Background: In Australia there has been a steady increase in the number of young people seeking body piercing. They have become more inventive with the position, number and type of piercing placed. These have included rings and studs being placed in the upper and lower lips, tongue and even uvula! Case 1: A 13 year old girl was referred to the Dental Dept. of Princess Margaret Hospital for Children for assessment of tooth 41 and the possibility that this was associated with an external draining sinus on her chin. Clinical examination revealed an external draining sinus on her chin with purulent discharge. Tooth 41 had an uncomplicated crown fracture and was moderately discoloured; grade I mobility, was not tender to percussion and gave a negative response to electronic pulp testing. A radiograph showed a periapical radiolucency associated with 41 about 20 mm in diameter. The girl gave a history of having her tongue pierced about 15 months previously and that she had bitten on the stud soon after, resulting in fracture of the tooth. Treatment: Endodontic therapy was carried out without the use of antibiotic therapy. Follow-up: Complete resolution of the periapical lesion was achieved over 18 months of endodontic therapy, but with a residual scar then revised by a plastic surgeon. Case 2: A 15 year old girl was referred to a facial swelling, present for about 4 days. She had had a tongue piercing placed approximately 2 years before and remembered biting on the ball 18 months later. The tooth had not fractured but had been hypersensitive ever since. Clinical examination revealed a mild to moderate swelling over the chin and a draining chin point sinus; tooth 41 was intrinsically discoloured and there was evidence of attrition on the incisai edge. The tooth was tender to percussion and gave a negative response to CO2 pulp vitality testing. A radiograph showed a radiolucent region at the apex of tooth 41. Treatment: The pulp was extirpated from tooth 41 utilising relative analgesia and local analgesia. Follow-up: The patient did not return to the department and was subsequently followed up by a private dentist.
oral piercing trauma dental children
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