Oral Piercing Aftercare

Woman With Cyber Bites Lip Piercings Congratulations on your new cheek, lip, oral web, or tongue piercing! Oral piercings and facial piercings that extend into the mouth on one side are attractive and a lot of fun to have, but you have to put in some work to ensure that yours heals well and stays with you for many years to come. It’s critical to the success of your new piercing(s) to practice proper oral piercing aftercare and regularly clean the external side of facial piercings that have an oral side. There are also a few things you should know before you get pierced or that you should at least discuss with your piercer immediately after getting pierced.

Things to Consider Before Getting a Lip, Cheek or Oral Piercing

The following information applies to both oral piercings, like oral web and tongue piercings, and facial piercings that have an oral side, like lip piercings and cheek piercings. If you’ve already gotten one of these piercings and have any concerns about the style or gauge jewelry you chose after reading the following paragraphs, contact your piercer and discuss a jewelry change.

Minimizing Migration & Rejection

Oral web (i.e. frenulum) piercings go through very delicate tissue and can be prone to migration and rejection. If you’re interested in getting a smiley (upper lip oral frenulum piercing), a frowny (lower lip oral frenulum piercing), or tongue frenulum piercing, ask your piercer if s/he believes your oral web is deep enough to be pierced with minimal chances of migration or rejection. If the tissue is too shallow, your piercing will be much more likely to work its way out over time. You should also ask your piercer to use the heaviest appropriate gauge needle and jewelry s/he can for your oral web piercing. The heavier the gauge of the needle and jewelry used and the more deeply your oral frenulum is pierced, the better your chances will be of getting a successful piercing that lasts as long as you want to keep it.

Choosing the Best Jewelry

Jewelry Material – Whatever type of lip, cheek or oral piercing you’re interested in getting, make sure you choose starter jewelry that’s made of either 316L surgical stainless steel, BioPlast or solid titanium (not titanium-coated jewelry, because the coating can chip away over time and expose a lower quality metal beneath). These three materials are the least likely to trigger an allergic reaction. If you have particularly sensitive skin, opt only for titanium or BioPlast. Titanium is the most inert metal and therefore least likely to trigger an allergic reaction, and BioPlast is hypoallergenic, fully autoclavable, and flexible, so you may find it more comfortable during the healing process.

Jewelry Style – You should be able to choose between different styles of starter jewelry for any facial/oral piercing. Ideally, you should get a long-shafted labret stud inserted into cheek piercings and lip piercings. The alternatives would be straight barbells for cheek piercings and hoops for lip piercings. Hoops aren’t a bad alternative type of starter jewelry for lip piercings as long as they don’t hug your lip too tightly (there needs to be room to accommodate post-piercing swelling), but labrets are even better during the healing process. Straight barbells aren’t as ideal as labret studs for cheek piercings, because the ball on the inside of your mouth could rub uncomfortably against your gums, making your gums feel raw and/or causing them to recede, or it could find its way between your teeth when you’re chewing and cause you to crack a tooth. Labret studs have flat backs that will be much more comfortable and less damaging to your mouth, particularly when you start out with flexible BioPlast labret studs.

As for oral web piercings, you usually have a choice between a micro bent barbell, a circular barbell or a captive ring for your starter jewelry. Sometimes short straight barbells are also an option. Micro bent barbells are ideal, because they’ll follow the curves of your mouth and put the least amount of pressure on your healing fistula (piercing hole). This is particularly true with smiley piercings, since the weight of the jewelry hanging down will be working against your healing piercing. There will be less jewelry hanging with a micro bent barbell than with a circular barbell or captive ring, if you’re getting a smiley piercing.

Unless you’re getting a forward tongue piercing rather than the traditional placement towards the center of your tongue, a tongue ring (straight barbell) is really your only jewelry option. (Captive bead rings and circular barbells can sometimes be used for forward tongue piercings, as shown in the image to the right.) You do at least have a degree of control over the style of barbell top you choose, the gauge of the jewelry, and the material from which it’s made. Consider getting a 12g-14g tongue ring with a flat disc top or other top with a thin profile that will lay fairly flush against your tongue and be less in the way when you eat and talk compared to a traditional ball top. Getting a flexible BioPlast tongue ring can help you avoid damaging your teeth and gums and make your jewelry more comfortable to wear during the healing process. Alternatively, you could opt for an acrylic tongue ring (i.e. a steel or titanium barbell with dental-grade acrylic ends) that will be less damaging to your teeth and gums than solid metal jewelry might be.

