title: The incidence of complications associated with lip and/or tongue piercings: a systematic review.
abstract: OBJECTIVE
  This review determines the incidence of complications associated with lip and/or tongue piercings based on a systematic evaluation of the available literature.
  
  
  METHODS
  MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were comprehensively searched through June 2014 to identify appropriate studies. The incidence of complications, as established by a dental professional associated with oral and peri-oral piercings, was evaluated in populations with lip and/or tongue piercings. The quality of the case-control studies was assessed using the Newcastle-Ottawa Scale. For case series studies, the risk of bias was assessed using the National Institute for Health and Clinical Excellence scale.
  
  
  RESULTS
  An independent screening of 1580 unique titles and abstracts revealed 15 publications that met the eligibility criteria. The incidence of gingival recessions appeared to be 50% in subjects with lip piercings and 44% in subjects with a tongue piercing. Tooth injuries were observed in 26% individuals with lip piercings and in up to 37% of individuals with tongue piercings. Subjects with a lip piercing were 4.14 times (P = 0.005) more likely to develop gingival recession than those without a lip piercing. Subjects with a tongue piercing were more likely than non-pierced subjects to experience gingival recession (relative risk (RR) 2.77; P = 0.00001) and tooth injuries (RR 2.44; P = 0.003).
  
  
  CONCLUSIONS
  Both lip and tongue piercings are highly associated with the risk of gingival recession, and tongue piercings are also associated with tooth injuries.
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: N L
authors.identifier: http://orcid.org/0000-0002-6740-5657
authors.initials: NL
authors.lastname: Hennequin-Hoenderdos
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: D E
authors.initials: DE
authors.lastname: Slot
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: G A
authors.initials: GA
authors.lastname: Van der Weijden
mesh_terms: D046288:Body Piercing / Q000009:adverse effects*; D005889:Gingival Recession / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008046:Lip; D014059:Tongue; D018677:Tooth Injuries / Q000209:etiology*
keywords: complications; incidence; lip piercing; oral piercing; systematic review; tongue piercing