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Chipped Tooth

Tongue Piercing with Needle
©Charles Knox/

I remember vividly a lecture that I had last year in one of my pediatric dentistry classes.  My professor told us a story about how she went down to one of the local piercing parlors and asked if she could take pictures of a tongue piercing.  They let her take some pictures and she showed them to our class.

She commented that if parents actually knew what happens when their kid gets their tongue pierced, there would be a lot less pierced tongues.

I debated about whether or not I should put an image of an actual tongue piercing in this article, but I think it may be too graphic for some people.  If you’d like to see what a tongue looks like as it’s getting pierced with a needle, you can see a photo with an explanation by clicking here.

Keep in mind that there are many risks with piercing your tongue, so I would advise against getting your tongue pierced.  In this article, I’ll simply focus on the process of getting your tongue pierced.

Tongue Piercing Procedure

The Tongue Piercing Procedure

First of all, the person piercing your tongue will use a marker to mark the spot on the taste-bud side of the tongue where the piercing will be.  If you look closely at the photo above, you’ll see a dark blue mark where the ring enters the tongue.

Next, the piercer will hold onto your tongue with some sort of a clamp so that it doesn’t move when it is pierced.  If the tongue moves and the needle goes through the wrong part, it could hit a blood vessel or cause damage to a nerve.

As they are holding onto the tongue, the piercer will stick a thick needle through your tongue without using any anesthetic.  (See a picture of this here – not for the faint of heart!)  Some people say this hurts, others say that as long as you find the right person to pierce your tongue, it shouldn’t hurt.  Since piercers are not licensed medical professionals, they are not permitted to give you any anesthetic to numb your tongue and prevent you from feeling pain.

Then, the piercer will put a long barbell through the hole that was made in the tongue.  Usually the barbell is 18 millimeters (about ¾ inch) long.  The initial barbell needs to be long because your tongue will swell a lot after the piercing.  If a short barbell is used, the tongue could swell around it and trap the barbell inside the tongue.  If this occurs, surgery will be needed to remove the barbell from the tongue.

If your tongue piercing is done in a clean, sanitary environment and doesn’t become infected., the initial 18 mm barbell can be replaced with a shorter barbell.


After your tongue has been pierced, you must leave the barbell in place or the hole can close up.  It can be removed for very brief periods of time without this occurring but there is always a risk.  It’s a good idea to remove any tongue jewelry when you’re playing sports so that you don’t damage your teeth.

Do you have any stories or experiences with tongue piercing?  I’d love to hear about your stories, questions and comments in the comments section below!

How Seatbelt Use Affects Dental Health

One of the questions we ask every new patient who comes in for a comprehensive dental exam at my dental school is this:

Do you wear your seat belt?

Wearing Your Seat Belt Can Avoid Facial Injuries

Why We Ask New Dental Patients If They Wear Their Seat Belt

This question is part of a form that we go through to assess our patients’ risk of dental disease.  A lot of people are caught off guard when we ask them about their seat belt usage.  In fact, when I first got into clinic, I thought it was a rather irrelevant question.  However, as I’ve been studying for my final exams, I found an interesting sentence in my oral surgery book that made this question hit home to me.  It says:

The major causes of facial fractures include motor vehicle accidents and altercations.  Other causes of injuries include falls, sports-related incidents, and work-related accidents.  Facial fractures resulting from motor vehicle accidents are far more frequent in persons who were not wearing restraints at the time of the accident.

Seat Belts Aren’t Just for Saving Lives

Many people don’t bother to put on their seat belts because they know that the chances are very small that they will be killed as a result of not wearing their seat belt.

What I think most people don’t realize is that by not wearing their seat belt, they are drastically increasing the chances that they will fracture a tooth or even worse, fracture bones on their face when they get in an accident.


If you’re getting relaxed about your seat belt wearing, know that if you get in an accident you are putting yourself at a much higher risk of getting a head injury.  It’s extra important during the holiday season when people can drive a little bit crazier!

If you have any comments to share, please leave them in the comments section below.  Thanks for reading!