Lip, Cheek & Oral Piercing Aftercare Instructions

Your piercer should give you a sheet of oral piercing aftercare instructions after piercing your tongue or oral frenulum, but you can use the tips below to supplement that information. If you’ve gotten a facial piercing with an oral side, like a lip or cheek piercing, ask your piercer for both external and oral piercing aftercare instructions, since you have to handle the two sides of the piercing differently.

What You Should Do After Getting a Facial/Oral Piercing

DO Stay Well. Bolster your immune system so it can focus on healing your lip, cheek or oral piercing by eating nutritiously, staying hydrated, avoiding alcohol, nicotine and recreational drugs, getting lots of quality sleep, avoiding stressors, and generally practicing good hygiene (including lots of thorough hand washing, particularly during cold and flu season).
DO Avoid Smoking. If you’re a smoker, invest in an e-cigarette that mixes nicotine with water vapor to avoid the drying, damaging effect of cigarette smoke on your oral piercing or the oral side of your facial piercing. Alternatively, you could wear a nicotine patch or try nicotine gum or lozenges. All of these options are great alternatives to cigarette smoke, which you have to eliminate from your life or at least minimize your intake of during the first few critical weeks of the healing process.
DO Keep Your Piercing(s) Clean. This is the most important “Do” on our list. If you have a lip, cheek, oral web, or tongue piercing, the best way to clean the inside of your mouth is with a sea salt mouthwash. Avoid alcohol-based mouthwash at all costs! It will dry out your mouth and your piercing(s) and delay the healing process, if not completely foil it. Recovery Oral Piercing Aftercare – Alcohol Free Mouthwash is the best thing to use, because it’s made from a healing mixture of purified water and sea salt with minimal other additives. The only significant additives are a preservative and flavoring that makes the oral rinse tastier, leaves your mouth feeling cleaner, and freshens your breath. The APP and master piercer, president of the APP and author of The Piercing Bible, Elayne Angel, recommend using either an alcohol-free antimicrobial rinse or sea salt solution to clean oral piercings. An alcohol-free antimicrobial rinse would be fine if you felt you needed it because, say, you suspected you were developing an infection, but typically sea salt mouthwash is a more than sufficient cleanser for healing oral piercings. Sea salt (not table salt, which contains iodine) naturally and effectively reduces bacteria, and since salt is naturally present in our bodies down to the cellular level, people with new oral piercings tend to respond best to sea salt mouthwashes. Sea salt mouthwash is gentle, effective and totally natural, making it the clear winner for oral piercing aftercare.If you’d rather make your own sea salt solution instead of buying a convenient, breath-freshening product like Recovery Oral Piercing Aftercare – Alcohol Free Mouthwash to clean your oral piercings, the recipe is simple. Boil water for 5 minutes to sterilize it, and then measure out 1 cup (8 oz.) into a heat-safe container. Stir in 1/4 teaspoon of sea salt until it’s fully dissolved. More salt is not better, and table salt is not a good alternative to sea salt. (Be sure to check out our Recovery Aftercare Sea Salt from the Dead Sea; it’s some of the best sea salt available.) Once the mixture is cool enough, use it to gently swish out your mouth for 5 minutes.
Whether you use homemade sea salt solution or a mouth-freshening store-bought alternative like Recovery Oral Piercing Aftercare, it’s important for you to swish your mouth for 5 full minutes per session 2-3 times a day and at least rinse briefly (for 30 seconds or so) after eating anything. We recommend doing full 5-minute sessions morning and night and then rinsing for 30 seconds after meals to get your 3-6 sea salt mouthwash rinses in each day. Make sure that whenever you brush, you do your sea salt solution swish afterwards, not before. You should also swish with sea salt mouthwash after smoking, if you cave and smoke a real cigarette or a cigar at some point.

