it develops quietly. Some people also find that a gem with sharp edges rubs the inside of the lip, causing a sore patch.
An item in the ADA News Huddles roundup on oral fashion trends lists the same set of concerns: plaque build-up, gum irritation, decay, enamel damage from poor placement or removal, chipping of opposing teeth and sores on the lips and cheeks.
Taking a gem off is where enamel can be damaged
Gems often come away by themselves, sometimes after months and sometimes after a couple of years; it is hard to predict. If yours is still attached and you want it gone, do not prise it off with a fingernail, tweezers or a knife. A dentist can lift the gem, remove the leftover adhesive and polish the surface smooth. Enamel does not grow back, so any scratches or gouges from forcing a gem off are permanent.
If a gem comes off on its own and leaves a rough or dull patch, a dentist can check it and polish or seal the surface.
If you swallow a gem
A small gem that comes off while eating is usually swallowed, and because it is so small it is unlikely to cause harm. If you think you may have breathed one in, for example if you start coughing or wheezing, or you have pain or difficulty swallowing, seek medical help promptly.
Looking after a gem you already have
- Brush twice a day with fluoride toothpaste, angling the bristles around the gem's edge.
- Clean between your teeth daily.
- Avoid biting directly into hard food with the gem tooth, and do not pick at it.
- Keep up regular check-ups and cleans so a dentist or OHT can look at the enamel and gum around it.
- Get any sore spot on your lip, or any dark mark around the gem, checked.
If what you really want is a brighter smile
Some people choose a gem to draw attention to their smile when what bothers them is colour or shape. If that sounds familiar, it can be worth comparing longer-term options. Professional teeth whitening lightens the overall colour, while composite bonding can reshape or repair chipped and uneven edges. Our articles on composite bonding versus veneers and tooth contouring go into more detail, and if you are tempted by quick fixes from social media, our look at charcoal whitening is worth reading first.
Tooth gem questions
Does getting a tooth gem hurt?
No. When it is bonded properly there is no drilling or injection. You may feel the tooth being cleaned and dried before the gem is placed.
Will a gem ruin my tooth?
Not by itself, if it is bonded to healthy enamel, kept clean and removed carefully. Damage usually comes from unsuitable glues, poor cleaning around the gem or forcing it off.
Can I have a gem on a crown or veneer?
Bonding to crowns and veneers works differently from bonding to natural enamel, so ask your dentist before putting anything on a restored tooth.
A check before and after
If you are thinking about a gem, or you already have one and want the tooth underneath checked, the team at Lumi Dental in Melrose Park can examine the enamel and gum around it at a routine visit. You can book online or see our current offers for cosmetic consults.
Sources
- Cleveland Clinic. Are tooth gems safe? health.clevelandclinic.org
- ADA News Huddles. Dentists urge individuals to avoid oral fashion trend. adanews.ada.org
