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Dangers and Complications of Oral Piercing

Not so long ago, an oral piercing was an extremely popular trend among adolescents and young adults and, in some cultures, it still is. It involves piercing areas of the mouth, usually the tongue and the lips, although the cheeks may also be pierced. As with all other forms of body art, oral piercing is performed as a form of personal expression to enhance body image or for acceptance into a peer group.

A piece of jewelry called a barbell is inserted through a hole made in the tongue or lip. It may be placed anywhere on the upper or lower lip. In the tongue, it is typically inserted vertically, midway across the width of the tongue, towards the front of the mouth. The cheek is usually pierced before or at the location of the first molars.

Pierced sites normally swell in response to the puncture trauma. The area may remain severely swollen if the site becomes infected. Oral piercings tend to be particularly susceptible to infection. The mouth is a moist, warm environment, inhabited by millions of bacteria. Puncturing tissue inside the mouth creates an open wound for bacteria to enter the bloodstream. This can lead to potentially serious infections in other parts of the body.

Tongue jewelry may rub or tap against teeth when a person talks, chews or swallows. A person with an oral piercing may have to relearn how to speak clearly because of the jewelry’s interference with normal oral function. Once jewelry is permanently removed from the site, the hole will close. Mouth tissues usually heal quite quickly, compared to other areas of the body.

Oral piercing is an unregulated procedure. Therefore, many piercing practitioners are unlicensed and have no medical background. Moreover, the piercing is often performed by teens on each other. Keep in mind that piercing performed by an amateur increases the risk of unsanitary conditions and infection and often lacks post-piercing care.

Potential Complications of Oral Piercing

Most dentists discourage oral piercing because of the numerous risks associated with this procedure. An oral piercing can lead to pain, swelling, scarring, drooling, loss of the sense of taste as well as tooth and gum damage. Specific complications associated with oral piercing include:

Infection. Infection can result from the use of unsterile equipment or the introduction of bacteria to the wound. Infection occurs in about 20% of oral piercings. It is particularly likely in people engaging in vigorous exercise due to increased breathing rates and blood flow. Infection can cause swelling and pain of the tongue, lip or cheek. A pus-like discharge may also occur. In addition, other body areas may become infected if bacteria get into the bloodstream. Specific infections of concern with oral piercing include:

  • Endocarditis. Bacterial infection of the inner layer of the heart that reaches the heart through the bloodstream. Patients with underlying heart problems are at an increased risk for endocarditis after an oral piercing. Antibiotics are required to treat this condition.
  • Ludwig’s angina. Bacterial infection of the floor of the mouth that may cause swelling, which obstructs a person’s airway. It may be necessary to cut open and drain the affected area in order to treat this infection.
  • Other blood-borne infections. Various blood-borne infectious diseases may be transmitted during an oral piercing procedure such as HIV/AIDS, hepatitis, tetanus or tuberculosis.

Allergic reactions. People receiving a piercing may experience an allergic reaction to the metal in the jewelry (e.g., nickel, brass).

Chipped tooth. This is a common complication associated with oral piercings. It usually occurs when metal jewelry repeatedly comes into contact with teeth or dentures while a person is eating, talking, sleeping or chewing on the jewelry. Tooth fractures can be too small to be seen, a condition known as cracked tooth syndrome, or can more seriously affect the surface of a tooth, requiring a filling, or they may be deeper, requiring a root canal treatment or even tooth extraction.

Gum damage. The gums may become inflamed and recede due to repeated contact with jewelry in the mouth. Periodontitis, an inflammatory gum disease, may develop in some patients, potentially leading to tooth loss if not timely identified and treated.

Problems with normal oral function. Having jewelry in the mouth can cause difficulty speaking clearly and lead to problems when chewing and swallowing.

Overproduction of saliva. Oral piercings can lead to increased saliva production. This can in turn cause gagging and drooling as well as difficulty breathing or speaking.

Excessive bleeding. This occurs if a blood vessel or artery is pierced during the procedure.

Nerve damage. Nerves can be injured during an oral piercing, causing a loss of sensation in the area. A sense of taste can also be altered.

Scar tissue. Scarring can occur and a lump of scar tissue may develop on the tongue, lip or cheek after an oral piercing.

Airway blockage. As a result of abnormal swelling of the tongue, difficulty breathing may occur.

Choking and intestinal injury. Jewelry that becomes loose while in the mouth may pose a choking hazard whereas intestinal injury may result if the jewelry is swallowed.

Chemical burns. These may occur on tissue near the piercing when certain after-care products, such as mouth rinses that contain alcohol or hydrogen peroxide, are used.

Patients with certain allergies, immune system deficiencies or heart defects should avoid oral piercings due to the many risks associated with this procedure. In case of any concerns involving the gums, teeth, tongue or tissue inside the mouth, it is necessary to consult a dentist. Furthermore, individuals who experience the following complications after an oral piercing should immediately seek medical attention:

  • Excessive bleeding from the pierced area
  • Extreme swelling of the tongue, making breathing or speaking difficult
  • Bleeding that occurs after the site has healed
  • Pain, tenderness or inflammation that becomes more severe
  • Yellow or green discharge from the pierced site
  • Persistent fever
  • Growth of thickened tissue in the area