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PubMed2003

Formation of mucogingival defects associated with intraoral and perioral piercing: case reports.

BACKGROUND: The authors provide clinical findings in five patients wearing oral jewelry to illustrate the risks of experiencing periodontal injury associated with body piercing involving intraoral and perioral sites. They also present a literature review of other adverse dental and medical consequences attributed to oral piercing. CASE DESCRIPTIONS: Five young adult patients with tongue and lip piercing sought dental care. Each patient exhibited some degree of gingival recession and mucogingival defects in proximity of their oral jewelry. Three of these patients had probing depths ranging from 5 to 8 millimeters in the affected areas. CLINICAL IMPLICATIONS: Intraoral and perioral jewelry may be associated with the development of significant mucogingival deformities. Because severe attachment loss can develop even when gingival recession is minimal, it is critical that patients with oral piercing routinely undergo comprehensive periodontal assessment. The authors urge clinicians to educate patients about the potential risks regarding the practice of oral piercing.

Adult↗
PubMedDate not supplied

Oral piercing: the hole story.

Oral and perioral jewelry is increasingly being viewed as an acceptable fashion statement in our society. Accordingly, dental professionals are being presented with questions by their patients as to the risks associated with this form of body piercing. This article reviews recommendations for individuals with, or contemplating, an oral piercing, common locations of piercings, risks associated with the piercing procedure, types of jewelry used, and post-piercing home care instructions. Current trends in the piercing industry will be discussed, and the recommendation made that dental professionals advocate for improved safety standards at body modification studios.

Adolescent↗
PubMed2004

Lip and tongue piercing: experiences and views of general dental practitioners in South lancashire.

PURPOSE OF THE STUDY: To ascertain the numbers of patients with pierced lips or tongues seen by dentists during routine consultations. The study also examined the provision of advice by dentists, and the nature of piercing-related complications. BASIC PROCEDURE: A postal questionnaire was sent to dentists in two Primary Care Trust areas in South Lancashire. MAIN FINDINGS: Sixty-four of the 106 questionnaires were returned, giving a response rate of 60%. Sixty-two dentists (96.9%) reported that they had seen patients with lip or tongue piercings during the previous 12 months and that they had seen a mean number of 2.8 patients with lip piercing and a mean of 9.0 patients with tongue piercing. A total of 56.5% of the dentists gave advice on oral hygiene and 79.0% on possible damage to the oral structures. Twenty-seven dentists (43.5%) said that their patients had oral health problems as a result of lip or tongue piercing. PRINCIPAL CONCLUSIONS: The dentists who responded to the questionnaire commonly saw lip and tongue piercings. All dentists should therefore be prepared to offer appropriate advice. A public health information leaflet available in all medical and dental practices would help to ensure that patients were better informed about body piercing and its complications.

Cosmetic Techniques↗
PubMed2003

Infection control practices among tattooists and body piercers in Sydney, Australia.

BACKGROUND: Tattooing and body piercing have a long history, and both have become increasingly fashionable worldwide. There is an association between tattooing/body piercing and hepatitis B and C infections. METHOD: We undertook an observational study to examine the prevalence and predictors of infection control practices among tattooists and body piercers in Sydney, Australia. Within each premise, data were obtained from owners/mangers and nominated staff completion of a knowledge and attitudes questionnaire, owner/manager demonstration of key infection control procedures, and an inspection of the premises. RESULTS: Consent to participate was obtained in 41 of 44 premises (93.2%). A low proportion of owners/managers and staff gave the correct answer for the purpose of disinfection (52.8%/26.9%) and sterilization (50%/53.8%). About one third of owners/managers (38.8%) and 56% of staff reported that their infection control compliance could be improved. Approximately one quarter of owners/managers reported that the frequency of inspections was inadequate. Even though the majority of demonstration and inspection items were complied with, deficiencies were observed concerning washing of hands, wearing of gloves, and sterilization procedures. CONCLUSION: There is a continuing need to improve infection control performance among tattooists and body piercers. The effectiveness of intervention approaches designed to achieve this should be explored.

Adult↗
PubMed1998

Tongue piercing and associated tooth fracture.

The case presented is designed to draw attention to the increasingly common occurrence of tooth fracture as a result of trauma incurred from a barbell inserted during tongue piercing. Oral piercing is on the rise. Of concern to health personnel are the associated risks, which include damage to dentition, infection, speech impediment and nerve damage. Also of concern is the belief that in some cases, clients considering body piercing may not be receiving sufficient care instructions, hence putting them at greater risk of post-operative complications. We conclude that a public health campaign in the form of health promotion and education is mandatory to ensure safe responsible piercing, and recommend that workshops, forums and educational leaflets aimed at the piercers, the clientele and the health care workers be developed in Alberta.

