A complication of lingual piercing: A case report Pı´a Lo´pez-Jornet, MD, DDS,a Fabio Camacho-Alonso, DDS,a and Jose M. Pons-Fuster, DDS,a Murcia, Spain UNIVERSITY OF MURCIA
Piercing is popular among young people, who view this practice as a sign of marginality, beauty, or group identity. The complications of lingual piercing include infection, pain, bleeding, edema, inhalation, dental trauma, contact lesions, and oral interferences. The objective of this case report is to present a case of lingual piercing in which the piercing had become partially embedded in the interior of the tongue. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:E18-9)
Oral piercing is a practice that is gaining acceptance as a sign of individuality, marginality, decoration, or group membership.1 The complications of lingual piercing include infection, pain, bleeding, edema, inhalation, dental trauma, contact lesions, and oral interferences.2 The proportion of the different complications that present with oral piercing is variable. Greif et al in 19993 found that 70% of subjects with piercing had had some type of complication, while for others, such as Mayers et al,4 this represents only 17%. The objective of this case report is to present a case of lingual piercing in which the piercing had become partially embedded in the interior of the tongue. CLINICAL CASE A 28-year-old male presented at the Department of Oral Medicine at the Hospital Morales Meseguer. Four months previously he had undergone a lingual piercing inserted at a tattooing and piercing establishment. The patient had no medical history of interest. He has no allergies, no toxic habits, and is not taking any medications. During the first week following the piercing he noticed a slight pain, which disappeared on taking analgesics (aspirin) and had no further complications (infection, pain, bleeding) during the following weeks. Two months after the piercing he noticed that the upper ball of the lingual piercing no longer appeared on the upper surface, becoming partially buried within the tongue. Two months later he consulted our service. On intraoral examination the dorsum of the tongue was covered by a mucosa of normal appearance and color,
Fig 1. Showing the dorsum of the tongue covered by mucosa of normal appearance.
and on palpation a hard swelling was detected. On the lower surface, there was a stud with a threaded ball (Figs 1 and 2). With informed consent, the patient was operated on under local anesthetic. Carrying out an incision on the dorsal surface and with a small de´bridement we exposed the ball (Fig 3). We then unscrewed the upper ball and removed the piercing. The incision was sutured and the wound healed within a week with no further problems.
a
Professor, Oral Medicine, Dental Clinic, University of Murcia, Faculty of Medicine, Murcia, Spain. Received for publication Jul 30, 2004; returned for revision Aug 31, 2004; accepted for publication Oct 14, 2004. 1079-2104/$ - see front matter Ó 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.tripleo.2004.10.009
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DISCUSSION In spite of its banal appearance, as we have seen in various scientific studies, piercing is not without its risks (Table I).1,5 Thus, from the scientific publications of the
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Lo´pez-Jornet, Camacho-Alonso, and Pons-Fuster E19
Table I. Potential adverse effects of oral piercing Local Pain
Hypertrophic scars Swelling Dental alterations Bleeding Gingival inflammation Infections Gingival recession Ludwig’s Increased angina salivation Allergies Halitosis Granulomatous Speech inflammation alterations
Fig 2. On the ventral surface, the piercing is apparent.
General Chewing problems Swallowing problems Tearing or perforation Airways aspiration Galvanism
Infectious: - Endocarditis - Viral (hepatitis, herpes, HIV)
Nerve damage Radiological interference
object, are more serious, with even some cases of Ludwig’s angina having been described. The type of piercing generally used in the tongue consists of a stud with 2 balls that are screwed to each end. It is inserted in the central, thickest area, always avoiding the lingual frenum, as well as taking care not to damage the vascular nerves. The size of the bar or stud is generally greater than the thickness of the tongue, which allows movement.5 Mayers et al, in a study published in 2002,4 found that 50% of the university student population has some sort of piercing, and that the incidence of complications are bleeding 4.5%, infection 9%, and local trauma 3%. These complications are sufficiently frequent to put into question the safety of piercing, the dangers of which can be considered.
REFERENCES 1. Stirn A. Body piercing: medical consequences and psychological motivations. Lancet 2003;361:1205-15. 2. Chen M, Scully C. Tongue piercing: a new fad in body art. Br Dent J 1992;172:87. 3. Greif J, Hewitt W, Amstrong ML. Tattooing and body piercing: body art practices among college students. Clin Nurs Res 1999;8: 368-75. 4. Mayers LB, Judelson D, Moriarty B, Rundell K. Prevalence of body art (body piercing and tattooing) in university undergraduates and incidence of medical complications. Mayo Clin Proc 2002;77:29-43. 5. Shacham R, Zaguri A, Librus HZ, Bar T, Eliav E, Nahlieli O. Tongue piercing and its adverse effects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:274-6.
Fig 3. Incision to eliminate the lingual piercing. Reprint requests:
past few years in which the most common complications are discussed, we can see that these complications are sometimes slight and reversible, while others, such as obstruction of the airway through inhalation of the
Pı´a Lo´pez-Jornet, MD, DDS Hospital Morales Meseguer Clı´nica Odontolo´gica Universitaria Avda. Marques de los Velez s/n 30008 Murcia, Spain
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