Pondering the pros and cons of tongue piercing

(1) Hey Alice,

I'm considering getting my tongue pierced. Is there anything I ought to know before I get it done? What should I look for in a piercing place? Does the piercing ever have negative effects — I don't know, tongue paralysis or something? Thanks!

(2) Alice,

If and when I decide to take my tongue ring out, I worry that there will be scarring tissue or an ugly hole in the middle of my tongue. Is this the case?

Dear Readers,

All the information and warnings about oral piercings can leave the potential piercee tongue-tied. Luckily, tongue paralysis from tongue piercing has not yet been documented. Yet there are a number of other potential complications ranging from minor to more severe.

Unlike many other hot spots for body piercings (ears, noses, brows, etc) the tongue is an oft-used muscle that is almost constantly in motion. Also, unlike many other piercing sites, the tongue happens to be in the mouth, one of the most bacteria-filled orifices that ever existed. These environmental circumstances present a double jeopardy for healthy healing. Not surprisingly, the most frequent issue that comes up is infection. How to prevent this?

Start with finding a reliable artist and piercing studio. A studio that is a member of the Association of Professional Piercers (APP) is likely to be a clean and reliable shop because the APP has very high cleanliness standards. But mostly, body art studios are unregulated. So a few questions to ask:

  • Is the business licensed and established, with separate clean, tidy, and well-lit rooms for procedures?
  • Are there trained and experienced piercers on staff who use new gloves and a fresh disposable needle for each procedure? Never go to a place that uses piercing guns — they are more difficult to clean and inflict greater tissue damage.
  • Do they have an autoclave and ultrasonic cleanser for sterilizing instruments are on the premises?
  • Do they answer all of your questions and concerns openly and directly? If you're unsatisfied or uncomfortable with the answers, or can't get them at all, go somewhere else.

While infection can happen during the piercing process, proper after-care during the four to six weeks after is supremely important for avoiding infection. Key aspects of oral piercing care include:

  • Cleansing the mouth at least a dozen times a day with a diluted mouthwash or sea salt water for one minute, including always rinsing after eating, smoking, and drinking. Avoid using hydrogen peroxide and mouthwashes that are high in alcohol.
  • Washing hands before touching the piercing (and touching it as little as possible, too).
  • Avoiding any kind of oral sex activity or open mouth kissing for four to six weeks.
  • Avoid applying any topical antibiotics to the site (ointments are hard to remove from piercings and can trap microorganisms).
  • Reduce swelling by sucking on some ice or drinking ice water.
  • Visit a health care provider immediately if you notice:
    • Abnormal or unusual appearance features, such as redness or inflammation that goes beyond a quarter-of-an-inch circumference from the piercing.
    • Thick fluid oozing from the site that's yellow-green in color.
    • Extensive bleeding.
    • A feeling of heat or red streaks radiating from the site.
    • Persistent or increased tenderness, discomfort, or pain.

More severe complications of tongue piercings that have been documented include brain and heart abscesses (some resulting in death) due to infection travelling in the bloodstream, airway blockage due to swelling of the tongue, swallowing or choking on loose jewelry, gum damage, and chipped teeth resulting from biting down on jewelry. Additionally, major infections can include hepatitis B and C, HIV, tuberculosis, and tetanus. Less severe complications can include increased saliva production, damage to teeth enamel, scarring, and pain. And certainly, lots of people get tongue piercings with few or no complications whatsoever.

If removing jewelry from a piercing before it’s completely healed, or when it’s infected, the site will close up rapidly, and more often than not result in negligible scarring. In cases of infection, it may be better not to remove the barbell in order to encourage proper healing and minimize potential for problems. Piercings that are older or larger in size will get smaller, but probably will not close completely even when jewelry is left out. In these instances, scar tissue inside piercings may develop, which may look like a small indentation and feel like a bump in the skin. With time, these scars often become more supple and decrease in size.

In addition to visiting a health care provider, many piercers make themselves available for repeat visits if problems arise during aftercare. S/he would be able to provide additional information and to help remove the jewelry if needed.

Happy piercing!

Last updated Jul 06, 2015
Originally published Mar 30, 2001