Wearing a tongue stud puts people at risk for chipped teeth, recessed gums and nerve damage. However, most people don't realize that getting an oral piercing also places them at risk for developing a fatal infection, such as Ludwig's angina or endocarditis, according to a report in the May/June 2004 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal.

Ludwig's angina, a bacterial infection of the floor of the mouth, occurs after a tooth infection, mouth injury, oral surgery or oral piercing. After getting an oral piercing, the mouth has an open wound that allows bacteria to travel through the bloodstream. Bacteria can cause the floor of the mouth to rapidly swell, which can block the airway or prevent the swallowing of saliva.

Endocarditis occurs when bacteria travels into the bloodstream through the piercing hole and infects the heart. People with a history of heart defects are at risk for endocarditis. At the dentist's office, a medical history is taken that helps the dentist determine who is at risk, and those patients are given antibiotics prior to certain dental procedures in order to avoid this potentially fatal problem.

"Some body piercers are unlicensed, and most are not members of the medical profession," says William J. Dunn, DDS, MAGD, ABGD, author of the study. "Because of this, health histories are not recorded or reviewed, emergency medical kits are not available, antibiotics are not prescribed and postoperative care is not available."

Postoperative care can also help identify these serious infections before they become fatal. "People are told to expect some swelling from a tongue piercing, but if they don't receive follow-up care, they may not be aware of abnormal swelling," says AGD spokesperson Melvin K. Pierson, DDS.

Unclean piercing equipment can cause other infections, such as hepatitis. Also, if a patient is not instructed to avoid touching the piercing, they might spread infections with their own fingers.

"I don't recommend piercing," says Dr. Pierson. "Because of the risks associated with this unregulated procedure, if someone is considering an oral piercing, they should discuss it with their medical or dental professional."