Tongue Piercing
The risks and statistics regarding this dangerous
trend.
by Adina Carrel, D.M.D.
TWEENS & TEENS News January 2006
As kids commit to New Year’s resolutions
and make changes to define their personal
style, they find themselves subject to peer
pressure to partake in the latest fashion
trends. While some fads annoy a parent’s
more mature sensibilities, many parents overlook
those that are benign. If your child is contemplating
having his or her tongue pierced, or already
has a tongue piercing, it’s time for
a tongue lashing from Mom or Dad because dentists
agree that this is one dangerous trend.
As a Manhattan dentist, I’m alarmed
by the escalating number of kids (and adults)
with tongue piercings. Anyone considering
tongue piercing should seriously understand
the risks before undergoing this procedure.
Unfortunately, the people who perform tongue
piercings do not usually have a license nor
do they discuss the risks involved in the
procedure, or the damaging consequences on
the teeth as a result of the trauma caused
by the piercing.
The most common dental problem is the damage
to teeth and gums that is caused by the metal
jewelry. The metal can cause teeth to chip
or fillings to break. Teeth may become sensitive
if a person develops the habit of biting on
the metal jewelry in one area of the mouth.
This can result in one or more teeth needing
root canal therapy. A local or systemic infection
is also a possibility. The human mouth is
a cesspool of bacteria, and even if instruments
are sterilized, a person who has this procedure
may still develop an infection. In some cases,
patients have had allergic reactions to the
metal jewelry. Also, if the jewelry becomes
loose it may be swallowed or, even worse,
aspirated.
A recent study published in the Journal of
Periodontology found that extended wear of
tongue jewelry (barbell-type) could increase
one’s chance of gum recession and tooth
chipping. Researchers from Loma Linda University
School of Dentistry and Ohio State University
College of Dentistry examined and surveyed
52 young adults with pierced tongues. They
found gum recession in 35 percent of subjects
with pierced tongues for four or more years,
and in 50 percent wearing long-stemmed barbells
for two or more years. During tongue movement,
long-stem barbells are more likely to reach
and damage the gums than short barbells. Over
time, this damage may cause the gums to recede,
which can lead to more serious dental/oral
complications.
A study from the University of Rochester School
of Medicine in New York presented results
on 4,500 adolescents aged 12 to 21 and found
that teens with body piercings are more likely
to smoke cigarettes, use drugs and exhibit
other types of unhealthy behavior. Study findings
were presented at the Society of Adolescent
Medicine’s annual meeting in Boston.
Tongue piercing concomitant with smoking raises
the risks of dental complications. Smokers
are more likely than non-smokers to have heavier
calculus deposits on teeth. When combined
with the gum recession due to trauma from
a dental piercing, these patients are at a
higher risk of developing periodontal disease
and root caries. It’s important to discuss
potential risk factors with your dentist before
tongue piercing. Additionally, anyone with
a piercing should receive a thorough oral
examination of his or her gums and teeth to
identify problem areas. Taking precautions
now will increase a person’s chance
of keeping his/her teeth for a lifetime instead
of needing dentures.
In addition to periodontal diseases, tongue
piercing may cause other complications such
as tongue swelling; difficulties with chewing,
swallowing and speech; an increase of saliva
flow; localized tissue overgrowth (keloids)
and metal hypersensitivity. What is most alarming
is that most people don’t realize that
getting an oral piercing also places them
at risk for developing a fatal infection,
such as Ludwig’s angina or endocarditis,
according to a report in the May/June 2004
issue of General Dentistry, the Academy of
General Dentistry’s (AGD) clinical,
peer-reviewed journal.
Ludwig’s angina, a bacterial infection
of the floor of the mouth, may occur after
a tooth infection, mouth injury, oral surgery
or oral piercing. After getting an oral piercing,
the mouth has an open wound thus allowing
bacteria to travel into the bloodstream. Bacteria
then cause an inflammatory reaction that leads
the floor of the mouth to rapidly swell, which
can block the airway or prevent swallowing.
Endocarditis is another inflammatory reaction
that occurs when bacteria travel into the
bloodstream through the piercing hole and
infect the heart valves. Patients with a history
of heart defects, heart murmurs, rheumatic
fever or mitral valve prolapse are at risk
for endocarditis. At the dentist’s office,
a medical history is taken which helps the
dentist determine who is at risk. Those patients
are given antibiotics prior to certain dental
procedures in order to avoid this potentially
fatal problem.
If all of the information is not enough to
dissuade would-be tongue piercers, then they
should be mindful that many people who perform
body piercings are not members of the medical
profession. Because of this, health histories
are not recorded or reviewed, emergency medical
kits are not available, antibiotics are not
prescribed and post-operative care is not
available. Post-operative care is necessary
because it helps identify serious infections
before they become fatal. People are told
to expect some swelling from a tongue piercing,
but if they don’t receive follow-up
care, they may not be aware of when swelling
is abnormal.
Additionally, if a patient is not instructed
to avoid touching the piercing, they might
spread infections with their fingers such
as the staphylococcus bacterial strains commonly
found on skin. In relation, not all piercing
parlors are up to date on OSHA sterilization
requirements and their sterilization machines
may not be effective in properly sterilizing
the instruments used in the piercing or the
jewelry placed in the piercing. Non-sterilized
piercing equipment can cause other infections,
such as blood borne hepatitis.
After meeting with a doctor and dentist to
be evaluated for any potential health risks,
those contemplating tongue rings should discuss
and evaluate these risks thoroughly. If the
person is still adamant about having the piercing,
then looking further into the sterilization
techniques of a piercing parlor is strongly
advised and of course a post-operative evaluation
of the piercing is highly recommended.
Adina Carrel, D.M.D., is a graduate of
Harvard School of Dental Medicine, one of
the top dental schools in the United States
with one of the most advanced research departments.
As a Harvard graduate, she received the Award
of Merit by the American Academy of Esthetic
Dentistry. She completed her General Dentistry
Residency at Massachusetts General Hospital
and Brigham Women’s Hospital. Dr. Carrel
has been practicing for over ten years in
New York City with an emphasis on veneers,
implants and other phases of cosmetic dentistry.
