A fad for vampire teeth means health troubles ahead, a health insurer warned Monday in Germany, where lovers of spooky Gothic music have been filing their canine teeth into sharp points.

KKH, an insurer in the northern city of Muenster, said filed teeth lacked their natural enamel and were likely to be hit by caries or to break off at the tip.

The music fans wear black clothing and make-up so that they look like scary people with a thirst for fresh blood.

Another variation in which a pointy crown is added to the canines could weaken the other teeth and make chewing painful and tiring, said KKH expert Uwe Starck. He said health problems caused by the vanity fad were not covered by health insurance.

"We don't know of dentists doing the alterations," said KKH official Uljana Klein. "It tends to be done by tattoists and the like."