Oral Piercings: Implications for Dental Professionals
Piercers

The decision to have any body modification should not be made lightly. The client should be fully aware of the impact of such a decision and make wise choices. One of those choices is the selection of the person who will do the piercing. The Association of Professional Piercers and others make the following recommendations.^9,11,24,26

1. The piercer should have knowledge of anatomy, medical conditions, sterilization and infection control measures, prevention and treatment of complications and medical emergency procedures.
2. Visit the establishment prior to getting a piercing. Observe the location for the following (Figure 27):

• Does the piercer wear gloves, mask and a ‘cover shirt;’ open sterile items in front of you; use disposable items when possible and appear clean?
• Does the location appear clean, have a separate treatment room, and a separate sterilization/infection control area?
• Is the piercer friendly and willing to answer all your questions and show you a portfolio of their work including photos both immediately after the piercing and later follow up photos? Do the piercings seem to be centered and angled correctly? Off-kilter piercings can rub, get caught or trap debris. Do they place quality jewelry? Do you find the results esthetically pleasing?
• Do they take a medical history and discuss any implications with you? Prevention of complications begins with a healthy piercing candidate. The medical history should ask about allergies, systemic diseases such as cardiac disease and uncontrolled diabetes or other conditions that may predispose the client to infection. The female client should be asked if she may be pregnant. Professional piercers will not perform piercings on a pregnant client because of the potential complications from infections.
• Does the studio have sterile, quality jewelry?
• Are aftercare instructions reviewed verbally and provided in writing?
• Is the piercer available for follow up and questions after the piercing?
• Does the studio advocate self-piercing? The internet provides myriad ‘how-to’ videos and sites but does not mention the risks involved. The self-piercer generally does not have appropriate knowledge of anatomy, infection control or other areas necessary for a safer piercing experience.
• Does the studio allow taping or photographing the procedure? These then could be posted on the internet and contribute to self or at home piercing. Generally professional piercers do not allow this and believe it can be a distraction while they work.
• Do they use a piercing gun? This pushes the jewelry through the skin and can be source of contamination (Figure 28).

• Are health certificates visible or available? All states require piercers to have current CPR, First Aid and Blood Bourne Pathogens training. Some states require periodic inspections of the studio. Only a few states currently require a certificate or license to be a piercer.
• The APP advocates that an apprenticeship with a clean, respected, skilled, experienced professional piercer is the best way to learn the art and science of piercing. The APP suggests the following for the novice piercer:
  • Attend a reputable training seminar of four days or longer. The course should combine lectures on anatomy, safety, hygiene, techniques, and hands-on piercing experience.
  • Spend a minimum of three months full time as a trainee, learning sterilization, disinfection, cross-contamination and other health and safety issues before piercing.
  • Spend a minimum of six months to one year in full-time supervised training as an apprentice before achieving the title of piercer. Location, volume and studio standards will help to determine the duration of an apprenticeship.
  • Observe all procedures before attempting them, and only attempt a new procedure with close supervision by a senior/training piercer.
  • Learn customer service, appropriate jewelry quality and selection, aftercare procedures, and troubleshooting.