Tongue piercing – complications, safety and the right choice of appliance

Dear Dr. Mo: I’d need some guidance about tongue piercing because my daughter has been mentioning she’d like to do it and I’d like to talk to her about it. What are the possible complications – is it infection, injury? What to do?

Avoid steel appliances

Avoid steel appliances

Dear reader: I understand your concerns. Being a parent myself, although blissfully still some years away from these and similar conversations with my daughter, I can appreciate your approach – being open about and discuss it is the right way to go.

To answer your question, it may come as a surprise that the most common complication of tongue piercing is not an infection and it’s not injury, although both of these tend to happen sometimes and could be serious. So, what is it?

The most common complication is more chronic in duration and it is something called Gingival recession.

Gingival recession is the exposure of the roots of the teeth caused by loss of gum tissue. The teeth involved are usually incisors. This happens as a consequence of a piercing appliance wearing away at the gum by rubbing against it.

As I said, the infection rate is low followed by chipped tooth at 5% and aspiration of the device, which is rare to happen but has been reported.

Infections are not common largely because the tongue is a very vascular organ – has a very good blood supply. However if they do occur, they are potentially serious and can come as endocarditis (infection of the heart), intracranial abscess (infection in the brain), staph aureus toxic shock syndrome (a systemic break-down caused by a bacteria called Staphylococcus Aureus), herpes simplex and hepatitis C (two serious viral infections, latter being more serious) etc.

Dental associations and physicians recommend against any oral piercings but if piercing is inevitable, one thing to remember is that the appliance type has an effect on the biofilm formation (microorganisms living in the mouth that colonize the appliance) – plastic is the safest in terms of not forming biofilms and not promoting infection.

So, if it has to be done, a reputable person using aseptic methods should do it and steel should be avoided by all means – plastic appliance should be used instead so at least stand your ground on that one if possible.

Here’s your opportunity to talk to your daughter further because studies show that those who are doing tongue piercing are also involved in other risky behaviors like smoking for instance. I’m not saying she is, but this may be a good chance to touch upon smoking and alcohol as well and start a conversation about these things.

Yours in Health,

Dr. Mo