Body art is increasing in popularity within a fashion industry. It includes tattooing, body piercings and oral jewellery, which consists of soft tissue piercings and/or objects attached to teeth. All body piercing presents a level of risk of infection. Because of the presence and variety of bacteria in the oral cavity, oral piercings are considered to have higher risk and are therefore strongly discouraged. But, now a new craze is sweeping across the world that will make you shine like a star ... to really be glamorous, unique, and fashionable, tantalize your teeth with top-quality tooth jewellry which is painless, no risk of infection, and add sparkle to a smile.
There are less document references available regarding this material so an effort is made to document about tooth jewellery.
Key words: tooth jewellery, tooth gems, cosmetic dental treatment, esthetic, tattoo
Today, people are becoming increasingly self-conscious about their appearance and smile. They are looking for various treatments like body art and cosmetic dental treatments to achieve the desired aesthetic appearance, attention, to make a fashion statement and to be unique among the crowd. Body art includes tattooing, body piercings and oral soft tissue piercings. All body piercings presents a level of risk of infection, and are painful. (1,2) Documented complications are related either to(a) the jewellery (aspiration, allergy or chronic injury to adjacent teeth/mucosa, including tooth fracture and gum recession, which can lead to tooth loss) or to (b) the piercing procedure (local bleeding, swelling, nerve damage, toxic shock, permanent drooling, impaired sense of taste, or distant infections of the liver, heart or brain), tongue and lip piercings with metal barbell that interferes with speech, taste and mastication. (2,3) but, with the introduction of cosmetic dental treatments like porcelain veneering, composite veneering, bleaching and placement of tooth jewellery, patients smile can be made more pleasing, appealing, and aesthetic. This results in increased self confidence of the patient. Among these cosmetic dental treatments bleaching and veneering procedures are indicated for patients with discolored teeth, spacing between teeth, and mild irregular teeth, where as oral tooth jewellery is for all patients who wants a dazzling smile. The advantages of it being a temporary, painless procedure and it do not involve any invasive treatment on the tooth like drilling holes.
Types of tooth jewellery:
Tooth gems are crystals glass mounted on a thin foil of aluminum to create the attractive spark available in different colors'. Skyce are clear and sapphire -white or blue crystals. Brilliance tooth jewelry is available in 3 different colors crystal clear, sapphire blue, ruby red and is of two sizes--1.8mm, 2.6mm Figure 1. Rainbow crystals are the least expensive version of tooth jewelry. They're ideally for short term attachment, to try the new service in your practice or for the customer with a smaller budget rainbow crystals are available in 10 different colors and two sizes (1.8mm and 2.5mm) Figure 2.
Twinkles are pure gold and precious stones like diamonds, sapphires and rubies in different shapes like diamond, star, triangle, heart shape, drop, navette, and round shapes Figure 3.
Procedure & bonding instructions:
* The tooth is cleaned with a fluoride-free polishing paste.
* Completely dry and isolate the tooth.
* Tooth is etched with 37% orthophosphoric acid for about 20-30 sec to increase the surface area for bonding.
* Rinse surface thoroughly with water and blow dry for 10 sec. (no etchant should remain on the tooth!)
* Apply a light-curing bonding agent. Leave it on for a maximum of 20 seconds, distribute bonding through air blowing. (4)
* Then light-cure for 20 sec.
* Apply a small amount of flow composite to the surface of the tooth. (5)
* Use a jewel handler to easily pick up the jewel. Press it into the center of the composite. (The composite must ooze on the sides so it is encircled by the composite, ensuring macro mechanical retention, but make certain the jewel is in contact with the enamel.)
* Now you may adjust the jewel while letting the patient check the desired positioning in the mirror.
* Take the light-curing lamp and start curing the composite from the top for about 60 seconds. Light cure from the sides for a few seconds and also cure the composite from the back of the tooth for another 60 seconds making sure the composite hardens evenly. Total curing time is approximately 180 seconds. (Follow instructions of the bonding-system you are using!)
