The size and shape of jewelry is usually determined by the body part being pierced.24 Shapes of jewelry for oral piercings include studs (Figure 13), a metal stem with a sphere on one end and a smooth flat disk on the other; closed rings (Figure 14) also called seamless rings; unclosed rings (also called circular barbells or horseshoes) which may have a sphere at one or both ends (Figure 15); and barbells, where the stem may be curved or straight and has a sphere on each end (Figure 16).18,19 A magnetic force 10 times the force of a conventional magnet may hold the parts of a stud together although internally threaded jewelry is used more often.19 Internal threading, where the head/sphere screws into the post over external threading, where the head/sphere screws onto the post, is preferred as it provides a cleaner, smoother, less traumatic surface especially with movement of the jewelry (Figure 17).19
Preferred materials for quality jewelry during the initial healing period include implant grade stainless steel, titanium and niobium. After the initial healing period, jewelry of 14K or higher gold, platinum or non-reactive, inert plastics like Tygon® or Teflon® may also be acceptable.9,13 Avoid metal alloys containing nickel due to the potential for allergic reactions. Sterling silver jewelry typically does not contain nickel but can cause discoloration of the surrounding area. Most plastic or acrylic jewelry is too porous and can, therefore, harbor bacteria and is not recommended for routine wear.9,13 These may be the materials of choice for temporary jewelry use to keep the piercing site open during procedures such as radiographs where metal jewelry would interfere with image quality (Figure 18). Temporary plastic jewelry is also known as a ‘retainer.’
Choosing a shiny finish, over a matte finish, is preferred as it is generally cleaner and less traumatic. Jewelry that comes with a lifetime guarantee is generally of better quality and is, therefore, preferred. Materials such as stone, bone and ivory were used in antiquity but are rarely used today except in certain cultures.21
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