Adult↗
PubMed2002

Gingival recession due to trauma caused by a lower lip stud.

Body piercing seems to be increasing in popularity, with more patients attending for their routine check-up having had a tongue or lip stud placed. Many complications have been documented, some of them, particularly involving tongue piercing, can be life threatening. There appears to be fewer problems associated with lip piercing; however this case study illustrates the damage that a lip stud can cause to previously healthy gingival tissue.

Adolescent↗
PubMed2001

Risk factors for acquisition of hepatitis C virus infection: a case series and potential implications for disease surveillance.

BACKGROUND: Transmission of hepatitis C virus (HCV) is strongly associated with use of contaminated blood products and injection drugs. Other "non-parental" modes of transmission including sexual activity have been increasingly recognized. We examined risk factors for acquiring HCV in patients who were referred to two tertiary care centers and enrolled in an antiviral therapy protocol. METHODS: Interviews of 148 patients were conducted apart from their physician evaluation using a structured questionnaire covering demographics and risk factors for HCV acquisition. RESULTS: Risk factors (blood products, injection/intranasal drugs, razor blades/ toothbrushes, body/ear piercing, occupational exposure, sexual activity) were identified in 141 (95.3%) of participants; 23 (15.5%) had one (most frequently blood or drug exposure), 41 (27.7%) had two, and 84 (53.4%) had more than two risk factors. No patient reported sexual activity as a sole risk factor. Body piercing accounted for a high number of exposures in women. Men were more likely to have exposure to street drugs but less exposure to blood products than women. Blood product exposure was less common in younger than older HCV patients. CONCLUSION: One and often multiple risk factors could be identified in nearly all HCV-infected patients seen in a referral practice. None named sexual transmission as the sole risk factor. The development of a more complete profile of factors contributing to transmission of HCV infection may assist in clinical and preventive efforts. The recognition of the potential presence of multiple risk factors may have important implications in the approach to HCV surveillance, and particularly the use of hierarchical algorithms in the study of risk factors.

Acute Disease↗
PubMed2003

Magnetic nasal foreign bodies: a result of fashion mania.

The fashion of body piercing among adults has encouraged children to have similar procedures or imitate them by applying small magnets to sustain the jewelery used in piercing in position [Emerg. Med. J. 19 (2002) 71]. We present cases of children who have placed magnets on their nasal alae that became misplaced on to the nasal septum causing severe pain and in some cases nasal bleeding and septal perforation. We describe management of these cases.

Adolescent↗
PubMed1998

Adhesive composite inlays for the restoration of cracked posterior teeth associated with a tongue bar.

While body piercing has become fashionable in contemporary society, numerous health risks are directly related to this trend. Tongue piercing in particular presents several concomitant complications for the attending clinician, including the possibility of soft tissue infection or damage to the natural dentition or existing restorations. Clinicians must be proficient in the selection of the proper materials and techniques utilized to treat affected patients. This article details a comprehensive clinical protocol for the use of adhesive composite inlay restorations for cracked posterior teeth.

Adult↗
PubMed2003

An initially unnoticed piece of nasal jewelry in a parturient: implications for intraoperative airway management.

The literature documenting the anesthetic implications of body piercing consists only of a few case reports that focus exclusively on interference with airway management by oral jewelry. To date, no case reports documenting anesthetic problems resulting from the presence of nasal jewelry have been reported. We present a case of a parturient who presented for an emergency cesarean section with nasal jewelry in situ, which was unnoticed preoperatively and then became externally loosened intraoperatively. This situation necessitated fiberoptic examination of the nasopharyngeal and oropharyngeal cavities and radiologic imaging studies to rule out aerodigestive tract aspiration of retained and missing piece(s) of the jewelry. Based on this experience, we now advise all laboring parturients with nasal or oral jewelry in situ to remove the hardware on admission to Labor and Delivery for safety precautions.

Adolescent↗
PubMed2005

Prevalence and risk factors for hepatitis C virus infection among adolescents in detention.

