Piercing problems

Here's a reason to think twice before getting your tongue pierced: A 20-year-old outside of Chicago developed a large growth near the barbell stud, which she referred to as her "second tongue."

The bump appeared just after she had her tongue pierced, and four months later it was the size of a marble. Her dentist, Ellis Neiburger, encouraged the woman to take the stud out, but at first she refused.

"She was really proud of that thing," he said of the stud. "We had to work around it."

Turns out the patient had a hypertrophic-keloid lesion, thick scar tissue more prevalent in women and minorities. Neiburger said he hadn't seen other cases of such a lesion forming around a tongue piercing.

He published the case in the Academy of General Dentistry Journal as a cautionary tale to others. With oral piercings so popular, Neiburger fears "second tongues" could become more common.

"If people keep doing it, you'll see this more and more," he said. "Piercing is becoming very middle class now."

As treatment, the patient replaced the bar with a shorter shaft, used stronger mouthwash and brushed more frequently to reduce plaque growing on the piercing. In about six months, it was smaller, but Neiburger says it will probably never go away.

"It's not cancer or anything of that nature, just sort of a heavy scar, but it can be an unsightly scar," he said.

The tongue and the lips are the most common oral piercings, according to a 2003 study in the Journal of the American Dental Association. Dentists are generally unhappy about that fact, because they say it causes infection and broken teeth. Tattoo artists who spend their days punching holes in willing customers say it's fine as long as the piercing is maintained.

At Village Pop Tattoo in New York's Greenwich Village, tattoo artist Evie Cruz has been piercing bodies for four years and says she'd never had a problem.

"Some people will come back worried because their tongue is still swollen," she said. "But they're always fine. The process takes a while to heal."

Cruz is a licensed tattoo artist and the parlor is sparkling clean. She gives her customers a tip sheet full of advice on how to care for a piercing. But the problem is, people don't take such care, dentists say.

"I have numerous patients that will come with a bad infection, a swollen tongue, they just don't do enough to prevent it," Neiburger said. Part of the problem is the tongue is a breeding ground for bacteria. When a large metal rod is stuck there, plaque and bacteria will cling to it. After oral piercings, some come in with chipped teeth, others with receding and injured gums.

"They won't be quite aware of it, bite down and there it goes," said Neiburger, who has been practicing for more than 20 years in Waukegan, Ill. "A root canal is $1,500, a big investment for such a little piercing."

Matt Messina, a dentist and consumer adviser at the American Dental Association, tells his customers to just say no to oral piercings. "I can lay out quite a string of risks," he said. "But I have a really hard time coming up with any benefits."

But if you're going to do it anyway, here's a few tips from dentists on how to avoid infection and other woes:

* Go to a clean, licensed shop. "Don't get drunk and end up in some back alley where someone isn't sterilizing," Neiburger says.

* Use the shortest bar possible. A longer bar will slide in and out of the tongue, pumping bacteria in. Gross.

* Use plastic ends to stud the barbell. You're more likely to crack your teeth or develop gum disease with metal.

* Keep the area clean. Use mouthwash, brush your tongue regularly.

* Don't touch it. Your hands are dirty!

* If something starts swelling, or if pus starts oozing out of the area, go see a doctor.