Whitening, polishing, shaping and replacing. The cosmetic industry has long been kept buoyant by a public who value now only how healthy their teeth are but also how they look.
In the 1990s tooth jewellery, also knowns as grills, grillz or fronts, took off in the US hip hop scene in the 199os and are now an international phenomenon, with both bespoke and over the counter grills of all sizes, colours and materials available, and in some cases up to 200 precious stones.
The insertion of gems into teeth predates hip hop culture, and started in what is now Mexico when wealthy Mayans drilled pieces of jade into their teeth, although some researchers have dated a man in Giza buried with two gold teeth as early as 2,500BC.
Oral health implications
Although there’s not a lot of research on grills, some dentists are concerned that these accessories might trap food and bacteria around the teeth and gums. This could cause bad breath, periodontal disease, and tooth decay. In addition, grills could rub away the enamel that protects the teeth. Real grills can cost up to £50,000; cheap ones may look like gold, but are actually high in nickel, and can cause allergic reactions and ulcers in your mouth. Eating with a grill in place runs the risk of breaking teeth when when bitting, meaning a risk of swallowing, or even worse, inhaling them, with potentially fatal consequences.
Despite this, the popularity of perioral accessories carries on increasing, including amongst children and young adolescents. Wiener (2012) presents a case study of an 8 year old child who reported for dental care with discomfort in the mandibular left second primary molar after she embedded a stick-on rhinestone stud into the tooth for aesthetics. It fractured the tooth and led to its loss.
Lack of regulation
Oral jewellery 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 countries.
It is increasingly common for people wanting grillz to turn to the internet for online shops which will either sell ready-made grillz or post a diy mould kit. Often, no dentists or dental practitioner is involved in the process to advice the patient’s suitability despite advice from the American Dental Association to have grills fitted properly by a dentist and to not wear them all the time. Some people have been known to cement the grills to their teeth, which can be destructive and damaging. Without a custom fit, plaque acids can cause decay around poorly fitting margins, especially in grills that have been permanently bonded.
Education on oral hygiene
It is important for dentists and hygienists to understand the fad and the health risks and educate patients and parents on the oral health implications in order to minimise any damage. Advice can include:
- Check grill tightness daily
- Clean regularly with water
- Avoid toxic jewellery cleaners.
- Brush the inside surfaces of grills with a soft toothbrush, rinse with hydrogen peroxide and rinse again with water.
- Brush natural teeth twice daily with fluoridated toothpaste and a soft-bristle brush.
- Floss natural teeth daily.
- Schedule regular professional cleaning and dental examinations
Jeger F, Lussi A, Zimmerli B. Oral jewellery: a review. Schweiz Monatsschr Zahnmed. 2009;119(6):615-31.
Wiener RC. Tooth jewelry in an 8 year old child: case report. J Dent Hyg.2012; 86(4): 278-81