Self-Advocacy at the Dentist

We have talked at length about oral piercings on this blog, from discussions of how to heal them, breakdowns of myths and misinformation about them, and a frank discussion of the oral health risks of them. I’ve tried to share as much information about how to wear these piercings safely with minimal damage to your teeth and gums. And a huge portion of this is maintaining good dental hygiene. Brushing, flossing, and rinsing regularly, and keeping your teeth and mouth clean. Another huge factor in keeping your piercings and your mouth healthy is going in for regular maintenance cleaning at your dentist. Unfortunately for folks with oral piercings, the dentist is often not a great experience. Studies estimate that between 9-20% of Americans avoid going to the dentist because of dental anxiety. Getting a cleaning or a filling is already a very stressful experience for many. Add into that some of the negativity and outright hostility that clients with piercings can face, and this becomes a very unpleasant situation to navigate. So unpleasant in fact that many folks just opt to avoid it.

As someone with multiple oral piercings, many I’ve had since high school I can relate. Over the years I would say about 75% of my trips to the dentist included some form of conversation (at best) or berating (at worst) from the folks I saw. This ranged from polite conversations about the risk of oral damage from my piercings to incredibly rude and demeaning comments about piercings. Now oral piercings can have a risk of oral damage- I’m certainly not pretending they don’t! So gently informing patients of the risks is quite reasonable. Telling me that my lip piercings are “unattractive to men”, and my cheek piercings “make my face look heavy”, or attempting to convince me my nostril piercing is causing issues with my teeth (???) These are not appropriate comments. And these comments are not only rude and hurtful, but they make patients not want to come back after hearing such hurtful or repetitive things.

However dental cleaning is incredibly necessary to keep your teeth and gums healthy. Small particles of food and debris can get stuck on our teeth, between them, and even under our gums. And even if you brush and floss regularly, invariably some of those pieces manage to get missed, and eventually harden into tartar. This can’t be removed by yourself, it needs to be removed with a professional cleaning by a dentist or dental hygienist. If allowed to remain it can contribute to dental decay and gum disease- so it’s very essential to keep up with your cleanings.

This blog post is about how I approach advocating for myself at the dentist, and make the experience a bit smoother and simpler for everyone.

Speak from a Place of Knowledge

Very often dentists are well-intentioned when they want to warn you about the risks that can come from oral piercings. Many clients don’t know or aren’t informed about these risks, and many piercers attempt to downplay them in order to get clients to get pierced with them. So to the dentist, they are doing the right thing by making sure you are informed of any risks to your teeth and gums. I find that letting them know not only are you aware of the risks, but you are extremely well informed goes a long way to helping them realize they don’t have to give you the same spiel. How this goes for me is usually as follows

Dentist: “Just so you know, those piercings can sometimes be very bad for your teeth and gums, they can wear down your gums and even chip your teeth.”

Me: “Oh absolutely- they can also contribute to plaque and tartar buildup if not cleaned correctly. I’m very well aware of all the risks having these piercings carries. My lip piercings were placed specifically with my bite in mind and I wear custom jewelry made for my mouth to be the least likely to catch or snag on my teeth. All of my jewelry is implant-grade titanium, the same material often used in dental implants, and biocompatible in the mouth. I don’t play with my piercings, I brush, floss, and rinse 2-3 times daily, and I use a Waterpik and denture cleaner to keep my jewelry clean. I’ve had most of these piercings for over 10 years, and haven’t had any documented instances of damage in that time. If you see anything else please let me know, but I do everything possible to make sure I have these piercings in a way that is safe for my mouth, they are very important to me.”

They are often pleasantly surprised that I am very informed of the exact risks these piercings can cause, and that I do so much as it is to minimize those risks. Letting them know from the start that I’m acutely aware of the risks and also already doing so much to reduce them kind of nips that conversation in the bud. And instead of spending 20-30 minutes being berated for the decision to have facial piercings, we say a few more things and then go back to regular doctor/patient chit-chat.

I also find stressing that the piercings are important to me after showing what I know and how I try to keep them safe is also an important part of that. It lets them know I’m not likely to remove this piercing just because they gave me a stern talk, and to please be polite about it as they are important to me.

Be Polite

This may seem simple, but it's unfortunately not. Just like piercers have dealt with rude and mean clients, many doctors and medical professionals have as well. Dentists more than most, as anxiety and tooth pain are a terrible combo to make folks likely to snap. Many medical professionals have reported harassment and abuse from patients, and are often on edge over that. Just as simple as being polite and friendly when you advocate for yourself goes such a long way. Don’t snap at them or be short with them, try to extend them the same grace and kindness you’d like to be treated with. Even if they open up a little harsh or short, responding back with extra kindness and gentleness can go a long way to steer the conversation in a good direction.

X-Rays

This is one of the most difficult parts of a trip to the dentist with piercings- getting your X-rays done. These are a necessary process to check the health of your teeth, but it’s also the point in the process when you may need to remove jewelry. However- this is often the last alternative, and there are many ways to avoid this.

To start, wear high-quality jewelry. Implant-grade titanium is ideal for dental X-rays, as it's the same material often used in dental implants. You can let them know you are wearing jewelry that is safe for imaging and shouldn’t cause any issues.

Dentist: “Can you take those piercings out for your x-ray?”

Me: “Actually, I’m wearing all implant-grade titanium jewelry, which is safe for MRI’s and Xrays- it's the same material often used in dental implants. I understand my jewelry may show up on the imaging, but it’s never been an issue with seeing my teeth in the past. Can we please try to take them with my jewelry in, and if it becomes an issue we can discuss a new plan at that time?”

And in all my years of getting dental X-rays, from my impacted wisdom teeth to my yearly checkups, my jewelry has never gotten in the way. Now that's not to say it doesn’t happen or couldn’t happen, but it seems to be less of an issue than it's made out to be. And given that some piercings can close if removed just for the length of time required for the X-rays (or techs will try to pressure you to leave them out for the entirety of the cleaning) advocating for yourself kindly but firmly here is a good idea. And if the jewelry truly is in the way, you can always come back another day with retainers in that won't obscure the imaging, or make plans to have jewelry removed and reinserted if necessary.

I hope this helps you feel more confident and prepared to navigate your next dentist's appointment. Happy healing!