OBJECTIVE: To assess the prevalence and correlates of hepatitis C virus infection in a sample of detained adolescents. DESIGN/SETTING/PARTICIPANTS: Cross-sectional prevalence study with 10- to 18-year-old adolescents who were consecutively admitted to a juvenile detention center in San Antonio, Tex. MAIN OUTCOME MEASURES: The prevalence of hepatitis C virus infection and associated risk factors. RESULTS: Of the 1002 participants, 75% were Hispanic and the mean age was 15 years. Twenty adolescents had laboratory data consistent with hepatitis C virus infection, giving an overall prevalence of 2.0% (95% confidence interval, 1.2-3.1). All adolescents infected with hepatitis C virus were Hispanic (13 boys and 7 girls). Although a high proportion of the participants reported having had intranasal drug use (55.6%), tattooing (50.5%), or body piercing (25.3%), the only factor significantly associated with hepatitis C virus infection was having a history of injection drug use. Injection drug use was reported by 5.3% of the participants but by 95% (19/20) of those infected with the hepatitis C virus. CONCLUSIONS: This study indicates that injection drug use was linked with the majority of hepatitis C virus infections in this population of detained adolescents, similar to findings in adults. These adolescents reported a high frequency of other behaviors that could potentially pose a risk for contracting bloodborne infections. Effective prevention and awareness programs in a detention setting need to be comprehensive and include screening, hepatitis A and B immunizations, and risk-reduction counseling.

Adolescent↗
PubMed2005

Infectious disease risk of cadaveric tissue donors who used non-injected illicit drugs.

This study assessed the correlation between a history of non-injection illicit drug use by cadaveric tissue donors and the presence of markers for Human Immunodeficiency Virus Type 1 (HIV-1), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), Human T Lymphocyte Virus Types I-II (HTLV-I-II), and Syphilis in their blood. It was found in 12,227 donors recovered in 2000-2002 that 9.68% of individuals with a history of non-injection drug use were seropositive for one or more infectious disease markers compared to 4.26% of donors without a history of drug abuse (p<0.001). A history of non-injection drug use had a positive predictive value of 9.68% and a negative predictive value of 95.74%. Analysis of seropositivity rates associated with individual drugs indicated that 9.6% of cocaine abusers were positive for one or more markers (p<0.001). Other drugs exhibited higher rates of seropositivity but the numbers were insufficient for statistical analysis. Other risk factors (transfusion of blood/blood products, tattoos and body piercing, incarceration) were not associated with higher incidence of infectious disease markers.

Biomarkers↗
PubMed2002

Management of viral hepatitis C.

The hepatitis C virus was first identified in 1989. It causes chronic hepatitis, cirrhosis and hepatocellular carcinoma. Global anti-HCV prevalence is 1-3%. Contaminated blood product, dirty needles and instruments, and injection drug use are the main parenteral routes of transmission. Cultural practices, such as acupuncture, tattoo, body piercing and scarring, also play a role. Universal precaution is the mainstay for prevention before vaccine is developed. Therapy for chronic hepatitis C (CHC) with interferon (IFN) is not satisfactory. Non-response and early relapse reduce sustained response (SR). In 1997, National Institute of Health consensus recommended IFN therapy only for selected patients with compensated CHC, raised ALT and moderate to severe histologic disease activity; 15-20% SR is expected. Major advances in CHC therapy is combination therapy. Ribavirin in combination with IFN significantly increases SR to 30-40%. Even patients with high viral load, genotype 1, significant fibrosis or cirrhosis respond better. EASL and APASL Consensus in 1999 recommended IFN-ribavirin combination as the first line therapy. Recent data on pegylated IFN showed very encouraging results. Combined with ribavirin, 60% SR was achieved. It benefits patients with severe bridging necrosis and also cirrhosis. However, 23-27% of patients receiving combination therapy with either IFN type, experienced adverse events and required therapy discontinuation. Many important issues remained unsolved. Therapy for children, the elderly, patients with comorbidity and extra-hepatic syndromes need to be addressed. Therapy is too expensive and not affordable to the majority of patients in developing countries.

Consensus Development Conferences, NIH as Topic↗
PubMed2002

Eleven pearls for cosmetic earlobe repair.

Earlobe repair is a common request in cosmetic facial surgery. Earlobe tears result from a variety of traumatic situations. A resurgence in body piercing and multiple facial and ear piercings is occurring in college-aged individuals. This increase in piercing will bring more piercing-related complications to the cosmetic surgeon. The author has outlined 11 surgical pearls to provide improved cosmetic results in the repair of torn earlobes. Also described is immediate repiercing of the earlobe at the time of the surgical repair. Preventive practices to decrease earring and earlobe trauma are also reviewed.

Dermatology↗
PubMed2001

Preventing the spread of hepatitis B and C viruses: where are germicides relevant?

