Oral piercing complications are relatively common. 2, 13, 26 Studies have also shown that lip or tongue piercings can harbor periodontopathogenic bacteria, 27, 28 and that piercing jewelry made of synthetic materials (e.g., polytetrafluoroethylene or polypropylene), rather than steel or titanium, have lower levels of bacterial colonization. There are also reports of the jewelry becoming embedded in surrounding oral tissues, requiring surgical removal. 5, 13 Oral jewelry or ornaments can compromise dental diagnosis by obscuring anatomy and defects in radiographs. 11, 13, 14 Airway obstruction due to pronounced edema 4 or aspiration of jewelry poses another risk, and aspirated or ingested jewelry could present a hazard to respiratory or digestive organs. The technique for inserting tongue jewelry may abrade or fracture anterior dentition, 3, 4, 12, 18 and digital manipulation of the jewelry may significantly increase the potential for infection. 24 Purulent, unusual and/or colored discharges from oral piercings have also been reported. 22, 23 Because of the tongue’s vascular nature, prolonged bleeding may result if vessels are punctured during the piercing procedure. 11, 12, 14 Other complications of intraoral and perioral piercings may include increased salivary flow 12, 15 gingival injury or recession 2, 11, 13, 16, 17 damage to teeth, restorations or fixed prostheses 2-4, 12, 13, 17, 18 lingual abscess 19 interference with speech, mastication or deglutition 3, 5, 11 oral lichenoid lesions 20 scar tissue and keloid formation 15, 21 and allergic contact dermatitis. 10Īs with any puncture wound or incision, oral piercings may cause pain, 5, 11, 12 swelling, 4, 5, 11-13 and infection. Tongue splitting is an invasive and dangerous procedure that directly compromises the intact physical barrier of the tongue surface, rendering it susceptible to severe bleeding and pain, bacterial infection, lingual nerve damage and other adverse effects. Tongue splitting is another form of body modification that literally splits, or bifurcates, an individual’s tongue from front to back, creating a “forked” appearance down the anterior midline. Numerous studies and case reports have shown that oral piercings may lead to a wide range of oral and systemic complications, including chipped teeth, gingival recession, soft tissue or mucosal injuries, embedding or aspiration of jewelry and other potentially severe infections, such as Ludwig’s angina 6 or infective endocarditis. Similarly, the term perioral piercing describes a piercing in which one end resides in the oral cavity and the other end penetrates the skin surface in the perioral region (e.g., the cheek, upper or lower lip, chin or associated tissues).Ĭommon forms of oral jewelry include studs, barbells, rings and hoops, which are fabricated using a variety of metals, such as stainless steel, gold, titanium and various alloys or synthetic materials. 1 There are two primary forms of oral piercing: the term intraoral piercing describes a piercing in which both ends of the oral jewelry (device or apparatus) reside in the oral cavity, as seen with tongue piercings. 3-5 Oral piercings are more typically seen in adolescents and young adults, and the tongue is considered the most common site for oral-piercing placement. 1, 2 Oral piercings may be placed intraorally (most commonly on the tongue) or periorally on the lips, cheeks or a combination of sites. Oral piercing is an ancient practice of body modification and self-expression that is also common in modern society. The ADA advises against the practices of cosmetic intraoral/perioral piercing and tongue splitting, and views these as invasive procedures with negative health sequelae that outweigh any potential benefit.The procedure is inherently invasive and dangerous, with significant risks of severe bleeding, infection, inflammation, lingual nerve damage, or other complications. By definition, the tongue-splitting process is one in which an individual’s tongue is severed into two pieces using various techniques. Tongue splitting is a less common form of body modification within the oral cavity.Complications associated with oral piercing include: swelling, bleeding, infection, chipped or damaged teeth, gingival recession, lacerations/scarring, embedded oral jewelry (requiring surgical removal), airway obstruction, hypersalivation, palatal erythema, oral lichenoid lesions, keloid formation, and purulent or unusual discharge from the pierced region.Oral piercings are more typically seen in adolescents and young adults, and the tongue is considered the most common site for oral-piercing placement. Oral piercing of the tongue, lip, cheek or other soft tissues is a form of body art and self-expression.
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