A tooth gem is a gemstone glued onto the enamel of a person's tooth. It can be a single gemstone, or multiple arranged into shapes, such as flowers and cherries. They are semi-permanent, lasting from several months to several years.[1] [2] Over time the bond between the tooth and the gem weakens which creates a gap which cannot be cleaned, allowing bacteria to accumulate and can eventually lead to tooth decay. Tooth gems can not be placed on veneers as they are too smooth.[3]