The American Dental Association and most pediatric dental professionals do not endorse tongue piercings. The ADA doesn’t go so far as to condemn the practice, but does use language like “Don’t pierce on a whim” and, addressing people who already have a tongue piercing: “ …the best option is to consider removing mouth jewelry before it causes a problem”.
The ADA’s position reflects an understanding that tongue piercing is a personal matter, an individual choice. Tongue piercing isn’t so risky that dental professionals flatly denounce it, but they do hope that people considering it will understand what they’re getting into and that those who have already done it will learn best practices for minimizing the risks.
Tongue piercings do pose risks to oral health.
The repetitive impact of the piercing on teeth and the changes in oral geometry appear to be causes of the more common problems. One of the larger studies found that tongue piercing is correlated with enamel fissures and enamel cracks. Accidental biting down on a piercing appears to cause cracks deep enough to expose the dentin and nerve inside a tooth. This is a severe injury that may require root canal therapy. Fillings, too, can be damaged by the impact of a tongue piercing.
Another result of the repetitive contact between a tongue piercing and teeth can be orthodontic in nature. Diastema is the loosening and movement of teeth, opening or increasing the gaps between them and possibly leading to malocclusion.
The soft tissues of the mouth are also at risk. Tongue piercings are associated with receding gum lines, although the way this happens needs more study. The piercing procedure itself has been seen to cause nerve damage, sometimes permanent, that numbs the tongue and can affect speech and the sense of taste. A tongue piercing that becomes infected can lead to very serious health problems, such as angina, hepatitis, and herpes.
Finally, the piercing itself is an obstacle to the pediatric dentist, as it can block x-rays and obscure important details in radiographic imagery.
For those who have made the decision to have tongue piercings and had them done, the American Dental Association has advice on how to minimize the risks, starting with selection of the piercing and through to good hygienic practices and emergency responses. The ADA doesn’t flat-out warn against tongue piercings, any more than it warns against ice cream. All human choices are trade-offs, with risks and rewards. What’s important is that our choices be informed choices.