Tongue Piercing Infection


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Evidence Based - Facts Checked

Today’s youth wants to go the extra mile to portray themselves as a fashion and style guru. Body piercing is of massive craze amongst the youth these days. When specific places of the body are punctured, followed by the installation of metallic adornments, it is known as body piercing1B;, J. F. (2009). 'Oral jewelry: A review' Source. Tongue piercing is one of the preferred body piercing types.

The piercing on the tongue is often done in the midline or middle of the tongue. Some of the tongue piercings are done on the front, upper or lower side of the tongue2CM;, S. L. (2006, January). 'An investigation into the practice of tongue piercing in the South West of England' Source, 3GN;, P. T. (2000, August). 'Oral and perioral piercing: A unique form of self-expression' Source.

Tongue Piercing Sites


Midline Tongue Piercing

Midline Tongue Piercing

Back Tongue Piercing

Back Tongue Piercing

FRont Tongue Piercing

Front Tongue Piercing

Side Tongue Piercing

Below Tongue Piercing


Shapes of Tongue Piercing

The tongue piercings are available in different shapes. The standard shape of the tip of the oral piercing is ball-shaped. Other forms include cone and cylindrical. These piercings are fabricated from titanium, steel, acrylic, and niobium materials4Ziebolz, D., Hildebrand, A., Proff, P., Rinke, S., Hornecker, E., & Mausberg, R. F. (2012, February). 'Long-term effects of tongue piercing--a case control study' Source.

Can I get an infection post tongue piercing?

Well, the answer is ‘Yes.’ Normally it takes around four to six weeks to heal5'ORAL PIERCING [PDF]'. (2015, May 15). College of Dental Hygienists Source however during this duration, the chances of an individual getting infected is quite high. As per a study, every fifth tongue piercing done can lead to inflammation and allergic reactions6Ziebolz D;Stuehmer C;van Nüss K;Hornecker E;Mausberg RF;. (2009). 'Complications of tongue piercing: A review of the literature and three case reports' Source

Depending upon the symptoms, the complications7López‐Jornet, P., Navarro‐Guardiola, C., Camacho‐Alonso, F., Vicente‐Ortega, V., & Yánez‐Gascon, J. (2006, January 17). 'Oral and facial piercings: A case series and review of the literature' Source due to tongue piercing can be categorized as:-

1. Complications During Tongue Piercing Procedure 

- Bleeding

In some cases, extensive bleeding can cause hypotension, which may even result in the individual’s death8IL;, H. P. (2000). 'Tongue piercing resulting in hypotensive collapse.' Source

- Localized infection

Chances of localized infection due to Clostridium tetaniStaphylococcus aureus etc. and infectious diseases like HIV, Hepatitis etc. are quite high.

- Nerve Damage

Nerve damage due to tongue piercing can happen leading to a loss of sensation of taste

- Trauma

Some individuals may experience a sudden trauma due to tongue piercing which may result in unbearable episodes of pain

- Paraesthesia

Numbness or sensation of needles or pin in the tongue caused due to central nervous system nerve damage while tongue piercing.

2. Complications Immediately After the Tongue Piercing Procedure

- Pain

Pain in the wound shall happen, accompanied by swelling and inflammation

- Bleeding

Bleeding post tongue piercing procedure due to a sudden accidental impact with the pierced metal can happen.

- Increase in Saliva 

Increase in the production of saliva due to the presence of pierced metal (foreign body) in the tissue of the tongue

- Trauma & Abrasion

Trauma and abrasion in the lingual gingiva i.e., the lower portion of the tongue

- Uneasiness in Tongue

Changes in the movement pattern of the tongue due to the presence of pierced metal

- Granulation Tissue

Formation of granulation tissue around the area of the piercing due to accumulation of blood

- Infection

Localized infection and chances of developing infectious diseases like HIV, Hepatitis etc.

- Difficulty in Swallowing

- Hoarseness of Voice

- Problem in Chewing Food


Serious Complications Immediately Post Tongue Piercing

Obstruction of the airway path may happen due to bleeding and the tongue’s edema (swelling). This can result in the death of the individual9D. (2020, July). 'Oral Piercing/Jewelry.' Source.


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3. Long Term Complications after the Tongue Piercing Procedure

- Tooth Damage

Damage to periodontium (tissues surrounding the teeth) and teeth because of the constant abrasion with the pierced metal.