Note for Those With Cheek or Lip Piercings: In addition to doing oral rinses 3-6 times per day, you’ll also need to keep the external side of your piercing clean. Apply Recovery Piercing Aftercare Spray or another quality sea salt-based piercing aftercare solution to the outside of your lip or cheek piercing 3-6 times per day after doing your oral rinses. Twice a day you should do full soaks, where you apply a series of sea salt solution-saturated cotton balls to your piercing for a total of 5 minutes. If your skin becomes dry or cracked around the external side of your piercing, you can saturate a cotton ball with sea salt solution and then add a single drop of tea tree oil to the cotton ball before gently pressing it against your piercing. Or, if you make your own sea salt solution, add 2-3 drops of tea tree oil per cup of sterile water and sea salt you prepare. (You can save on ingredients by purchasing our Recovery Sea Salt and Tea Tree Oil Combo Pack.) Do not apply tea tree oil directly to your piercing; it can do more harm than good without being diluted in a carrier like sea salt solution or another oil. Most oils, balms and creams aren’t good for healing piercings, though, so it’s best to dilute your tea tree oil in sea salt solution.
DO Brush Your Teeth & Floss Carefully. You need to keep up with your regular oral hygiene, like brushing your teeth and flossing, while your facial/oral piercing heals. You just have to be a little more careful about how you brush, particularly if you have an oral web piercing. Brush gently when in the vicinity of your piercing, and try to avoid banging your toothbrush into your piercing or snagging it with dental floss. The best time to do your sea salt solution swishes is after brushing your teeth and rinsing your mouth with plain water. If you were to rinse and then brush instead, you’d wash away the remnants of the healing sea salt solution you just used and negate its benefits.
DO Avoid Trauma. In addition to being careful while brushing your teeth and flossing, you need to avoid excessive talking and playing with your jewelry to minimize undue trauma to your healing piercing. Trauma can cause excess scar tissue to develop, make you more susceptible to infection, trigger jewelry to migrate, and cause other issues that could negatively impact your lip, cheek or oral piercing.

What You Should NOT Do After Getting a Facial/Oral Piercing

Do NOT Drink Alcohol or Take Aspirin. During the first week or so after getting pierced, you’ll be more prone to occasional bleeding. Alcohol and aspirin thin the blood and make it harder for your body to clot around an open wound, so it’s best to avoid both things altogether. Avoiding alcohol will help your immune system stay stronger, too, and allow your body to focus its energy on healing your new cheek, lip or oral piercing.
Do NOT Use Alcohol-Based Mouthwash. Alcohol-based mouthwash will dry out your piercing, delaying the healing process and potentially leaving you more susceptible to infection. Bacteria loves to take root in any dry, cracked entry point into the body it can find. If you feel the need to clean your mouth with something stronger than sea salt solution periodically, use an alcohol-free antimicrobial mouthwash. Hydrogen peroxide is acceptable if it’s been diluted per the bottle’s instructions for using it as a mouthwash, but it tastes terrible. If you’re fighting signs of infection, though, it couldn’t hurt to add a hydrogen peroxide or other alcohol-free antimicrobial mouthwash rinse to your oral piercing aftercare routine at least once a day.
Do NOT Play With Your Jewelry. It can be incredibly tempting to roll a tongue ring back and forth across your lips or poke at a web, inner cheek or inner lip piercing with the tip of your tongue. DON’T DO IT! Playing with your jewelry is a bad idea. You might damage your teeth or gums, cause excess scar tissue to develop, trigger migration/rejection, or push bacteria into the healing fistula and put yourself at risk for developing an infection. Don’t touch your jewelry with your hands, either, unless you absolutely have to, and then only if you’ve thoroughly washed them or donned gloves first.
Do NOT Kiss Anyone or Engage in Oral Sex. Don’t panic; you can give your partner love pecks while your lip, cheek or oral piercing is healing, but you need to avoid open-mouth kissing until your piercing is fully healed. Most oral piercings heal within 4-6 weeks, although cheek and lip piercings can take longer for some people. During that time, you have to do everything you can to minimize the amount of bacteria that comes in contact with your vulnerable healing piercing. That means avoiding other people’s bacteria by skipping open-mouth/French kissing and oral sex. No exceptions!
Do NOT Chew on Foreign Objects. You shouldn’t bite your nails or chew things like tobacco, pencil erasers, pen ends or other foreign objects, because they could introduce bacteria into your mouth and trigger an infection to develop in your new piercing.
Do NOT Share Food, Drinks or Utensils. Sharing food, drinks, cutlery, or plates with other people would expose you to their bacteria and make you more susceptible to infection. It’s nearly as bad as open-mouth kissing and oral sex for a healing facial/oral piercing.
Do NOT Change Your Jewelry Prematurely. It’s really important to wait until your piercing is fully healed before considering a jewelry change. The only exception is if your jewelry becomes too tight due to swelling or triggers an allergic reaction, in which case you should see your piercer right away and get him or her to help you change your jewelry. Even once your piercing is healed, it may be hard for you to change your jewelry yourself. Consider having your piercer help you the first time. The longer you have your piercing, the better reinforced your fistula will become, which will make it progressively easier for you to change your jewelry by yourself down the road.
Do NOT Submerge Your Healing Piercings in Water. This is less of an issue for oral piercings than for cheek piercings and lip piercings. If you have one of those types of piercings, you should avoid swimming, soaking in hot tubs, etc., because of the bacteria such environments may harbor. Even a chlorinated pool is a bad idea; chlorine doesn’t kill all bacteria, and it can irritate new piercings.
Do NOT Apply Creams, Oils or Balms to Lip or Cheek Piercings. If your skin gets dry around the external side of a cheek or lip piercing, it can be tempting to apply cream or oil to help it recover. Tea tree oil-infused sea salt solution is a much better idea, though. It’s a natural moisturizer and it has antiseptic properties that will fight any bacteria that’s nestled into your irritated skin. If your skin doesn’t improve after a few days of using sea salt solution with tea tree oil, you can try mixing a drop of tea tree oil with a few drops of emu oil and gently massaging the mixture into the skin around your piercing. Even though emu oil won’t clog your pores the way other oils can, it’s best to use it sparingly and not slather it over top of your fistula.