Tongue Piercing Licking Lips

Oral piercing is a practice that seems to be gaining popularity in the United States.  The most common places to get a piercing in your mouth are the lips, tongue, cheek, and the uvula (the “hangy-ball” thing in the back of your throat.) Tongue Piercing Can Hurt Your Teeth!People want to get their tongue pierced for a variety of reasons.  One of the biggest reasons is to make them look trendy — people want to fit in, and if they can be seen as cool for getting their tongue pierced, then they’ll go for it. Unfortunately, not many people are aware of the many risks associated with getting your tongue pierced.  I think if people understood the dangers of tongue piercing, fewer piercings would be performed. I’m planning on writing a couple of articles about the risks of tongue piercing.  This first article will focus on ten ways that tongue piercing hurts your mouth and teeth.  The next one will talk about the negative effects that oral piercings have on the rest of your body.

The Risks of Tongue Piercing: 10 Ways Tongue Piercing Hurts Your Mouth and Teeth

1 – Tongue piercing causes chips, cracks, and/or fractures in your teeth. Wearing tongue jewelry can not only damage your teeth, but it can damage expensive dental work that you may have already had done. The effect of tongue jewelry on teeth is especially important when participating in exercise and athletic activities.  When in doubt, take the barbell out!  It is important to note that if you leave out your tongue jewelry for more than a few hours, it may be next to impossible to get the jewelry back in.

Tongue piercings are just one of the many ways you can chip or crack your teeth.  To learn more,read 10 Easy Ways to Chip or Crack Your Teeth.

2 – Tongue piercing causes gum recession, also called localized periodontal disease. If you wear a barbell in your tongue, it can rub up against and irritate the gums on the tongue side of your teeth.  This has led to gum recession in many people who have their tongue pierced.  In older adults, periodontal disease (not cavities) is usually the most common cause of tooth loss. 3 – Tongue piercing can wear down your teeth. Out of habit, many tongue-ring wearers often rub their tongue ring up against their teeth. Over time, this can wear down the enamel. Over time, you could expose dentin or experience increased sensitivity or cavities. If you insist on having a tongue piercing, trying out a shorter barbell may reduce the damage that it inflicts on your mouth — although it would be best to get rid of the tongue jewelry altogether!

Concerned about wearing down your teeth? Learn more about the four ways we wear down our teeth.

4 – Tongue piercing can cause speech impediments. Tongue piercing can make it more difficult to talk.  You use your tongue for making a lot of sounds when you talk.  If you get a tongue ring, it makes it a lot harder to speak correctly. 5 – Tongue piercing can cause nerve damage. An inexperienced piercing parlor worker may inadvertently cause permanent damage to the nerves in your tongue or other areas of the mouth depending on how the tongue is pierced.  The person doing the piercing needs to have a sound knowledge of the anatomy of your tongue.  If you do get your tongue pierced, it’s important to find a reputable, high-quality piercing parlor to cut a hole in your tongue. You probably wouldn’t enjoy having parts of your tongue permanently numb.  Many people hate having their tongue numb for a couple of hours after getting a filling — just imagine how hard it would be to not fully enjoy the taste of your food or constantly have your tongue give you that numb, tingling sensation. 6 – Tongue piercing can cause bad breath. Tongue jewelry is a good place for the plaque in your mouth to live.  It’s harder to brush if you have tongue jewelry.  Also, if you don’t regularly clean your tongue jewelry, it can accumulate bacteria that make your breath smell pretty disgusting! Tongue Piercing Damages Your Mouth! 7 – Tongue piercing can cause a space between your two upper front teeth, also known as a diastema. Although this isn’t very common, it does happen as evidenced by this case report written by orthodontists. 8 – Tongue piercing can cause excessive drooling. Tongue piercing can cause an increase in the amount of saliva you make.  Although saliva is good for the teeth, too much can be a problem.  You probably won’t look too cool with a tongue ring if you leave a puddle of spit everywhere you go! 9 – The metal tongue jewelry can cause a metal hypersensitivity reaction. You could end up being allergic to the metal in your tongue jewelry. If you were excited about having metal tongue jewelry and then end up having to wear a plastic barbell, you may be disappointed. 10 – Tongue piercing can cause pain and infection. The tongue piercing itself could cause pain and other complications.  Many people who have had their tongue pierced say that it was quite painful.  Here’s one story about how much tongue piercing hurts from Yahoo! Answers. You might get an infection depending on how sanitary the piercing parlor is. Most people have some degree of swelling after their tongue piercing. If you have a low tolerance for pain, you may want to reconsider.

