By Shirley Gutkowski
Oral piercing and body tattoos are very interesting topics. Research on the effects and reasons for piercing and tattooing is coming fast and furious. Insights are developing from pediatric and social/cultural studies that are helpful in understanding these most unusual forms of body decoration.
Dental manifestations of tongue piercing can include wear facets on teeth and full vertical fractures of lower anterior teeth. Physical manifestations of bad piercing experiences can range from local edema to death. Although health-care providers may think that tongue piercing could be the most dangerous of all piercings, statistically it's the safest. Among body piercings, the fewest amount of complications come from piercing the tongue. That's interesting fact No. 1.
Interesting fact No. 2 is that a study of girls in an alternative high school showed that those who had high anger scores had more piercings and tattoos. This study found that girls who had some body art did not score highly in positive self-esteem. Researchers measure self-esteem with an index called the School Short Form of the Coopersmith Self-Esteem Inventory. They measured the girls' body image with a method called the Body Investment Scale (BIS). The BIS has subsections that include images, feelings, and attitudes about the body; comfort with physical touch; body care; and desire to protect one's own body.
The fact that there are tests to measure these things is interesting fact No. 3. Dental hygienists strive for quantifiable results and look for numbers to guide our decisions. Some clinicians might find it a little disconcerting to read a paper in which feelings are measured, even though they know information about those feelings is important in understanding other people.
The discussion section in the aforementioned study stated: "Hence, the greater the number of body modifications, the more negative feelings toward the body." This interesting piece of information is fact No. 4. The authors found that young women with permanent body modifications didn't have the same response to their body image as those without. According to the study's authors, these findings were contrary to numerous other studies that found an increase in self-esteem following body art modification. These results could be specific to the anti-social cohort studied.
However, another study, with a different cohort, found the same results. This study's only weakness was that it was conducted at only one center — a primary care clinic in San Diego. The respondents were children whose parent(s) were in the armed services, which gave a broader base for study. This research found similar findings. The children who had tattoos and piercings had worse body images, higher suicide indices, and a greater propensity for hard drugs.
This study also looked at the differences between those that had professionally applied tattoos and those whose tattoos were applied by an amateur. Amateur tattoo wearers had higher indices for hard drugs and violence than those who wore professionally applied artwork. Children that got tattoos before age 14 had higher scores for violence, sexual behavior, and suicide. In addition, these researchers studied the correlation between piercing and tattoos, taking into account a number of other risk-taking behaviors:
• Eating disorders (exercise, dieting, diet pills, or purging in the last 30 days)
• Violence (carrying weapons, physical violence in the last year)
• Gateway drugs (alcohol, tobacco, marijuana)
• Hard drugs (Ecstasy, crystal methanphenamine, cocaine, inhalants, and intravenous drugs)
• Sexual behavior (age at first intercourse, number of partners, contraceptive use)
• Suicide (intention and attempts in the last year)
Some of the results are listed below.
• 13.2 percent of the 484 participants aged 12 to 22 had tattoos.
• 5.2 percent of them had more than one tattoo.
• 29.2 percent had their first tattoo before age 17.
• 4.6 percent had their first tattoo before age 14 (this would be the highest risk group).
• Of the 13.2 percent of the tattooed adolescents, 60.3 percent had only one, 39.7 percent had more than one.
• 26.9 percent of the 484 adolescents filling out the questionnaire had piercings.
• 11.8 percent had more than one. (Ear lobe piercing was not included in this study.)
• 13.6 percent had their ear cartilage pierced.
• 11.2 percent had their tongue or mouth pierced.
• 54 percent of the pierced people had it done before age 17.
• 20.9 percent were pierced before age 14; paradoxically, respondents who had piercing before age 10 were in the lowest risk categories.
The most significant correlation found in this study was between kids with tattoos or piercings and Gateway drugs, hard drugs, violence and sexual behavior. The violence index was more than three times higher in males with tattoos compared to those without. The respondents with two body piercings had scores twice as high on the hard drug index as those with only one piercing. And there's more ...
Most dental articles or papers refer to the oral consequences of piercing. For us, this qualitative information is just another piece to help us know and understand the young person in the chair. The patient is not a mouth ... the patient has a mouth. If a patient is permanently adorned with tattoos or pierced jewelry, then we can be assured that this person in our chair is a risk taker. Will lecture #35 address his or her needs? It's doubtful. Hopefully, he or she will grow out of it.
While parents are waiting for the end of the destructive phase of their child's life, we can step up our remineralization attempts. We can apply fluoride varnish or a thin coat of a glass ionomer to highly susceptible cervical areas to protect against erosion from a poor diet.
So why do people do it? Do they find piercing and tattooing the answer to some underlying primal need? As you can imagine, there are a number of reasons. These include self-love, self-hate, or a belief that tattoos and piercings are true art. People get body art to commemorate special occasions or events, or people are marked as property. Reasons range from affiliation to alienation.
Be aware. Dental hygienists must watch for clues to the mental and physical states of our patients. Knowing more about the meaning of body modification — from tattoos to imbedding foreign objects under the skin — will make us better clinicians.
Shirley Gutkowski, RDH, BSDH, has been a full time practicing dental hygienist in Madison, Wis., since 1986. Ms. Gutkowski is published in print and on Internet sites, and speaks to groups through Cross Links Presentations. She can be contacted at [email protected].