This is one of those questions that we wish we would hear more often before a patient considers having any body modifications done, but since we do get surprised by a tongue sporting a metal barbell on occasion when a patient opens their mouth for the first time, we thought we’d let you know some of the problems we’ve seen this sort of piercing cause.
Because there are lot of blood vessels in the tongue, there’s always a risk of uncontrolled bleeding with the initial piercing (and we’re not even going to start in about the pain factor!). Additionally, nerves in the tongue can be permanently damaged, causing numbness or a permanent burning sensation.
You need to be sure that the piercing establishment is following strict infection control procedures or else you can end up with tetanus, hepatitis, HIV or other communicable diseases. The piercing appliance needs to be removed and thoroughly cleaned at least daily to prevent swelling or at the very least, bad breath from an overgrowth of bacteria or fungus.
Anywhere the appliance rubs is very likely to abrade the soft tissue along the gumline of the teeth and cause your teeth to get longer and become more sensitive. We see this along the lower front inside teeth in approximately 40% of people with tongue piercings.
Stainless steel is the safest metal commonly used for tongue barbells, but it will easily break a tooth if you happen to bite on it. We’ve seen dozens and dozens of cusps sheared off of teeth that would have never been lost if the tongue piercing didn’t exist. For this reason if you insist upon wearing a barbell we recommend that your appliance be made out of acrylic instead of metal, but this means that it will need to be cleaned at least twice daily since acrylic tends to harbor more bacteria.
Even when you’ve had your tongue pierced for many years, sometimes it may only take a few hours or days for the opening to begin healing and closing. That’s because your tongue is a muscle, not skin, and that your body understands that it is an unsafe opening into your immune system. So why take a chance for the sake of making a statement? That’s what tongues are supposed to do anyways.