* The total time for jewel to set into the composite is 20 sec. Do not touch the jewel with your fingers once it's removed from the case. To guarantee maximum adhesiveness, it is essential to avoid skin contact with the special coating on the backside of the jewel
* It takes about 4 minutes to safely affix the jewel. Figure 4.
* The enamel is treated with topical fluoride to remineralize the etched area.
Removing the tooth jewel:
* The jewel is removed in the same way as an orthodontic bracket and the enamel will not be harmed. (6)
* After removal of the gem, the tooth needs to be polished, which takes away any remaining bonding materials.
* Use a scaler or a rubber polisher when removing the stone. In case of leftover bonding or composite on the tooth, simply remove it by using a polishing tool. It is recommended to treat the tooth with fluoride, so remineralization and stabilization of the enamel is provided.
The practice of soft tissue piercings like nose, ear, eyebrows with ornaments jewelleries, and body tattooing are ages old started in Egypt, china and medieval around 5000 years back. They were considered as a sign of religious and social rank in the community (7) but now it is regaining momentum as a fashion and style statement by many young people.
Many people are looking for restorative and surgical procedures to look more beautiful and to have a attractive smile. Esthetic procedures like teeth bleaching, veneers, and ceramic crowns are used to improve colour, shape and size of teeth. Then there are new trends of tooth decorative procedures like tooth tattoo, tooth jewellery, grills, and ornamental body piercings of lip, tongue and tooth. Figure 5
Tooth tattoo is applying various shades of porcelain in various designs like hearts, symbols, and pets carved on ceramic crown, crown and bridge by lab technician, then fired in ceramic furnace. Figure 6. It gives personalized embellishment and alternative to body tattoo. But it is an indirect procedure, experienced lab technician, tooth reduction is required to make crown. A tooth tattoo is also easily removed by simply grinding the image off of the crown.
A grill is a form of detachable sewellery accessory and comes bathed in metal and on-Demand it is available in gold, encrusted diamonds, imprinted alphabets, thereby making it more attractive. Their price varies depending upon the choice of grills. Grills are considered Status symbols within the hip-hop fashion scene. However, tooth ornaments favors the accumulation of plaque and can diminish the ability to articulate teeth and speech. Figure 7 Lip and tongue piercings with metal stud and barbell leads to infection, swelling, aspiration Fracture of teeth; interfere with speech and mastication. (2,8,9) Tooth drilling and piercing causes pulp injury, pain, nonvital and fracture of tooth. Figure 8 Tooth jewellery is of two types tooth gems, and twinkles that are attached to anterior healthy tooth with composite resin cement. They shine brightly, splashing bright rays around them and emphasizing the natural whiteness of enamel and add sparkle to a smile. They are bonded to tooth without pain, infection, drilling. They do not interfere with oral hygiene maintenance but if composite resin margins are not polished there is more plaque accumulation and possibility of caries. Tooth jewellery may get deboned if more stress is applied at bonding interface due to hard brushing, eating sticky and hard foods, then it may lost or may go to digestive tract or respiratory (9) and needs medical emergency attention. Patient is instructed about these to take care before tooth jewellery procedure.
Unlike other, tooth gems and jewellery, there is no more pain, infection, no drilling, and no damage to tooth, easily removable and at the same time add more attractiveness and sparkle to the smile, makes them more user friendly. Forget tattooing and body piercing, to be a really celebrity tantalize your teeth with tooth jewellery or tooth gems, add sparkle to your smile. Proper oral hygiene maintenance and regular checkup visit to dentist are required to avoid debonding and caries.
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(7.) Hoffmann-axthelm, walter. History of dentistry. Chicago: quintessence pub., 1981
(8.) Jay t. Biber: oral piercing: the hole story; journal of minnesota dental asso: 2003:82(6).
(9.) Anyawu ch, foreign body airway obstruction in nigerian children. J trop paeditri 1985:31: 70-73.
Anandkumar G Patil 
Department of Prosthodontics Bhabha College of Dental Sciences Bhopal
Received: July 12, 2010
Review Completed: August 15, 2010
Accepted: September 12, 2010
Available online: october, 2010
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