Grillz and tooth gems: Can they cause pain, decay or gum damage?

If you’ve been wearing grillz or just got a tooth gem, you might love the look. You might also have a nagging question. Could this hurt my teeth? Dental jewelry can contribute to decay and gum problems, especially when cleaning falls short.¹ That doesn’t mean every wearer will have damage. If something feels different, a dental exam can help you find out what’s going on. 

What you'll learn: 

• How removable grillz and bonded tooth gems affect your teeth differently 

• Why plaque buildup and contact with jewelry can cause problems 

• Which symptoms call for a dental visit or emergency care 

• What to discuss with a provider about wear, cleaning and removal 

Noticed a change since getting dental jewelry? Schedule a dental exam with an Aspen Dental provider to discuss your symptoms and have the area checked. 

How are grillz and tooth gems different? 

Grillz and tooth gems may seem like similar ways to add sparkle to your smile. But one covers your teeth, while the other stays bonded to a tooth's surface. That difference matters for everyday care and removal. 

Removable grillz 

Grillz are decorative pieces, usually precious metal and sometimes set with stones, that slip over your teeth. Most can be taken out; permanent crowns made to resemble grillz are different.² Here, we're focusing on the removable kind. If yours is fixed in place, check with a dental provider before trying to take it off. 

Bonded tooth gems 

A tooth gem is a small decoration attached directly to a tooth with bonding material. It isn't something you take out for meals like removable grillz.³

Can grillz and tooth gems cause decay or gum damage? 

Both can collect plaque, which can raise the risk of cavities and gum infection when cleaning falls short.¹ A grill can also hold food against your teeth. That gives bacteria time to make acids, which can lead to decay and gum irritation.² Research has not shown that grills harm the mouth, and it has not shown that wearing them long term is safe either.² 

Tooth gems also create places for bacteria to collect, and possible problems include cavities, inflamed gums, discoloration and enamel damage. A gem applied by a dentist carries a lower risk than a grill, but it can still harm a tooth.³ 

The concern isn't just how the gem looks. The tooth surface and surrounding gums matter too, even when the decoration still seems firmly attached. 

Pain doesn't always come from decay. Grillz can irritate nearby tissues and wear down enamel on teeth that contact them.² So if wearing yours has become uncomfortable, it's worth getting the area checked rather than trying to work out the cause from the pain alone. 

When should you contact a dental provider? 

New soreness, a change around the jewelry or difficulty keeping the area clean are all worth a call. Explain what you've noticed, and the office can help you decide how soon to come in. 

Symptoms that need prompt dental care 

Some symptoms can point to a tooth abscess, an infection that needs prompt dental care.

Watch for the following signs:⁴

• Severe throbbing tooth pain that continues rather than settling 

• Pain or discomfort when biting or chewing 

• Fever or swelling in your face 

These symptoms don't establish a diagnosis on their own. When you call, describe all of them, including anything that has changed since the discomfort began. 

When to seek emergency care 

Trouble breathing or swallowing needs emergency care. So does a fever with facial swelling if you can’t reach your dental provider.⁴ Don't wait for a routine appointment in either situation. 

What should you discuss at your dental appointment? 

Start with when the symptoms began and whether anything changed around that time. Mention how often you wear grillz, how you clean them or who placed your tooth gem. Include any attempts to glue, adjust or remove the jewelry. 

Some dental problems can’t be spotted by looking in the mirror.³ The visit is a chance to understand how the tooth and gums are doing and whether the jewelry needs to come off. 

How can you care for your teeth if you wear grillz? 

If you already wear removable grillz, these care steps can help reduce potential problems:²

• Wear them for shorter stretches, and take them out before you eat. 

• Clean the grillz daily to remove bacteria and food debris. 

• Keep brushing and flossing your teeth. 

• Skip jewelry cleaners or any product that isn’t safe to swallow. 

If you're unsure how to clean your particular piece, ask your dental provider for guidance. 

These habits don't make dental jewelry risk-free. Because it can harm teeth and gums, cosmetic tooth jewelry is discouraged.¹ If you're deciding whether to keep wearing yours, use your next visit to talk through the risks and any problems found during the exam.

Get help with discomfort from dental jewelry 

If you've noticed a change in your teeth or gums, schedule an assessment with your local dental provider. Explain what you're wearing and what feels different so you can discuss the next steps. 

Grillz and tooth gems: Can they cause pain, decay or gum damage? FAQs 

Can the metal in grillz cause an allergic reaction? 

Grillz made from base metals, the non-precious kind, can irritate the mouth or set off an allergic reaction in some wearers.² Bring any material information you have to your appointment, and mention known metal allergies. A sore spot alone won't tell you whether metal sensitivity is the cause, so it's worth having the area checked. 

Is a DIY tooth gem kit safe to use? 

Do-it-yourself kits introduce risks from materials that may not be suitable for the mouth and bonding to an unhealthy or poorly prepared tooth.³ Even a tooth that looks healthy may need a closer look first. If you're considering a gem, start with a dental visit rather than an at-home kit. 

Can a dental provider remove a tooth gem? 

Yes. A provider can use dental instruments to release the gem and polish away remaining bonding material.³ If you're ready for a change, you can book a visit to have it removed. It's also a chance to ask how the tooth looks underneath and whether it needs any care. 

Sources 
 
¹ American Dental Association, ADA Library and Archives: “Oral Piercing/Jewelry.” https://www.ada.org/resources/ada-library/oral-health-topics/oral-piercing-jewelry 

² American Dental Association, MouthHealthy: “Grills.” https://www.mouthhealthy.org/all-topics-a-z/grills 

³ Cleveland Clinic: “Are Tooth Gems Safe?” https://health.clevelandclinic.org/are-tooth-gems-safe 

⁴ Mayo Clinic: “Tooth abscess.” https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901