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Tooth decorations and modifications – current trends and clinical implications

From Volume 43, Issue 4, May 2016 | Pages 313-318


Sonam M Sanghavi


Foundation Dentist in the 2 year Longitudinal Wales Scheme, Dental Core Trainee (DCT) in Restorative and Oral Surgery

Articles by Sonam M Sanghavi

Ivor G Chestnutt


Professor and Hon Consultant in Dental Public Health, Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff CF14 4XY, UK

Articles by Ivor G Chestnutt


Since earliest times, humans have felt the need to modify and beautify their bodies. Adornments in the form of tooth decorations have featured around the world for generations and continue to evolve. This paper describes current and forthcoming trends. It explores the use of tooth jewels, ‘dental grills’ and tooth tattoos which are not yet common in the UK, but are currently trending in the United States of America. This article reviews the literature and aims to describe the clinical effects each tooth decoration has on the dentition, along with appropriate management strategies. Owing to the lack of good quality studies, it is difficult to determine accurate effects on the dentition, but dental practitioners should focus on conservative and preventive management strategies.

CPD/Clinical Relevance: This paper describes modern day tooth decorations, explores the possible effects on oral health and suggests management strategies.


Since earliest times, humans have felt the need to modify their bodies for varying reasons, adornments being both permanent and semi-permanent in nature. This phenomenon has seen a resurgence in the last decade. At the current time, it seems that a tattoo is the rule rather than the exception, particularly in the under thirties, and in the would-be under thirties. Body modification is, of course, not limited to the skin and over the centuries has applied equally to the teeth and oral tissues.

‘Intentional tooth modification’ or ‘tooth decoration’ refers to the process of deliberately changing or altering natural tooth tissue for reasons other than treating dental disease. This global phenomenon dates back several thousand years. Ancient civilizations practised tooth modification for a number of reasons: ethnically for enhancement of physical attractiveness; in ritual ceremonies involving transition into adulthood; as a symbol of wealth, religion, tribal identification; and for survival purposes.

The ancient Mesoamerican-Maya civilization are well known for introducing tooth filing, whereby grooves and notches were created to achieve a variety of shapes in anterior teeth. They were also the pioneers of placing decorative dental inlays. Precious stones such as jade, jadeite, turquoise, obsidian, pyrite, gold and haematite were cemented to fit perfectly over cavities prepared on the labial surfaces of anterior teeth.1

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