Decorative Dentistry: Dental Patients Continue to Invest in Trendy Teeth Modifications

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It is no secret that society has become center focused on appearance, and the mere fact that “selfie” was named word of the year in 2013 by Miriam Webster further clarifies this.1 Focusing on ourselves more leads to the desire to look better.

New research reveals that American women spend nearly a quarter of a million dollars on their appearance in a lifetime. That study goes on to state that more than one-fourth of all appearance-related spending is on the face ($51,120), which is more than any other body part or area.2 The oral cavity is not exempt from trendy cosmetic enhancements.

Decorative Dentistry History

While dental enhancements are flourishing, particularly among younger generations, these trends are not the first of their kind. Native Americans decorated their teeth with gems, grooves, and notches nearly 2,500 years ago. Dental décor was predominant in men, and ornamental stones such as jade, turquoise, gold, and hematite were applied to the teeth using natural resins (plant sap) mixed with other chemicals and crushed bone.3,4 Ancient Mayans also placed fillings in teeth in angular shapes and other patterns as a rite of passage to adulthood.5

From 250 to 1870, the Japanese practiced a ritual known as “Ohaguro,” or dying their teeth black when they reached puberty.4 This process was done by dissolving iron filings in vinegar and was also thought to preserve teeth. The Meiji government banned this custom in 1870.

In 1178, the Chinese explorers in the Philippine mountains recorded the earliest known written record of cosmetic dentistry. They wrote about a fierce tribe with “pegged-gold teeth.” Archeologists suggest that gold plates were hammered onto the teeth or were adhered by drilling holes into the teeth.4

From 1401 to 1500, the Pangasinan decorated their teeth with a pattern of fish scales made of gold. Archeologists believe a higher social class only wore this type of decoration after examining the graves in Bolinao. This ornate detail was a status symbol among the Philippines that was achieved by intricately placing individual gold scales on the teeth after drilling holes.4,5

Contemporary Dental Decorations

Decorative dentistry has continued to evolve since ancient times. Dental professionals should stay abreast of these trends so they can offer advice and education to their patients.

Dental Grills (Grillz or Fronts)

Dental grills are removable covers placed over the existing teeth that are comprised of silver, gold, or other metals embellished with jewels. While many associate this trend with the 1980s and the rap music industry, it actually dates back to 800 to 200 BC and the Etruscan civilization of ancient Italy. Archaeologists discovered that affluent women would adorn decorative teeth elements similar to the dental grill.

Rap artists such as Flava Flav popularized the dental grill in the 1980s. In 2005, hip-hop artist Nelly revived the dental grill with his hit song, “Grillz.” Dental grills have been spotted on several celebrities and even on swimmer Ryan Lochte at the London Olympics when he wore a patriotic grill.

While there are no conclusive studies that this variation of dental decoration is hazardous, the American Dental Association suggests that they aren’t perfectly safe either as any modification can pose a risk depending on the patient’s individual circumstances.6

Grill wearers should limit the wear time to prevent the incubation of plaque and bacteria. The teeth should be brushed and flossed thoroughly prior to wearing; in conjunction, the grill should be brushed and free from debris. Dental professionals should warn patients that attempting to glue the grill in can be harmful to the enamel and gingival tissue ─ not to mention toxic. It should also be mentioned that the patient should be conscious of the materials used to make the grill to ensure that no conflicting allergies exist. Most commonly, gold or silver are used to create a grill, and many are encrusted in various jewels such as diamonds.

Tooth Gems

Tooth gems are intricate gems placed on the teeth as jewelry. These gems come in a variety of colors, sizes, and shapes that are adhered to the tooth. One popular brand uses Swarovski crystals, while some information on the web suggests real gemstones such as diamonds can be used. Some gems are attached with a similar method to adhering orthodontic brackets, making them last longer. Other gems are applied with a UV bonding liquid that allows for easier removal.

While tooth jewels are used to enhance the sparkle in a smile, they do not come without concern. Patients should practice thorough dental hygiene in order to minimize plaque retention and decay around the gem. Gems should be removed with care (or by a dental professional) as the risk of chipping and cracking the enamel is a possibility.

Other complications include gingival recession, aspiration, allergic reaction, and tooth sensitivity.7

Tooth Polish

The most recent dental embellishment is tooth polish. Tooth polish is a colored liquid applied to the teeth, similar to the application of fingernail polish. The polish is temporary and can easily be removed with a clean fingernail, according to the manufacturer.

The most popular brand claims their polish is comprised of all-natural ingredients that are safe to be used in the mouth. However, they do go on to advise that tooth polish is not appropriate for all teeth and suggest that interested consumers consult with a dentist if there are any pre-existing dental issues such as untreated tooth decay, cracked or broken teeth. It is also not suggested for those in orthodontic appliances, sensitive teeth, cracked, broken, or decayed teeth, as well as for use on temporary dental restorations.

Dental professionals should be aware of the contraindications (teeth requiring restorative treatment) and advise patients that this trend presents very few risks if used appropriately on healthy teeth. It is also important that patients read the ingredients to ensure that no allergies are present; if an allergic reaction should occur, a dental professional should be consulted.

Tooth Filing

During the pandemic last year, a video went viral of a female filing her teeth with a nail file to achieve more even teeth. This led many other viewers to attempt the same.

Filing the teeth is certainly not a DIY project any person should attempt. Those without a dental degree do not understand that teeth have a softer inner layer of dentin that could potentially be exposed by this mindless act creating sensitivity and vulnerability to decay. Dental professionals should discuss these hazards with their patients if their patients inquire. It is imperative to remind patients that nails will regrow but tooth enamel will not.

Decorative dentistry will inevitably continue to evolve and influence society through the strong avenue of social media. With proper knowledge and staying abreast of the trends, dental professionals can be a constant source of intervention and guidance for patients. Decorative dentistry provides a perfect platform for dental professionals to highly encourage healthy dental hygiene habits and routine care. Bear in mind while these trends will fade, pearly whites will never go out of style.

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  1. Selfie. (n.d.). Merriam-Webster Dictionary. Retrieved from
  2. 2. (2017, July 6). Vanity Costs American Women Nearly a Quarter of a Million Dollars. New York Post. Retrieved from
  3. LeFever, G. (2009, May 19). Ancient Native Americans Decorated Teeth. Ancient Tides. Retrieved from
  4. History of Oral Health: Teeth Embellishments. (n.d.). Delta Dental. Retrieved from
  5. Oral Piercing/Jewelry. (n.d.). American Dental Association. Retrieved from
  6. Grills. (n.d.). American Dental Association. Retrieved from
  7. Sonal, B., Arora, V., Gupta, N., et al. Tooth Jewelry – Its Knowledge and Practice Among Dentists in Tricity, India. Journal of Clinical and Diagnostic Research. 2016; 10(3): ZC32-5. Retrieved from