Updated: Oct 15
To be clear, this article isn't about condemning smiley piercings because they're the spawn of Satan and how they'll leave a trail of destruction in your mouth. Instead, we're going to cover all of the pros and cons of getting this lip frenulum piercing. We will also provide scientific evidence to solidify claims and debunk myths regarding this piercing.
Table of Contents:
What is a Smiley Piercing?
A smiley piercing (lip frenulum piercing) is a piercing through a thin piece of tissue on the inside of your upper lip. That tissue is called the upper frenulum and it connects your upper lip to your gums, right above the two front teeth. The purpose of the frenulum is to anchor your upper lip to the gums so that when you smile you don't get a "gummy smile".
The name is derived from the fact that you normally can't see it unless you smile and that fun little surprise is what draws people towards it. It is also why people call the piercing a "smiley" for short.
Types of smiley piercing jewelry
There are a lot of different variations and designs that this piercing can come in but the most common seems to be the circular barbell smiley. There is no one size fits all because people tend to choose whatever shape they find the most visually appealing.
Here are a couple of common designs and what they look like.
Circular barbell smiley
The circular barbell looks like a semi-circle with two circular knobs at each end. It looks very similar to a weight lifting barbell that is bending due to heavy weights on each end. This is also the most common design that is worn by most people.
Here is what the barbell smiley looks like in the mouth:
Smiley piercing fangs
For those who are more adventurous, they can opt to swap out theirs for a smiley piercing fang, which look like vampire fangs. Instead of the ends having two circular knobs, this variation has two slender cone shaped knobs that resemble vampire teeth.
Here is what a vampire smiley piercing looks like in the mouth:
When you smile with the piercing fangs, it makes it look like you have vampire teeth. Certainly a fun design around the holidays, especially on Halloween.
Captive bead ring
The first time you get pierced, you'll most likely end up with a captive bead ring, which is a circular ring that can open and close. It pinches the bead in the middle but the bead can be removed whenever you want such as for cleaning.
Here is a video of how this piercing works, showing you how to remove it and put it back on.
As with all jewelry, they can come in a variety of different metals and materials. What you'll be able to obtain would depend on what the piercing parlor has in stock or you can simply order them online.
Surgical stainless steel. Mostly hypoallergenic but in rare cases can cause reactions.
Niobium. Periodic table Nb with atomic number 41. This hypoallergenic material is often an alternative to nickel.
Titanium. Typically very compatible with the body since knee and hip replacements are also made of titanium. Last but not least, so are your dental implants.
Gold. Highly sought after metal due to the way it looks. If you opt for this, expect the cost for the total procedure to be higher.
Does a smiley piercing hurt?
All piercings hurt because you are intentionally puncturing a part of your body with a sharp object and smiley piercings are no exception. In fact, they tend to hurt more than most other types of lip piercings but less so than a cartilage piercing.
The reason smileys hurt more is because the frenulum is a very thin piece of tissue and that actually makes it hurt more than the thicker fleshier tissues. However, due to the fact that it is very thin, the piercing process should be very quick and you'll most likely feel sharp pain for only a second at most.
If it makes you feel any better, at least it hurts less than the cartilage piercings, which have to puncture through flesh and cartilage.
How long does a smiley piercing take to heal?
The general consensus is that a smiley piercing can take 4-12 weeks for it to heal but that time frame seems overly conservative to us. Our estimate pegs the healing time at an average of 2 weeks but it could take as long as 4 weeks for those who tend to heal slower.
The reason for our expedited healing time estimate is due to a comparison of this piercing procedure with a surgical frenulectomy, which is when the frenulum is removed completely. For a frenulectomy, the area is healed and closed by around 2-4 weeks.
Here are pictures showing the surgical procedure from start to finish by one study:
This surgical procedure cuts and removes the entire frenulum.
Much more traumatic than a smiley piercing and it requires stitches as well.
As you can see, the surgical site is completely healed at the 4 week mark. Due to this reason alone, we would have to say that it definitely takes less than 4 weeks for a smiley piercing to heal. In fact, some of these frenulectomy procedures are fully healed by 2 weeks!
Therefore, we would say on average it'll take about 2 weeks to heal since it is less traumatic and less invasive than the surgical procedure above. The soft tissue in the mouth tends to heal very quickly so a 4-12 week estimate is overly conservative in our opinion.
Caring for it and maintenance
After you get the piercing you have to take care of it while it is healing and also after it is fully healed. You don't want the piercing to get infected because if it does, you may need to have it removed for it to heal before you can try getting it again. Here are
What you should do:
Use a salt water rinse after every meal. The salt is a natural antiseptic and can help reduce swelling while it is healing. Make sure you tilt your head forward so that you can let the solution soak the area of the piercing.