More Reading on the Negative Effects of Tongue Piercing

I read a LOT of great articles while researching for this post.  Here are a couple you might be interested in:


Keep in mind that of all of the negative effects listed above, the most common are damaging a tooth and causing gum recession. If you’re thinking about getting your tongue pierced, please re-think your decision.  You may look cool around some of your friends, but the damage that tongue piercing does to your mouth isn’t worth it. Although I didn’t mention this above, because it’s not a huge consequence of tongue piercing, think about how much you love tasting your food —  especially with Thanksgiving tomorrow.  Do you really want to damage some of your valuable taste buds by getting your tongue pierced? For all of the Americans reading this, have a great Thanksgiving day tomorrow!  If you have any questions or comments about tongue piercing and oral health, please leave them in the comments section below.

Easy Ways to Crack or Chip Your Teeth

Many people end up cracking or chipping their teeth at some point in their lives. A majority of cracked and chipped teeth injuries are preventable.

Tongue Rings Can Crack Your TeethTo illustrate that point, I’ve come up with 10 easy ways that you can crack and chip your teeth.  A lot of the ways don’t even involve doing anything.

Here’s a tip: If you want to keep your teeth crack and chip free, don’t do anything on the list below!

10 Easy Ways to Crack or Chip Your Teeth

1 – Get your tongue pierced and wear a hard metal object in it.  The hard metal will constantly bump up against your teeth and can chip and/or cause cracks.  A major cause of chips in front teeth is from tongue barbells.

2 – Don’t wear a protective athletic mouth guard when playing sports.  This one’s pretty easy, since it involves doing nothing.  Just don’t go to your dentist and get a custom mouthguard made, and you’ll be at a much higher risk for getting a cracked or chipped tooth.

That’s not all mouth guards do!  Here’s six reasons to wear an athletic mouthguard.

3 – Chew on ice or any other hard object.  To read more about the damage that chewing on ice does to your teeth, read How Chewing on Ice Affects Your Teeth.

Another common culprit of cracked teeth is popcorn kernels.  For some reason, people like to finish the whole bag of popcorn, and if some kernels didn’t pop like they were supposed to, they feel like they need to get eaten too.  If your popcorn bowl looks like the one below when you’re done, then congratulations!

Cracked Teeth Can Occur from Chewing Unpopped Popcorn Kernels

4 – Use your teeth as tools – to open things, use them as scissors to cut tape or cut tags off of new clothes.  Pretty much any way you use your teeth as tools, you will be putting excessive wear on them that could cause small cracks.

5 – Grind your teeth and don’t do anything about it.  If you grind your teeth, you could end up cracking them or even wearing your teeth down to almost nothing.  If you think that you may be grinding your teeth while you sleep, it’s best to talk to your dentist about it.  Most dentists will make an appliance you can wear to help stop teeth grinding.

6 – Don’t brush, make sure you get a big cavity, then go to your dentist and have a really big filling put in your tooth.  By losing so much tooth structure to tooth decay, it will be a lot easier to get your tooth to crack.

7 – Don’t get braces.  By not having the teeth in proper alignment, it is easier to put stresses on them when you bite, which could lead to worn down teeth, or cracking in more extreme circumstances.

8 – Clench your teeth often.  A lot of people clench their teeth when they’re stressed out.  Well, clenching can also stress out your teeth!  That’s alright if you want to crack or chip your teeth, but if you want to keep your teeth nice and healthy for a lifetime, try to stop clenching.

9 – Keep on getting older.  After a lifetime of wear, teeth can get pretty worn down and cracked.  Some experts believe that as you get older, your teeth become more brittle, which makes them more prone to cracking.

10 – Eat rocks or bones.  It does happen.  A lot of people find rocks in a can of re-fried beans or don’t sort out rocks from dried beans.  Another culprit is finding a bone in a fast food hamburger or chicken sandwich.  When you unexpectedly bite into something hard with a lot of force, it can easily crack or chip a tooth.


Ideally, you should try to not do anything on the above list.  Alright…  Unless you can live forever like the Tuck family in Tuck Everlasting(4th grade reading assignment), you probably can’t avoid #9.  #10 is also pretty hard to avoid, but the rest of the list involves choices that we make that can wear down our teeth over time.

Do you have any questions or comments about cracked or chipped teeth?  Leave them in the comments section below!  Thanks for reading!

Biting Nails Teeth
©Diego Cervo/

It’s been estimated that about half of all humans bite their nails.  At ten fingernails per human (and maybe some toenails thrown in for good measure), that adds up to billions of fingernails that are chewed on everyday.

