Labret spike
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A labret spike is simply a standard labret stud with a spike bead screwed onto the end rather than a normal round bead (although some designs are a single piece — simply a spike attached to a flat backing). It does not need special placement. Most people with labret spikes wear them for decorative reasons and do not wear them at all times.
Labret spikes are available in many different lengths, from cones not much larger than a round bead would be on up to long spikes inches in length.