Maintain oral hygiene. Brush your teeth twice a day for at least 2 minutes each. Don't forget to floss before you go to bed!
Avoid acidic and spicy foods. While the wound is healing you don't want to aggravate it with overly spicy, sour, or acidic foods. That would just make the wound burn.
What you shouldn't do:
Don't play with it. Don't play around with the smiley piercing and don't keep touching it. Leave it alone and let it heal because if you keep moving it around it can get infected or delay healing.
No kissing. While it is healing, please refrain from any type of french kissing or oral performances. It is best to not put too much pressure on the piercing while its healing. You could accidentally rip it and tear it off with sudden motions.
Smoke. Smoking will cause vasoconstriction which constricts your blood vessels. What this does is delay healing because it is preventing nutrients from going to the area.
Alcohol. Aside from the fact that too much is bad for you, the alcohol content will burn the piercing while the wound is still open.
Avoid hard crunchy foods. These types of food can get caught in the piercing or snag it causing it to be pulled. That can injure the area while it is healing.
How to clean a smiley piercing
Once the piercing is fully healed, there are a lot less restrictions with it but you still need to keep it clean because plaque can accumulate on the smiley. There isn't anything special that you need to do to keep it clean because you can simply treat it as if it was just another tooth. You can brush it with regular toothpaste. In fact, most people just use the same toothbrush and toothpaste that they were brushing their teeth with to clean it.
Here is a video showing how to brush the smiley piercing to clean it:
You just brush it as if it was a tooth but here are some subtle tips you may want to follow:
Brush more gently when you get to the piercing so you don't injure it.
Lift it up so you can brush the upper front teeth unobstructed.
Make sure you slide the smiley to the left and right so that you can clean the portion that is in between the frenulum.
Rejections & Infection
Getting a smiley piercing is not guaranteed because you run the risk of getting an infection and also the body rejecting it. Therefore the success rate may vary and some individuals may never be able to get one even if they really want it.
Infected smiley piercing
As with all piercings, the smiley can get infected either during the initial piercing or afterwards if you don't take care of it.
Initial piercing. Right after getting the piercing, the area is basically an open wound that needs to heal. Since it is wide open and the mouth is full of bacteria, the piercing site can get easily infected. This is why it is of utmost importance to keep your mouth as clean as possibly for the first 2-4 weeks. Make sure you rinse with salt water after each meal to minimize the chances of infection.
Poor maintenance. You may be surprised but you can get plaque build up on the smiley piercing! Its not that unusual if you think about how people with permanent retainers in their mouth get a lot of tartar accumulating around the retainer.
Here is how to tell if your smiley is infected:
Area feels painful even after a week or two.
Looks very red.
Foul taste in your mouth.
Presence of white pus oozing out of the piercing.
If you have these signs, you may want to return to whoever pierced it for you and have them take a look. You may need to have it removed and start over again after it heals. When in doubt it is better to get it checked out.
Smiley piercing rejection
May be a strange concept to understand but your body can physically reject the smiley piercing. In the piercing community, this phenomenon is known as piercing migration, which is the process of the piercing slowly moving out of the body over time.
What it looks like is the piercing being in a different location after a certain period of time. Given enough time, the piercing would've moved out of your body all on its own. That is what is described as the piercing migrating through your body.
Essentially it is your body rejecting the piercing because it perceives it as a foreign body. It slowly pushes it out by migrating it. The process is usually painless so you may not even notice it happening until it falls out completely.
What would make me ineligible to get one?
Technically the only requirement to get a smiley piercing is if you have a frenulum. If you don't have one then you can't get one because the smiley is pierced through anchored onto the frenulum. If its not there then you have nothing to pierce through!
That may be the only hard requirement but there are other conditions, which may make you want to reconsider getting one. These other conditions may affect the longevity of the piercing or may offer a poor value proposition in relation to your overall oral health.
Frenulum thickness. A smiley piercing will last the longest on a thick fleshy frenulum. A very thin frenulum on the other hand may not last as long because it is more prone to tearing. Normal everyday eating and talking will move the lips up and down. The constant lip movement can put a lot of strain on the thin frenum which can cause it to tear. If you have a thinner frenulum, the piercing may only last up to a year at most.
Frenulectomy. If you've had the frenulum removed in the past, that would disqualify you from getting one because there is nothing to pierce through. If you wanted an alternative you can try getting a "frowny" which is done on the lower frenulum instead of the upper.
