Youths are lifting barbells -- with their tongues. And breaking tooth enamel in the process.
And that's one of the more minor injuries that can occur, according to the Utah Dental Association, which earlier this year issued a warning against oral piercing -- the piercing of tongues, cheeks and lips -- because of its potential to damage teeth and lead to infections. Of particular concern is tongue piercing.The American Dental Association also issued a warning against the practice, which has been billed as a form of body art and self-expression, especially among teenagers and young adults.
Local dentists report that the injuries aren't as common as originally feared. But they still encourage their pierced patients to remove the hardware and forget it.
"I have not as yet seen any real issues in my patients (who have had the piercing done.) But I don't like it and think they should take them out," said Richard Featherstone, a dentist and spokesman for the American Academy of General Dentistry.
"I tell them that people have gotten infections and broken teeth. The barbells are quite long and move up and down, so if you crunch down, you can break off a good piece of enamel. But it's like telling someone he should quit smoking. The reason they do it in the first place is it's a faddish, stylish thing. They already have a sense that it's risky, but they've chosen to take the risk."
While serious effects haven't been reported locally, dentist Kyle Curtis said one of the primary dangers is in the piercing of the tongue itself. The tongue has two major veins and arteries that can -- and in other places have -- been nicked, causing substantial bleeding. "There's a chance of hitting a problem in the the anatomy that the tongue piercer, who is unregulated and not formally trained, doesn't know."
And he has seen one of the most common dangers realized. Patients have come in with broken teeth from hitting them with the barbell, which is a rod inserted through the tongue and screwed into a stem. Curtis has seen snowboarders who slammed their knees into their chin and damaged their teeth. Damage can also occur if someone clenches down on the hardware while sleeping or chewing.
When he tells his patients they should take the barbells out, the response is mixed. "I had two teenage kids who put them in on dares from friends, and all they needed was someone like me to tell them it's not a great idea. It's a good out for them."
He said he's heartened that he's not seeing as much oral piercing as he did a year ago.
According to the American Dental Association, tongue piercing is usually done on the midline of the tongue without anesthetics. A clamp is used to stabilize the tongue while it's pierced with a 14-gauge needle. That size needle has a diameter seven times greater than the needle used for dental anesthesia.
If the person piercing the tongue nicks an artery of hits a blood vessel, the result can be prolonged and profuse bleeding.
The association has a long list of complications that dentists around the country have encountered with the devices:
Damage to the tongue tissue
Speech impediments
Gum injury
Blood poisoning from the metal studs or barbells
Food particles and dying cells trapped in the hole in the tongue
Prolonged bleeding
Chipped or cracked teeth from biting the jewelry
Loss of taste sensation because of nerve damage
Difficulty chewing
Blockage of dental x-rays
Allergic reaction to jewelry metals
Infection
In virtually all cases, there's an increase in saliva, which can be quite annoying, according to Chris Simonsen, pediatric dentist. And an uncommon but severe infection called Ludwig's angina can make it impossible to breathe.
Simonsen said that at least six of his patients had had their tongues pierced; most of them removed the jewelry within six months.
"It's difficult to chew with it in," he said, "so some take them out to eat. You can get quite a bit of swelling in the tongue. And it can be dangerous. If you develop Ludwig's angina, you can die.
"I haven't minced words with them. It's a real risk. With an open area like that, you can easily see transmission of infection, AIDS, hepatitis, allergies to the metal. There's scar tissue that can form in the tongue and reduce some of the mobility. Nerve damage. Injury to taste buds. I had one girl who cracked a molar and had to get a crown on a tooth that had never had anything on it before. There are also a lot of speech problems."
He's particularly worried because "we autoclave and sterilize everything. I'm concerned that (those who do the piercing) are not following the same standards they need to follow to prevent HIV and hepatitis. Those are things you can introduce especially in the tongue, which is so full of blood vessels. We're rather blunt with kids on this."
Some piercers use an autoclave, others don't.
The damage that can result from cheek or lip piercing is usually a little less severe -- but not much more appealing, according to the Academy of General Dentistry. With cheeks, objects close to the teeth can break teeth. Damage to the cheek tissue is possible, too.
Piercing lips can cause drooling, the result of damage to salivary gland ducts. And sometimes lips remain inflamed and enlarged.
"The bottom line is, other than the cultural popularity of it among kids, there is no upside," said Curtis. "Cosmetically it doesn't do anything. You have to stick your tongue out to show someone."