Tongue piercing has some complications which need to be known before going for it. Some of the complications are general and some are related to dental health.

Immediate Complications

1.   Bleeding: Bleeding is the most common early or immediate complication of tongue piercing. As tongue is richly supplied by blood vessels any damage to these causes enormous bleeding. So major blood vessels should be prevented from being pierced. A professional body piercer usually has the knowledge about the location of important blood vessels and nerves of tongue and how to avoid them during tongue piercing.

2.   Swelling and Pain: Body reacts to any kind of injury by swelling and inflammation which causes pain. Also the swollen tongue is more liable to be cut between teeth during eating or speaking. Thus the person should be very careful for the first few days not to bite the tongue.

3.   Increased Salivary Flow: Any foreign body in the mouth stimulates the salivary glands leading to the production of copious amounts of saliva. This may be embarrassing at times as it leads to drooling of saliva from the corner of the mouth.

4.   Injury to Nerves during piercing at the hands of untrained people can lead to the formation of traumatic neuromas which are very painful and affect the taste sensation.

5.   Scar Tissue Formation: At times the wound heals with a scar, which can be unaesthetic.

6.   Interference with Deglutition: Initially it is difficult to eat with the tongue pierced due to swelling and pain. Also the food gets stuck in the jewelry. People should avoid sticky food during the healing period and rinse the mouth after every meal.

7.   Speech Impairment: With the tongue pierced one may have difficulty with lingual sounds such as ‘Ss’ , ‘SHs’, ‘JHs,’ ‘PHs’, etc. but with practice most get accustomed to the piercing and speak clearly without any difficulty.

8.   Localized Tissue Overgrowth: In some cases the tongue may swell and heal over the jewelry if the barbell is not of adequate length, leading to undesirable results or in some tissue may heal with tissue overgrowth on both sides of the tongue or keloid formation.

9.   Allergy or Hypersensitivity to Metal: Various metals or alloys especially those containing nickel can cause allergy or hypersensitivity in susceptible patients. They may cause foreign body type reactions.

10.   Secondary Infections: The mouth is full of bacteria and these may enter the blood circulations through the cut blood vessels during the tongue piercing. These bacteria remain in the circulation for long and cause disease when the immunity of the host is lowered.

Dental complications of Tongue Piercing

1.   Tooth fracture: Most often people with tongue piercing bite the barbell while chewing leading to cracking or chipping of the teeth. In most cases the anterior teeth are involved, fracture of these can result in Pulpal insult often requiring endodontic treatment followed by costly crowns.

2.   Fracture of the restorations: Porcelain crowns when present get fractured due to the constant hitting of the tongue jewelry. As porcelain is very brittle, it is recommended that nonmetallic jewelry should be worn on pierced tongue.

3.   Galvanism: The metal of the jewelry when comes in contact with the metallic restorations in the mouth creates a galvanic current/ shock. This causes sharp pain whenever the two metals contact.

Gum Recession & Periodontal Diseases:

The tongue piercing usually comes in constant contact with the gums of the lower teeth and irritates them while eating or speaking. This constant irritation causes the gums to recede, followed by resorption of underlying bone. Thus a periodontal disease has set in eventually making the teeth loose in the socket. The teeth may become so mobile that extraction or splinting may be required.

Pulpal Hypersensitivity: The metallic jewelry can abrade the enamel and dentin of the teeth exposing the dentinal tubules, through which the bacteria and saliva seep into the pulp leading to hypersensitivity to cold and hot, eventually leading to Pulpal degeneration.

Oral Examination is a problem as the jewelry interferes with the placement of radiographs in the mouth and thus complete oral examination is problem.

Bad Odor: Food and debris gets collected over and around the tongue jewelry if oral care is not adequate. The debris becomes a nidus for bacteria leading to altered taste sensation and bad odor.

Fatal Complications of Tongue Piercing

The most fatal complication of tongue piercing can be death (very rare). Death can occur in patients with pierced tongues in the following cases:

1.   Tongue usually swells after the piercing is done. At times the tongue swells to enormous size resulting in edema and obstruction of the airway which would ultimately lead to asphyxiation and death.

2.   In cases of emergency after an accident if artificial respiration is required, the tongue jewelry will act as a hindrance to the oropharyngeal tube. This means delayed artificial respiration or no respiration at all at times.

3.   If the jewelry becomes loose, chances of its aspiration are there. This may result in choking or severe damage to the respiratory or digestive tract.

4.   In medically compromised patients or patients on anticoagulant therapy, tongue piercing can lead to excessive bleeding and hemorrhage which can be fatal.

5.   Risk of transmission of life threatening disease like Hepatitis B,C,D, HIV/AIDS, syphilis and tetanus are there due to lack of aseptic techniques used for tongue piercing.

6.   In some cases staphylococcal infection occur leading to toxic shock syndrome. Symptoms of toxic shock syndrome include sunburn like rash, fever, muscle aches, vomiting, dizziness and rapid pulse. This can be very fatal if proper and immediate treatment is not given.

7.   Recently a correlation has been found between tongue piercing and   staphylococcal and Haemophilus aphrophilus endocarditis. Usually the mitral valve is involved and valvulectomy and valve replacement is required.

8.   Tongue piercing may cause Ludwig’s Angina in rare cases which can lead to death due to respiratory insult.

Conclusion

So if you want to get your tongue pierced be sure to get it done from a trained body piercer at a regulated center where all precautions are taken care of and tongue is pierced under aseptic conditions. Aftercare should not be taken lightly. Be aware of the complications that may arise and contact your piercer or the doctor in case of any symptoms at the earliest.

Eating after Tongue Piercing

After the piercing, the tongue usually swells to enormous size within a few hours and takes nearly a week to return to its normal size as the healing proceeds. During this time, eating and speaking becomes difficult as tongue plays an important role in both these activities. Avoid biting your tongue while eating or speaking. Take a soft liquid diet for first few days. Avoid hot and spicy food as this can irritate the healing wound. Alcohol and smoking should also be avoided.

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