Identifying & Addressing Cheek, Lip & Oral Piercing Problems

There are a number of issues that may arise during the lip piercing, cheek piercing or oral piercing healing process. You should familiarize yourself with these potential problems so you can spot and address them quickly if they happen to you.

Discharge of Lymph

During the facial/oral piercing healing process, it’s perfectly normal for the body to excrete lymph, which is a clear substance that dries to a whitish crust. When people complain about “crusties” forming around their healing piercings, they’re talking about lymph. It’s really nothing to worry about unless the discharge becomes thicker, yellowish and more pus-like. If you experience that, then see the “Infection” section below. Otherwise, you can deal with crusties that form around the external side of cheek and lip piercings by saturating a cotton ball with sea salt solution, pressing it gently against your piercing to soften the crusties, and wiping them away carefully with a clean tissue or cotton swab. It’s highly unlikely for lymph to crust around oral piercings or the oral side of facial piercings the way it does around external piercings. If you need to cleanse your mouth of lymph, just swish gently with sea salt solution for 30 seconds or so to remove it.

Swelling

Excessive swelling can cause your jewelry to press into the skin around your piercing, which left unattended may cause necrosis (tissue death) and lead to infection. If your tongue “swallows” your tongue ring or your lip or cheeks swell so much that your labret jewelry seems suddenly embedded in your skin, see your piercer immediately. S/he will have to outfit you with longer jewelry or a different style of jewelry until the swelling subsides. Your starter jewelry should be sufficiently long enough to avoid this issue from the get-go, but some people swell more than others, and if you’re one who swells significantly, you have to do something about it–and we don’t mean changing your jewelry yourself! That’s never a good idea with a fresh piercing. Just pop by your local piercing shop and have your piercer change it for you.

Infection

Infection in a facial/oral piercing can be devastating if left unattended too long. Infections in the head have a shorter, straighter route to the brain, where they can do all kinds of damage. If you suspect you’re developing a facial/oral piercing infection because you’re feverish, the skin around your piercing(s) is hot to the touch, your fistula is discharging thick, yellow pus, and/or there are red streaks radiating from your piercing, there are two things you should do. First, ramp up your aftercare regime. Do more sea salt mouthwash rinses for more time each day (e.g. 5 minutes 3-4 times per day + 30-60 seconds after eating). You can also add an alcohol-free antimicrobial mouthwash to the mix to see if that helps. If you have an irritated lip or cheek piercing, use tea tree oil-enhanced sea salt solution to clean the outside of your piercing. Tea tree oil is a natural antiseptic in addition to being a moisturizer. It is not intended for internal/oral use, though, so don’t swish your mouth with it. If you don’t see any improvements after a couple days of increased aftercare or if you get worse, see your family physician right away. S/he may prescribe an antibiotic to remedy the infection. You should keep up with your facial/oral piercing aftercare while taking the antibiotic, and do not remove your jewelry. If the fistula closed up around the infection, infected fluids wouldn’t be able to drain out and you could develop an abscess.

