HJAR Jan/Feb 2023

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2023 51 found to be more abrasive than other types of whitening toothpastes. However, these activated charcoal pastes only have the ca- pability to clean extrinsically, so the other peroxide chemical is needed to whiten the intrinsic portion, thus making the tooth ap- pear whiter. Studies have proven while this abrasive quality removes the extrinsic stain, it’s so abrasive that it could be detrimental to the enamel. It has not been shown to be superior to the other whitening pastes but in fact could be harmful. 5 Oral piercings of tongue, lip, and cheek jewelry have gained traction among the ado- lescent and young adult population in re- cent years. The main draw is interest in style, fashion, body art, and self-expression. Other historical factors have included religion, tra- ditional issues, rituals, or connecting to a social group or other branding concepts. 6 The piercing of body parts is a custom that has tribal origins and affirms belonging to a particular class or ethnic group. 7 Unfortu- nately, the majority of these piercings have undesirable consequences. Oral jewelry can have adverse complica- tions when contacting the teeth. The com- mon areas for these hardware accessories are lip, cheek, periodontal tissue, and tongue, with the tongue being the most common site. Since the tongue moves when speak- ing, chewing, swallowing, and yawning, the hardware can hit and damage the teeth. Fractures of teeth and broken fillings are common, and swallowing these accessories has been reported. Gingival recession is also common since the hardware contacts the soft tissue causing injury to these periodon- tal structures. 8 Since the jewelry is hard to place back in the correct position without pinching the Niki Carter, DMD, MPH Dental Director Delta Dental of Arkansas REFERENCES 1 Vernon-Sparks, L. “A history of tooth whitening.” The Seattle Times (Nov. 15, 2010). https://www. seattletimes.com/seattle-news/health/a-history- of-tooth-whitening/ 2 Carey, C.M. “Tooth whitening: what we now know.” The Journal of Evidence-Based Dental Practice 14 Supplemental (June 2014):70-6. doi: 10.1016/j.jebdp.2014.02.006 3 Dahl, J.E.; Pallesen, U. “Tooth Bleaching—a Criti- cal Review of the Biological Aspects.” Critical Re- views in Oral Biology & Medicine 14, issue 4 (July 2003):292-304. doi:10.1177/154411130301400406 4 Ogura, K.; Tanaka, R.; Shibata, Y.; Miyazaki, T. “In vitro demineralization of tooth enamel subjected to two whitening regimens.” Journal of the Amer- ican Dental Association 144, issue 7 (July 2013): 799-807. doi: 10.14219/jada.archive.2013.0190 5 Tomás, D.B.M.; Pecci-Lloret, M.P.; Guerrero- Gironés, J. “Effectiveness and abrasiveness of activated charcoal as a whitening agent: A systematic review of in vitro studies.” Annals of Anatomy 245 (January 2023):151998. doi: 10.1016/j.aanat.2022.151998 6 Yadav P, Mohapatra AK, Jain A. Oral Piercing/ Art-Fashion or Risk. Journal of Advanced Medical and Dental Sciences Research 2, issue 2 (April- June 2014):100-103. http://www.jamdsr.com/ pdf2b/OralPiercinganArtFashionorRisk.pdf 7 Covello, F.; Salerno, C.; Giovannini, V.; et al. “Piercing and Oral Health: A Study on the Knowl- edge of Risks and Complications.” International Journal of Environmental Research and Public Health 17, issue 2 (Jan. 18, 2020):613. doi: 10.3390/ ijerph17020613 8 Plastargias, I., Sakellari, D. “The consequences of tongue piercing on oral and periodontal tis- sues.” ISRN Dentistry (Jan. 29, 2014):876510. doi: 10.1155/2014/876510 9 Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research Institute, LLC. “Oral Piercing/Jewel- ry.” American Dental Association (Last updated Aug. 5, 2022). https://www.ada.org/resources/ research/science-and-research-institute/oral- health-topics/oral-piercing-jewelry 10 Westgarth, D. “The alarming rise of DIY dentist- ry.” BDJ In Practice 34 (2021): 10-14. doi: 10.1038/ s41404-021-0974-2 11 Cleveland Clinic. “Dental Fillings.” Last Re- viewed Feb. 23, 2021. https://my.clevelandclinic . org/health/treatments/17002-dental-fillings 12 Križnar, I; Seme, K.; Fidler, A. “Bacterial micro- leakage of temporary filling materials used for endodontic access cavity sealing.” Journal of Dental Sciences 11, issue 4 (Dec 2014):394-400. doi: 10.1016/j.jds.2016.06.004 13 Heng C. “Tooth Decay Is the Most Prevalent Dis- ease.” Federal Practitioner. 2016 Oct;33(10):31-33. PMID: 30766141; PMCID: PMC6373711 pierced site, it is commonly left in place, which causes it to be cleaned inadequately. Halitosis is often reported, and plaque clings around the area, causing the oral cavity to have lingering bacteria present. As cusps are broken on molars, crowns are needed to fully restore these fractured teeth, as it is damaging to the oral cavity. Patients’lack of information on potential risks and adverse effects is likely due to the fact that dentists do not place the hardware accessories nor inform patients of these risks that follow. The ADA released a statement that advises against the practice of intraoral piercing and views this invasive procedure as producing negative health outcomes that outweigh any potential benefit. 9 Do it yourself (DIY) fillings have been on the rise in the past couple of years, partly as pandemic shutdowns forced dental offices to close. Add the fact that a large number of people were out of work and without in- come, many resorted to this type of “fix.” 10 DIYfillings do not contain the same com- position as fillings received in the dental of- fice and are meant to provide temporary comfort until a person can visit their den- tist. 11 These temporary fillings can plug up a hole and shield hot/cold stimuli from food and drink but are prone to leaks and allow bacteria to thrive when these microorgan- isms are not removed thoroughly or correct- ly by a licensed dentist. 12 When bacteria are left in the cavitation, decay can develop and lead to potentially long-term problems in- cluding root canal treatment or, in the worst case scenario, loss of a tooth. 13 Visiting the dentist regularly keeps minor dental issues from growing into major ones and assists in ensuring good oral health, which is required to maintain overall health. n