Fingernail biting has been linked to genetics and occurs more often in females than males.  I bit my nails frequently from the age of 5 up until about 25, when I kind of grew out of it.

Our teeth can do many amazing things, like helping us speak, making us look more attractive than we really are, and allowing us to chew a variety of healthy foods.  One thing that teeth aren’t good for though is biting our nails!

In fact, biting your nails can actually cause harm to your teeth and other structures inside of your mouth.  Here’s a breakdown of some of the negative effects that biting your nails can have on your oral health.

6 Reasons Why Biting Your Nails is Bad for Your Teeth

Nail Biting Can Harm Your Teeth

1– Biting your nails can cause your teeth to get chipped. This is definitely the biggest reason to not bite your nails.  Chewing on hard fingernails can take its toll on your teeth.  Sometimes when bite through a nail, your teeth hit together pretty hard, which could chip a tooth.

Repeated flexing of your teeth’s enamel occurs when you bite your nails and can cause the enamel to fracture or chip.

To find out more about enamel and the other layers of your teeth, read The Anatomy of a Tooth.

For most people, chipping a tooth is the only negative effect that biting your nails might have on your teeth.  In fact, the book Pediatric Dentistry by Pinkham states:

There is no evidence that nail biting can cause…dental change other than minor enamel fractures.

However, various studies have shown that nail biting can cause other oral problems.  Keep in mind that some of the following negative effects are very rare and won’t always occur with everyone, so you might want to take them with a grain of salt!

2 – Biting your nails can cause a diastama — a gap between your two front teeth. If the nail biting habit begins when the child is very young, it has been reported to cause a gap between teeth.  While I was unable to find a study to confirm this, I did find a dentist has a a picture of it on his website here.  While this can occur, it probably won’t unless someone is constantly shoving their nail up between their teeth.

3 – Nail biting can cause the roots of your teeth to become weaker. Nail biting during orthodontic treatment (braces) has been shown to cause root resorption, which is when parts of the roots of your teeth get dissolved by the bone surrounding them.  This causes the roots of the teeth to become weaker.  Here’s one study and another one that explain this phenomenon.

4 – Biting your nails can cause you to lose your teeth. This study claims that biting your nails can cause you to lose your teeth.  Remember — this is the only study that I’ve found that claims this, and we definitely would need more studies to be done in order to verify this.  See my disclaimer above!

5 – Biting your nails can cause TMJ problemsThis study tells how biting your nails can cause disk displacement in the temporomandibular joint.  If you have pain in your TMJ, perhaps it is being caused by your fingernail biting habit.

6 – Biting your fingernails can cause gingivitis. This case report (PDF file) details the story of a young child that bit his fingernails and then shoved them up between his gums and teeth.  The report even has pictures if you’re curious.  You would think that this would be pretty rare but it might not be as uncommon as you’d think.  Here’s another report here and one more here! It does go to show that kids can think of anything to do with their fingernails after they’ve chewed them off of their fingers.


I have talked about some of the extreme cases of biting your nails.  Obviously, many people do bite their nails without any dental problems.  Sometimes, however, people do develop problems.

One interesting fact I found while researching for this article is that biting your nails actually contaminates your mouth with interesting varieties of bacteria that are found on your hands.  Since I’m a slight germophobe (as mentioned here and here), this tidbit encourages me keep my nail biting habit in remission.

Hopefully the information provided above can give you the encouragement you need to help you to kick your fingernail biting habit.  Or, maybe you’re willing to take the risk and keep on biting your nails.

Have you ever hurt a tooth or had any dental problems due to biting your nails?  Please share your comments below!

Chewing Ice Cubes Hurts Teeth

Have you ever eaten all of your dinner, drank all of your water, and then flirted with the last remaining edible item on the table – the ice in the bottom of your glass?  If so, you’re not alone.  Many people chew on ice cubes for a variety of different reasons.

You may think this habit is relatively harmless since ice is made of water.  After all, it’s not like you are sucking on a piece of sugary candy, right?  Well, the impact of ice-chewing on your teeth is less than desirable.  Here’s why:

4 Reasons Why Chewing Ice Cubes Hurts Your Teeth

Chewing Ice Cubes Can Crack Your Teeth!

1 – Chewing ice puts an enormous amount of pressure on your teeth. While the dentin in your teeth is relatively flexible, the enamel is very hard and doesn’t flex much.  Chewing ice can wear down the enamel and even chip or fracture pieces of the enamel off of your teeth.