Braces. You should not get this type of piercing if you're in the middle of braces because the piercing can snag on the wires and brackets. This can either rip the piercing out or damage the braces. It will be one bloody mess if the wire and piercing gets tangled up. You should wait to be finished with braces before attempting to get one.
Dental veneers. If you have veneers on your upper front teeth, you may want to reconsider getting the smiley. Since the piercing is made of metal, you don't want it banging into the veneers and scratching them every time you move your lips. That is a very poor value proposition because the smiley costs less than $100 while your veneers are well over $1000. Don't let something less expensive ruin something that is more expensive. That is your money!
Why would someone need a frenulectomy?
In case you were wondering why anyone would have their frenulum removed, here are a couple of reasons.
Aberrant frenulum attachment that causes a diastema or gap between your teeth.
Frenum that is attached to the gingival margin which causes your gums to recede.
Aberrant frenum that is inadequately attached to the gums, thus giving a shallow vestibule.
How much does it cost?
The average price to get a smiley piercing is between $30-$90 but the variation has to do with which piercing parlor you're going to. Is it a standalone store or is it just a stand at the mall?
Of course, the price may only include the most basic design of the jewelry. If you wanted something more fancy such as a gold smiley or a diamond studded one, you can expect to pay more. That is all additional and completely optional.
Pros and Cons
Since we're in the profession of dentistry, our list of risks and benefits will be based around how it affects your oral health. What your dentist is primarily concerned about would be how the smiley affects your oral hygiene, gum health, and teeth. You may be surprised by what we say.
Fun and cute. The reason people get this piercing is because of how interesting it is. WHen you smile, it shows a piercing and that little surprise is what keeps people going.
Switchable. They can be easily removed and replaced by a different design.
Does not scratch your teeth. Was that a shocker? The smiley piercing does not scratch your natural enamel because the enamel is harder than the metal the piercing is made out of. It has to do with the Mohs scale of mineral hardness.
Your enamel, which is made of hydroxyapatite is the hardest substance in your body with a Mohs score of 5. All metals such as steel, iron, nickel, and gold all have a lower Mohs score than enamel. Lower Mohs score minerals cannot scratch a higher score one.
However, this only applies to the materials attempting to scratch one another. This means that the smiley cannot scratch up the enamel but what it can still do is bang into the enamel and crack it if enough force is applied. That isn't likely to happen unless someone elbows or knees the piercing into your tooth.
Gum recession. The piercing may not be able to scratch the enamel but it can certain scratch up the gums. The constant up and down motion can wear away at the gum line and cause it to recede upwards. This is more likely to happen if you happen to have thin gums and less likely to happen if you have thicker gums. Gum recession can cause teeth sensitivity and cosmetic concerns.
Cleanliness. The piercing does require additional maintenance because now you have one extra thing in your mouth to brush. If you weren't the best at brushing and flossing, we're a little doubtful if you'd be able to keep the smiley clean. If it starts collecting a lot of plaque, it can negatively affect your teeth and gums.
Longevity. People who've had the smiley piercing often comment that it does not last forever. Due to the fact that the frenulum isn't the sturdiest tissue in your mouth, the piercing can tear off over time from wear and tear. The average lifespan is only a couple of years. However, people who happen to have a naturally thinner frenum may only get a year out of it.
Difficult to hide. The piercing is definitely very noticeable and if you wanted to hide it for whatever reason, it may be difficult. Although you could try switching to a small smiley piercing which isn't as long to help hide it. The smaller ones may also last longer as well since they'll be lighter and will be less prone to ripping.
Taking into account all of the risks and benefits, we're not opposed to getting a smiley piercing. If you want to get it you can go ahead and get it. From what we can gather, it seems like it doesn't last that long anyway. The worst that can happen is if it gets infected or it gets rejected by your body. If that happens then you basically start back at square one. A really bad infection may require the frenulum to be removed but plenty of people have it removed for various other reasons anyway so it's not the end of the world. Not that its the most pleasant experience but the choice is yours to make.
The only time we would seriously reconsider getting it is if you have a gum recession problem on the front teeth or if you have dental veneers on them. Receding gums is one of the most annoying problems in the world. The dental veneers are just plain expensive so you don't want to risk damaging them with an inexpensive smiley piercing. Replacing the veneers is going to cost you.
We're probably the most liberal dentist that you've ever met but when in doubt, it is better to get it checked out.
Author: Written by Dr David Chen DDS, a dentist in long island city, NY.