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Oral Health

HomeLeading InitiativesOral Health
HomeLeading InitiativesOral Health
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Jan K. Mitchell, DDS, M.Ed
Dental College of Georgia, 
Augusta University

Interprofessional - Oral Health

The direction of healthcare in the United States and abroad is evolving with increased emphasis on preventive services and care. Additionally, a paradigm shift is occurring, moving towards an interprofessional model of care that demonstrates improved patient outcomes. This shift has caused educational and healthcare institutions to alter their cultural climate, and address the issue of interdisciplinary team based care. However, this interprofessional model needs to be introduced and integrated throughout the educational system when health care profession students begin their education. 

As a result of the global IPE initiative, OADN is launching an initiative to provide practical information in educating your students on oral health. As nurses we are very aware of the oral-systemic link, and yet many nurses do not have a strong current knowledge base in this area. Sharing the expertise of fellow dental professionals would be a huge asset in increasing the knowledge level of students and ultimately helping patients. OADN is fortunate to be able have a resident dental expert to assist us with dissemination of information in our new website column: “Nursing Bites for Oral Health.” Dr. Mitchell will provide brief practical information you can use in the educating your students.

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Nursing Bites for Oral Health

  • Oral Piercing and "Dental Jewelry"

    Jewelry and piercing- it's not just for ears anymore! Oral and perioral tissue piercing has become more popular in the past decade. As the prevalence increases, however, so have the complications associated with the practice:

    • Unlike ears, these tissues have important structures that can be damaged inadvertently in the piercing process, including blood vessels, nerves and minor salivary glands. Over the past decade, approximately 3,500 patients per year were treated in US emergency department with piercing-related injuries which include bleeding, edema and infection.
    • Infections. Because of ease of spread in oral tissues, space infections, endocarditis and even Ludwig's angina have been reported. Unregulated piercing parlors have been identified by the NIH as possible vectors for disease transmission including hepatitis.
    • Damaged teeth. Permanent tooth damage was seen in a quarter of all patients with lip piercing, and between a third and half of patients with tongue jewelry. Most common is tooth fracture, which may be repairable or may cause the tooth to be lost. "Grills" hold plaque against teeth and increase the cavity rate.
    • Metal allergy. Since the metals used are rarely non-allergenic, like gold, this practice contributes to allergy to metals like nickel.
    • Periodontal disease. The jewelry physically damages delicate gum tissues so those with lip piercing were 4 times more likely to develop recession than those without. Additionally, these patients have higher levels of plaque which can lead to periodontal disease.


    Patients generally are not aware of these complications and one study showed that over half of recipients did not receive any explanations before the procedure. Not all received appropriate follow-up instructions or care. The Academy of Pediatric Dentistry has come out strongly against oral and perioral practice because of the complication rate.

    A care provider who knows and is trusted by the individual is in a position to give the patient the facts and risks of these procedures as the piercing business often does not. A word of caution my take a little of the glitter off the bling!