Not sure what enamel and dentin are?  Read this article about the anatomy of a tooth.

2 – Chewing ice causes a repetitive hot/cold cycle in your mouth. This can cause microcracks in your enamel over time.  Also, tooth enamel expands at a different rate than fillings.  If you have a white filling, it will expand and contract much faster than the tooth when exposed to hot and cold temperatures.  This could lead to a breakdown of the seal at the tooth/filling interface and may shorten the life of your filling.

3 – If you have braces, the ice could damage them.  It might break off a bracket or move a wire, making it ineffective at doing its job of bringing your teeth into proper alignment.

4 – It can damage your gums. Ice chunks are hard and can be pretty sharp.  Although I don’t know of any studies to back this up, it would seem that if you are constantly chewing ice and pressing down on the gums, you could cause injury to your gums and perhaps even cause gum recession.  For example, tongue rings press on the surface of your teeth closest to your tongue and have been shown to cause gum recession in these areas.

Why Do You Want to Chew Ice Cubes?

Try to figure out what is causing you to chew ice cubes in the first place.  It could be a sign of stress or a more serious medical condition, such as iron-deficiency anemia.  Perhaps a multi-vitamin with iron is all you need to help you stop your habit.

More than likely, though, you are just chewing on ice because you are bored and still sitting at the table after you have finished your food.  There are also some people who just like chewing ice.  I loved chewing ice cubes when I was a kid, and I’m pretty sure there’s nothing terribly wrong with me…!

Healthier Replacement Habits

Once you find out why you’re chewing ice, you can try to do something to treat the cause of your ice chewing habit.  For example, if stress or social anxiety causes you to chew ice, learn some new techniques to handle these feelings differently.

If you just like chewing ice because of the crunchy noise or the satisfying feeling of chewing through something hard, you can try eating something crunchy, like carrots or apples.


Ice Cube

If you can, it is a lot better to simply suck on ice cubes rather than chew them.  Although this still can cause extremely cold temperatures in your mouth which could shorten the life of your fillings, it is much better to suck on ice than it is to chew on it.

Are you an ice chewer?  Have you ever chipped or cracked your tooth by chewing on something?  If you have any experiences to share or questions, please leave them below in the comments.

Thanks for reading!

Chipped Tooth Fixed Filling

Breaking one of your front teeth is something that nobody wants to go through, but unfortunately it is a common occurrence.  Luckily, modern dentistry is able to make these teeth look normal after a tooth fracture has occurred.  Chipped teeth can be repaired with crowns, veneers, and ordinary white composite fillings.

Today in my pre-clinical lab, we fractured a tooth on purpose and then repaired it.  I took some pictures of the finished result so you can see how it looks.  My professor had us mount some natural teeth in a yellow plaster.  When we got to the lab, he had us cut a few millimeters of tooth structure off of an incisor to simulate a front tooth that had been chipped.  Front teeth can be chipped when someone trips and hits their mouth on a hard object, during fights, or for many other reasons.

I worked on the middle tooth in the photos below.

Composite Filling Dry
Above is the finished tooth in the middle. When it’s dry, it’s easy to see the difference between the filling and the natural tooth. In the bottom photo, I drew a red line showing where the natural tooth ends and the filling begins.

In the bottom photo, you can see a red line.  Everything below that red line is the composite filling, and everything above it is natural tooth structure.

In both of these photos, the tooth is dry, so it is easier to differentiate between the white filling and the natural tooth structure.  The composite filling is also easier to differentiate in this example because we only have a couple of shades of composite available to us in the pre-clinic lab.

I took a second photo of the filling after getting the teeth wet.  This better simulates the real world since our teeth live in a very wet environment in the mouth.

Class IV Composite Filling Wet
Here is the finished tooth. I put some water on it to simulate saliva. When the filling is wet (as it is in the mouth), it appears more aesthetically pleasing.

You will notice that it is a lot harder to see the difference between the natural tooth structure and the composite filling when the tooth is wet.

When you compare it to the tooth on the right, you can see that the colors match pretty well; it is more yellow at the top, and gets whiter as you go down the tooth.

If I’d have used the right shade of composite (and if I had a few more years of experience!), it would be nearly impossible for the untrained eye to detect the difference between the composite filling and the natural tooth structure.

Have you ever chipped a tooth?  Did you get it repaired?  If you have any comments or questions, please leave them below in the comments section below.