Hypergranulation

Hypergranulation is red, puffy tissue around a fistula that may take on the appearance of a fluid-filled pustule. It’s most likely to occur when a wound has too much prolonged pressure on it, particularly when excess moisture is also present as it is in the mouth. If you’ve had significant swelling around a lip, cheek or oral piercing or your jewelry is just ill-fitting, you may develop a hypergranulation issue. The best thing to do is get the pressure off, since you can’t do much about the moisture level in your mouth. Have your piercer replace your jewelry with a longer barbell or different style of jewelry altogether, and then ramp up your aftercare regime in the way described under “Infection” above. The hypergranulation should subside given time once the pressure is off your piercing and you’ve ramped up your facial/oral piercing aftercare regime.

Scarring

Scar tissue can develop around any wound, including lip, cheek and oral piercings. The three types of scarring people experience with piercings are hypertrophic scars, atrophic scars and keloids.

Keloids

The formation of keloids around wounds is a genetic issue that affects a very small percentage of the population, so unless you know you’re prone to keloids or someone else in your family is, it’s highly unlikely you’ll have to worry about this type of scarring. A true keloid would grow out of control, spreading well beyond the immediate area around your piercing. The scars would be a dark reddish-purple color and bulbous yet smooth-surfaced/taut (i.e. may look fluid-filled). Most people who jump to the conclusion that they have a keloid are actually experiencing a hypergranulation issue.

If you develop a legitimate keloid, you’ll need to see a dermatologist for help having it minimized or removed. Keloids may be treated with corticosteroids or radiation to shrink them, they can be lasered or frozen off, or they can be surgically removed. Sometimes applying a silicone scar therapy gel can help minimize keloids, but it typically will not remove them completely.

Hypertrophic Scars

Hypertrophic scars are much more common than keloids. They tend to form tightly around a fistula, remain fairly flesh tone/close in color to the surrounding skin, and have a textured yet fairly flat top. People who have had their tongues pierced more than once in the same area frequently develop a hypertrophic scar on the underside of the tongue, although it can happen even after just a single tongue piercing. This type of scarring could also form around oral web piercings and the inside or outside of lip and cheek piercings.

If you develop a hypertrophic scar inside your mouth, you could see a dermatologist about having it surgically removed. S/he may tell you that’s likely to just result in worse scarring, though, and suggest you let it be. If you develop a hypertrophic scar around the outside of a lip or cheek piercing, you can treat it with a silicone scar therapy gel or jojoba oil once your piercing is fully healed. Whether you use silicone scar therapy gel or jojoba oil, you would massage a small amount into the scar tissue twice a day for as many weeks or months as it takes to sufficiently minimize the appearance of your scar or eliminate it altogether.

Atrophic Scars

Atrophic scars are recessed/indented scars that are most likely to form where a retired piercing was. They’re the result of your body’s collagen cells getting mixed up and not doing their job completely as they work to fill a piercing fistula after you remove your jewelry. Unless you had a seriously-stretched piercing, an atrophic scar will likely be more than a tiny little divot in your skin where your piercing once was. The center of the divot may look slightly roughly-textured, but it will most likely match your general skin tone and be barely noticeable, particularly if one forms where you had an oral piercing previously.

Unfortunately, there’s not much you can do about an atrophic scar that forms where an oral piercing was, other than to take comfort in the knowledge that it’s highly unlikely anyone will ever see it or notice it if they did see it. If you develop an atrophic scar after removing a lip piercing or cheek piercings, you can massage silicone scar therapy gel or jojoba oil into the scar tissue twice a day for as many weeks or months as it takes to eliminate the scar. Note that you shouldn’t apply jojoba oil before your external piercing is fully healed, though.

To learn more about avoiding, identifying and treating piercing scars, read our blog post titled Identifying & Minimizing Body Piercing Scars.

More Lip, Cheek & Oral Piercing Information

Our Blogs section and Information Center contain a wealth of piercing information that’s available to the public for free. You may be interested in reading some of these related articles and blog posts to learn more about facial piercings and oral piercings:

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References

“Oral Care” Section of Piercing Care Article on ThePiercingBible.com

PDF of the APP’s Suggested Aftercare for Oral Piercings Brochure