Position on Dental Jewelry

The National Dental Association has been an advocate for quality dental health care for the underserved, and a steward of health education and dental care in the African American community. The NDA is committed to working with other dental organizations, legislative entities and member dentists to educate, protect and improve dental health in the communities they serve. The issue of an increasing popularity of oral jewelry in these communities is of concern to the NDA and its component societies.

Oral Jewelry has become a million dollar industry encompassing several modalities of invasive techniques, as well as intraoral techniques which are performed in many cases by non dental personnel. This constitutes the practice of dentistry by non dentists, which is illegal in most states. The scope of the techniques includes:

a. Impression taking.
b. Fabrication of prosthetic appliances both fixed and removable
c. The use of non approved intraoral dental materials (copper, platinum, diamond, semiprecious stones, gold of questionable assay, lead based alloys)
d. Surgical piercing of lips from skin surface through to mucosa, creating a fistulous tract.
e. Surgical piercing of the tongue with insertion of non dentally approved metal or plastic rods into the openings
f. Splitting of the anterior third of the tongue by surgical and non surgical techniques

Fixed and removable jewelry has been referred to as grills, fronts, golds and pullouts. They range in value from cheap mall based overdentures to $100,000 platinum and gold overlays popular in the music industry. The procedure may involve reduction of the interproximal and/or incisal surfaces of vital healthy teeth in order to accommodate the prosthesis. The cutting of teeth by non dentally trained personnel as well as invasive surgical procedures, such as piercing or splitting of the tongue and lips, are illegal and should be regulated as such. The placing of oral jewelry is associated with multiple pathological problems, to include:

a. Periodontal degeneration under poorly constructed prostheses (gum disease)
b. Damage to teeth from metal tongue and lip rings
c. Infections causing loss of tissue and embedding of foreign bodies in soft tissue structures of the oral cavity.
d. Temporomandibular joint disorders secondary to interference with the balance of occlusion and changing of the equilibrium of tongue and lip pressure.
e. Tooth loss due to gross caries developing under poorly constructed and seldom cleaned prostheses.
f. Transmission of disease due to non sterile surgical techniques in arenas which are not under the control or regulation of the state or the dental profession.
g. Halitosis from retention of food and residue under the poorly constructed prostheses.
h. Toxicity from contaminants in non dentally approved metals and alloys

It is therefore the position of the NDA that

1. the fabrication, use and application of oral jewelry should be strongly discouraged,
2. that the placement of invasive oral piercings and jewelry and the splitting of lips and tongues should be considered surgical techniques, and should be regulated by the state laws, and
3. that performance of these techniques by non medical personnel should be considered the practice of dentistry and/or medicine without a license. The damaging effects of these appliances as a fad should be included in the dental curriculum as part of the mainstream dental education, and the NDA is continuing to coordinate its efforts with healthcare and civic organizations to protect the health of individuals in the communities it serves.

ADOPTED: FEBRUARY, 2007

The National Dental Association (NDA) seeks to provide continued advancement of the highest quality of oral health care and safety for the public. As a resource to key decision makers and the public on a variety of oral health issues, it is our goal to provide timely, evidenced and researched based perspectives. Position papers are reviewed periodically by our policy committee for reaffirmation, updating or expiration. An update concerning a specific recommendation in a paper is released when warranted.

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