In some cases, due a sudden accidental contact with the ball-shaped pierced metal, tooth fracture and enamel erosion also may happen

Tongue piercings can also lead to sensitive teeth, especially the lower first molar teeth. This occurs due to the abrasion caused by the piercings against the teeth’s surface, which involves enamel, dentin, and even pulp as well10Ziebolz, D., Hildebrand, A., Proff, P., Rinke, S., Hornecker, E., & Mausberg, R. F. (2012, February). 'Long-term effects of tongue piercing--a case control study' Source,11De Moor RJ;De Witte AM;De Bruyne MA;. (2000). 'Tongue piercing and associated oral and dental complications' Source.

- Widening of Interdental Space

Some individuals like playing around with the pierced metal by rolling it with the tongue. This can lead to an increase in the space between the teeth.

- Bifid Tongue

It is a defect in the tongue in which splitting of the tongue happens from the midline due to the infection caused by piercing12Bagnall, S. (2011, November 25). 'Oral piercing & dental complications.' Source.

- Ingestion of the Jewelry

While playing with the jewelry, an individual can accidentally ingest it if the metal ball comes out

- Plaque and Tartar

Accumulation of plaque and tartar can happen on the pierced metal if proper oral hygiene is not maintained.

- Systemic Infection

Systemic infection can occur due to the growth of microorganisms at the piercing site. Once the infection develops it may enter the blood circulation.

This situation can be hazardous, especially in the case of immunocompromised patients13VR;, L. S. (2005). 'Streptococcus viridans endocarditis from tongue piercing.' Source.

The most common microorganism that is detected at the site of piercing is Aggregatibacter actinomycetemcomitans.

- Widening of the pierced hole

- Infections of the Salivary Glands

- Scar tissue formation

- Swelling in the lymph nodes

- Sarcoid-like formations in the tongue

- Granulomas in the tongue




 Summary - Time Since Piercing and Prevalence of Problem Post Tongue Piercing

  (Percentage of Cases Affected)

Problem Reported

Within 24 Hours.

Up To 1 Week Later

More Than 1 Week Later

Enlarged Piercing Hole

1%

2%

12%

Plaque on Jewelry

1%

3%

26%

Tooth Fracture

2%

2%

28%

Ingestion of Jewelry

3%

2%

29%

Speech Problem

24%

19%

9%

Difficulty Eating

34%

29%

2%

Bleeding

41%

1%

1%

Pain

54%

15%

1%

Swelling

54%

36%

7%




CAN tongue piercing infection be prevented?

Yes, tongue piercing infection can be prevented if certain precautions are taken after the piercing. These precautions include14Plastargias, I., & Sakellari, D. (2014, January 29). The Consequences of Tongue Piercing on Oral and Periodontal Tissues. Source:-

- Diet

Take a cold liquid diet on the day of piercing, followed by a soft diet. You can consume mashed potatoes. Avoid spicy or acidic foods as they can cause pain at the infection site.

- Ice

It is advised to apply ice externally for a time period of 30 minutes five times a day. Ice will help in controlling swelling and inflammation

- Antiseptic Mouthwash

Use non-alcoholic mouthwash 0.12% chlorhexidine mouth wash for the next ten days post piercing. It will help in keeping a check on the microorganisms responsible for causing a local infection on the site.

- No Alcohol and Tobacco

It is advised to reduce alcohol intake, smoking, and caffeine intake as it interferes with the healing process, post tongue piercing.

- Timely Replacement of Piercing Metal

It is vital to keep a check on the metal as it may go bad after some time. In such a case, it is advised to get it changed.

- Oral Hygiene

Since tongue piercing leads to calculus and plaque formation on the pierced metal, it is essential to maintain good oral hygiene to prevent it.

- Salt Water Rinse

Do a saltwater rinse 3-4 times in a day to control infection.

- Avoid Touch and Play with the Metal

It is an inquisitive human nature to get attracted to a new object. Since pierced metal is a new object in the mouth, it is quite commonly seen that people tend to play with it by rolling their tongue. This may lead to a sudden accidental movement of the pierced metal, leading to bleeding, followed by an infection.

- Avoid Kissing During Healing

During the healing process, it is advised not to indulge in exchanging body fluids with your partner. It may lead to infection as the pierced site may still be open and shall get infected by any probable microorganism that may travel via the exchange of body fluids.

- Talking and Screaming

Try controlling excessive talking or screaming during the initial healing duration as it may lead to a sudden movement of the pierced metal and thereby result into infection.

- Piercing from a Qualified Person

You must make sure that the person carrying out the tongue piercing is qualified and experience enough to carry out the procedure.

Also, make sure that he/she has autoclave sterilization equipment and use disposable gloves to carry out the procedure.

Alternatively, you can also try checking with the individuals who have already got the piercing done from the same professional that you are deciding to go for.

- Avoid Nickel

Nickel made piercing jewelry can lead to Nickle allergy




When to See a Doctor?