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most prevalent bloodborne pathogens. Infections caused by these organisms can become chronic and may lead to liver cirrhosis and carcinoma. Limited chemotherapy is now available, but only HBV can be prevented through vaccination. Both viruses are enveloped and relatively sensitive to many physical and chemical agents; their ability to survive in the environment may not be as high as often believed. As a result, their spread occurs mainly through direct parenteral or percutaneous exposure to tainted body fluids and tissues. Careful screening of and avoiding contact with such materials remain the most effective means of protection. Nevertheless, the indirect spread of these viruses, although much less common, can occur when objects that are freshly contaminated with tainted blood enter the body or contact damaged skin. Germicidal chemicals are important in the prevention of HBV and HCV spread through shared injection devices, sharps used in personal services (such as tattooing and body piercing), and heat-sensitive medical/dental devices (such as flexible endoscopes) and in the cleanup of blood spills. Microbicides in vaginal gels may also interrupt their transmission. General-purpose environmental disinfection is unlikely to play a significant role in the prevention of the transmission of these viruses. Testing of low-level disinfectants and label claims for such products against HBV and HCV should be discouraged. Both viruses remain difficult to work with in the laboratory, but closely related animal viruses (such as the duck HBV) and the bovine viral diarrhea virus show considerable promise as surrogates for HBV and HCV, respectively. Although progress in the culturing of HBV and HCV is still underway, critical issues on virus survival and inactivation should be addressed with the use of these surrogates.

Animals↗
PubMed2007

HIV and ethnicity in Canada: is the HIV risk-taking behaviour of young foreign-born MSM similar to Canadian born MSM?

There is a dearth of information on the HIV risk-taking behaviour of foreign-born men who have sex with men (MSM) in Canada. This study focused on identifying sexual risk behaviour among MSM who immigrated to Canada and compared them to MSM who were born in Canada. Baseline data from the Omega Cohort in Montreal and the Vanguard Project in Vancouver were combined to form four ethnicity/race analytical categories (n = 1,148): White born in Canada (WBIC), White born outside of Canada, non-White born in Canada (NBIC) and non-White born outside of Canada (NBOC). Psychological, demographic and sexual behaviour characteristics of the groups were similar except: NBOC were more likely to be unemployed, less likely to be tattooed, had fewer bisexual experiences and less likely worried of insufficient funds. WBOC were more likely to report unprotected sex with seropositives and more likely to have had unprotected sex while travelling. NBIC were more likely to have ever sold sex and to have had body piercing. WBOC are at high risk of acquiring as well as transmitting HIV. It is important to consider place of birth in addition to ethnicity when developing programmes to prevent the transmission of HIV.

Adolescent↗
PubMed2001

Substance abuse and high-risk needle-related behaviors among homeless youth in Minneapolis: implications for prevention.

Homeless and runaway youth face a variety of health risks, including those related to substance abuse and use of unsterile needles. During 1998-1999, we recruited 201 Minneapolis homeless youths aged 15-22 years; these youths were interviewed by experienced street outreach workers from settings where street youth were known to congregate. Respondents spent a median of 6 months in the previous year living on the streets or "couch hopping." There were 37% who reported having 15 or more alcoholic drinks per week, 41% smoked 1 pack or more of cigarettes per day, and 37% used marijuana 3 or more times a week; 15% reported lifetime injection drug use, including 6% who used injection drugs within the previous month. Twenty percent had received a tattoo, and 18% body piercing with a needle that had not been sterilized or had been used by someone else. There were 68% who had been tested for human immunodeficiency virus (HIV), 52% for hepatitis B, and 25% for hepatitis C. There were 44% who said they did not have enough information about hepatitis B and C. Less than half (43%) received hepatitis B vaccine; however, 51% of unvaccinated youths indicated that they would receive vaccination if offered. These Midwestern homeless youths face multiple health risks, including those related to substance use and exposure to unsterile needles. Despite unsafe behaviors, many of these youths were interested in methods to protect their health, including education, knowing their HIV or viral hepatitis serostatus, and obtaining hepatitis B immunization.

Adolescent↗
PubMed2005

The Miami, Florida, Young Men's Survey: HIV prevalence and risk behaviors among urban young men who have sex with men who have ever runaway.

Youth in urban areas with a history of running away from home often have special needs. Importantly, risk factors for HIV/AIDS might be associated with such a history. We assessed the association between having a history of running away from home and the occurrence of HIV infection and risk behavior among young men who have sex with men (YMSM), aged 15-22 years. A cross-sectional epidemiologic and behavioral survey was conducted between 1995 and 1996 in Miami, Florida, as part of a national Young Men's Survey. Of 488 YMSM, the prevalence of HIV infection among those with a history of running away from home was 10.5% (adjusted odds ratio=3.4; 95% CI 1.5-7.8). YMSM who had ever run away were more likely to be HIV infected, be out of school, and have ever had vaginal or anal sex with females, been forced to have sex, injected drugs, and used needles for self-tattooing or body piercing. The prevalence of HIV infection and associated risk behaviors among runaways was high, highlighting the ongoing need for prevention and social support services for youth with a history of running away from home.

Adolescent↗