THE LINGUAL BARBELL: A NEW ETIOLOGY FOR THE CRACKED-TOOTH SYNDROME

Abstract

( attooing and body piercing are companion customs that have been observed across cultures over many centuries. Historically, both practices have satisfied people's need to participate in proscribed cultural, spiritual, sexual and decorative practices. Body piercing is currently experiencing increasing popularity in the United States as a form of personal esthetic expression. According to Armstrong, part of the motivation or preference for body piercing over tattooing is the perceived lack of permanence of the former activity.' Common body-piercing sites include the ears, lip, eyebrow and nose. Additional sites involve the navel, nipples and genitals. Of particular interest to the dentist is tongue piercing. Three recent reports in the dental literature describe this intraoral practice and conclude with the caution that as tongue piercing increases, dentists may see damage to the teeth.2'4 Boardman and Smith questioned patients who had undergone tongue piercing about oral complications; they identified chipped teeth, trauma to the lingual anterior gingiva, increased salivary flow and infection as the most commonly occurring sequelae of the procedure.' Prior to these reports, the greatest concerns had been infection and edema of the tongue, both of potentially serious consequence.6'7 The technique is fairly straightforward and accomplished without anesthetic. The tongue is generally pierced in the midline anterior to the lingual frenum. The piercing is accomplished with a large-bore needle followed immediately by insertion ofthe barbell stem. An oversized (long) stem is placed initially to accommodate the lingual swelling that accompanies the procedure. After the swelling subsides, a shorter stem is inserted so that the metal balls or caps of the barbell rest close to the dorsal and ventral surfaces of the tongue.