  • If the swelling in a tongue increases and may lead to difficulty breathing, you should rush to the hospital.
  • The area around the piercing becomes tender and red; you should consult your physician
  • If the bleeding starts post piercing and It does not stop, you need to rush to the hospital.
  • If you notice a pus formation, fever, and discharge from the pierced site, it is a sign of infection and therefore you should immediately consult your physician.


What Should I do in case My Tongue Piercing Site Gets Infected?

In case the tongue piercing site gets infected, please visit your physician as soon as possible. Usually, you will come to know about the infection if there is an unusual pain followed by fever and inflammation15Yu, C. H., Minnema, B. J., & Gold, W. L. (2010). 'Bacterial infections complicating tongue piercing'. Source.

1. Your physician/surgeon shall remove the pierced jewelry if the infection is present.

2. After that, the pierced site is cleaned thoroughly. Any thickened skin, infected tissue, or debris is removed during the process.

3. Chlorhexidine mouthwash and Antibiotic therapy shall be prescribed by your physician post the minor surgical process.

4. Follow-up is essential to monitor the infection control. A tongue piercing infection usually heals between six and eight weeks. However, the healing period can vary from individual to individual.

Conclusion

Oral piercing has become a trend in the last few years in the younger generation of society. If proper care of the piercing site is not taken, it can lead to local as well as systemic complications. The repercussions can be not only on soft tissues of the oral cavity but also on the hard tissues. Therefore, it is advised to maintain proper oral hygiene and follow preventive measures after the piercing procedure to avoid tongue piercing infection.

References

  1. 1
    B;, J. F. (2009).
    Oral jewelry: A review.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/20112640/
  2. 2
    CM;, S. L. (2006, January).
    An investigation into the practice of tongue piercing in the South West of England.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/16444231/
  3. 3
    GN;, P. T. (2000, August).
    Oral and perioral piercing: A unique form of self-expression.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/12167881/
  4. 4
    Ziebolz, D., Hildebrand, A., Proff, P., Rinke, S., Hornecker, E., & Mausberg, R. F. (2012, February).
    Long-term effects of tongue piercing--a case control study.
    Retrieved November 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259306/
  5. 5
    DN;, R. S. (2004).
    Traumatic lesions of the gingiva: A case series.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/15212360/
  6. 6
    ORAL PIERCING [PDF]. (2015, May 15).
    College of Dental Hygienists.
    Retrieved November 29, 2020, from https://www.cdho.org/Advisories/CDHO_Factsheet_Oral_Piercing.pdf
  7. 7
    Ziebolz D;Stuehmer C;van Nüss K;Hornecker E;Mausberg RF;. (2009).
    Complications of tongue piercing: A review of the literature and three case reports.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/20020083/
  8. 8
    López‐Jornet, P., Navarro‐Guardiola, C., Camacho‐Alonso, F., Vicente‐Ortega, V., & Yánez‐Gascon, J. (2006, January 17).
    Oral and facial piercings: A case series and review of the literature.
    Retrieved November 29, 2020, from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-4632.2006.02743.x
  9. 9
    IL;, H. P. (2000).
    Tongue piercing resulting in hypotensive collapse.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/11022380/
  10. 10
    D. (2020, July).
    Oral Piercing/Jewelry.
    Retrieved November 29, 2020, from https://www.ada.org/en/member-center/oral-health-topics/oral-piercing-jewelry
  11. 11
    Bagnall, S. (2011, November 25).
    Oral piercing & dental complications.
    Retrieved November 29, 2020, from https://www.nature.com/articles/vital1443
  12. 12
    De Moor RJ;De Witte AM;De Bruyne MA;. (2000).
    Tongue piercing and associated oral and dental complications.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/11202888/
  13. 13
    VR;, L. S. (2005).
    Streptococcus viridans endocarditis from tongue piercing.
    Retrieved November 29, 2020, from https://pubmed.ncbi.nlm.nih.gov/15961010/
  14. 14
    Plastargias, I., & Sakellari, D. (2014, January 29).
    The Consequences of Tongue Piercing on Oral and Periodontal Tissues.
    Retrieved November 29, 2020, from https://www.hindawi.com/journals/isrn/2014/876510/
  15. 15
    Yu, C. H., Minnema, B. J., & Gold, W. L. (2010).
    Bacterial infections complicating tongue piercing.
    Retrieved November 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852294/

This content is medically reviewed by Dr. Sharwari Dabhade Dua and written by Dr. Betina Chandolia

Last Medical Review Date - 29th November 2020




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This content is only for educational purpose and should not be considered as a substitute for your Physician's/Doctor's clinical judgement

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