Case Report: The Hazards of Oral Piercing

  • M. G. FosterEmail author
  • P. Readmans


Background: In Australia there has been a steady increase in the number of young people seeking body piercing. They have become more inventive with the position, number and type of piercing placed. These have included rings and studs being placed in the upper and lower lips, tongue and even uvula! Case 1: A 13 year old girl was referred to the Dental Dept. of Princess Margaret Hospital for Children for assessment of tooth 41 and the possibility that this was associated with an external draining sinus on her chin. Clinical examination revealed an external draining sinus on her chin with purulent discharge. Tooth 41 had an uncomplicated crown fracture and was moderately discoloured; grade I mobility, was not tender to percussion and gave a negative response to electronic pulp testing. A radiograph showed a periapical radiolucency associated with 41 about 20 mm in diameter. The girl gave a history of having her tongue pierced about 15 months previously and that she had bitten on the stud soon after, resulting in fracture of the tooth. Treatment: Endodontic therapy was carried out without the use of antibiotic therapy. Follow-up: Complete resolution of the periapical lesion was achieved over 18 months of endodontic therapy, but with a residual scar then revised by a plastic surgeon. Case 2: A 15 year old girl was referred to a facial swelling, present for about 4 days. She had had a tongue piercing placed approximately 2 years before and remembered biting on the ball 18 months later. The tooth had not fractured but had been hypersensitive ever since. Clinical examination revealed a mild to moderate swelling over the chin and a draining chin point sinus; tooth 41 was intrinsically discoloured and there was evidence of attrition on the incisai edge. The tooth was tender to percussion and gave a negative response to CO2 pulp vitality testing. A radiograph showed a radiolucent region at the apex of tooth 41. Treatment: The pulp was extirpated from tooth 41 utilising relative analgesia and local analgesia. Follow-up: The patient did not return to the department and was subsequently followed up by a private dentist.

Key words

oral piercing trauma dental children 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Al-Kandari AM, Al-Quoud OA, Bennaji A, Gnanasekhar JD. Cutaneous sinus tracts of dental origin to the chin and cheek: case report. Quint Int 1993;24: 729–33.Google Scholar
  2. Armstrong ML. You pierced what? Ped-Ners 1996;22: 236–8.Google Scholar
  3. Botchway C. The need for standardisation of practice among tongue piercers. J Can Dent Assoc 2001;67:18–19.PubMedGoogle Scholar
  4. Brennan M, O’Connell B, O’Sullivan M. Multiple dental fractures following tongue barbell placement: a case report. Dent Traumatol 2006;22(1): 41–3CrossRefPubMedGoogle Scholar
  5. Caliskan MK, Sen BH, Ozinal MA. Treatment of extraoral sinus tracts from traumatized teeth with apical periodontitis. Endod Traumatol 1995;11:115–20.CrossRefGoogle Scholar
  6. Chan C-Po, Chang S-H, Huang C-C, Wu SK, Huang S-K. Cutaneous sinus tract caused by vertical root fracture. J Endodon 1997; 23(9): 593–5.CrossRefGoogle Scholar
  7. Cohenca N, Kami S, Rotstein I. Extraoral sinus tract misdiagnosed as an endodontic lesion. J Endodont 2003;29(12):841–3.CrossRefGoogle Scholar
  8. Dubose J, Pratt JW. Victim of fashion: Endocarditis after oral piercing. Current Surgery 2004;61(5): 474–7.CrossRefPubMedGoogle Scholar
  9. Farah CS, Harmon DM. Tongue piercing: case report and review of current practice. Aust Dent J 1998;43: 387–9.CrossRefPubMedGoogle Scholar
  10. Fehrenbach MJ. Tongue piercing and potential oral complications. J Dent Hyg; 1998;72: 23–5PubMedGoogle Scholar
  11. Folz BJ, Lippert BM, Kuelkens CK, Werner JA. Hazards of piercing and facial body art: a report of three patients and literature review. Ann Plast Surg 2000;45:374–81.CrossRefPubMedGoogle Scholar
  12. Hadi HI, Quah HM, Maw A. A missing tongue stud: an unusual appendicular foreign body. Int Surg 2006; 91(2): 87–9.PubMedGoogle Scholar
  13. Hardee PS, Mallya LR, Hutchison IL Tongue piercing resulting in hypotensive collapse. Br Dent J 2000;188: 657–8.PubMedGoogle Scholar
  14. Hodges TP, Cohen DA, Deck D. Odontogenic sinus tracts. Amer Family Pract 1989;40:113–16.Google Scholar
  15. Javid B, Barkhordar RA. Chronic extraoral fistulae of dental origin. Compend Contin Edu Dent 1989;10:11–14.Google Scholar
  16. Levin L, Zadik Y, Becker T. Oral and dental complications of intra-oral piercing. Dent Traumatol 2005; 21: 341–343.CrossRefPubMedGoogle Scholar
  17. McNamara C, McNamara T, Field D, Ryan D. Hidden tongue jewellery. Singapore Dent J 2001;24(1): 51–53.PubMedGoogle Scholar
  18. McWater GM, Alexander JB, del Rio CE, Knott JW. Cutaneous sinus tracts of dental etiology. Oral Surg Oral Med Oral Pathol 1988; 66: 608–14.CrossRefGoogle Scholar
  19. Nedbalski TR, Laskin DM. Loss of a sewing needle in the tongue during attempted tongue piercing: a case report. J Oral Maxillofacial Surg 2006; 64(1):135–7.CrossRefGoogle Scholar
  20. Neiburger N. A large hypertrophic-keloid lesion associated with tongue piercing. Gen Dent 2006; 54(1): 46–7.PubMedGoogle Scholar
  21. Perkins CS, Meisner J, Harrison JM. A complication of tongue piercing. Br Dent J 1997; 182: 657–658.CrossRefGoogle Scholar
  22. Rosivack RG, Kao Juei Yl. Prolonged bleeding following tongue piercing: a case report and review of the complications. Pediatr Dent 2003;25: 154–6PubMedGoogle Scholar
  23. Scottp Baker A, Spencer RJ. Oral piercing and associated complications: two case reports. Dent Update 2004;31: 421–22.Google Scholar
  24. Scully C, Chen M. Tongue piercing (oral body art). Br J Maxillofac Surg 1994;32: 37–8.CrossRefGoogle Scholar
  25. Stirn A. Body piercing: medical consequences and psychological motivations. Lancet 2003; 361: 1205–15.CrossRefPubMedGoogle Scholar
  26. Tidwell E, Jenkins JD, Ellis CD, Hutson B, Cederberg RA. Cutaneous odontogenic sinus tract to the chin: a case report. International Endodontic Journal 1997;30: 352–5.CrossRefPubMedGoogle Scholar
  27. Towle H, Karpina K. Localised periodontitis as a long-term effect of oral piercing. Compendium of Continuing Education in dentistry. 2006; 27(1):24–7.PubMedGoogle Scholar

Copyright information

© European Archives of Paediatric Dentistry 2007

Authors and Affiliations

  1. 1.Dept. Paediatric DentistryPrincess Margaret Hospital For ChildrenPerthAustralia

Personalised recommendations