A tongue piercing involves inserting a piece of jewelry, typically a straight barbell, through the midline of the tongue. The question of whether this procedure can be done while wearing braces is frequently asked, and the answer is complex. While technically possible, the combination of a foreign object in the tongue and orthodontic hardware significantly increases the potential for complications. Most professionals strongly recommend waiting until the braces treatment is complete, as the combination creates a challenging environment for oral health and tooth movement.
Physical Damage to Orthodontic Hardware
The most immediate concern with a tongue piercing and braces is the potential for mechanical harm to the orthodontic appliances. The jewelry, especially the metal barbell ends, can repeatedly strike the brackets and wires during normal oral functions like speaking and chewing. This constant, accidental impact can cause brackets to pop off the tooth surface, requiring an unplanned repair appointment with the orthodontist. Dislodged brackets and bent archwires disrupt the precise force mechanics engineered to move the teeth, potentially lengthening the overall treatment time.
Metal-to-metal contact between the jewelry and the braces poses a risk of damaging the appliances or the tooth enamel. The habit of unconsciously playing with the jewelry increases this friction and impact. Furthermore, the constant pressure of the barbell against the teeth can, over time, cause enamel erosion or small fractures in the teeth. The forces applied by a tongue piercing can counteract the movements intended by the braces, potentially pushing teeth out of alignment.
Increased Risks During Healing
The initial healing phase for a tongue piercing, which typically lasts around four to six weeks, is marked by significant swelling. This tissue expansion in the crowded space of the mouth can lead to discomfort and difficulty with speaking, eating, and swallowing. The presence of orthodontic appliances further complicates this period, as the swollen tongue is forced to rub against the metal hardware, causing excessive irritation and inflammation.
The numerous surfaces of brackets and wires create additional areas where bacteria can accumulate, raising the risk of infection in the fresh piercing wound. An open wound provides a direct entry point for these bacteria into the bloodstream. A piercing infection can be serious, potentially spreading to the jaw or causing systemic issues like endocarditis. Maintaining the rigorous oral hygiene required for a healing piercing becomes difficult with braces, as the appliances impede access for thorough cleaning and rinsing.
The continuous friction between the jewelry and the orthodontic appliances can also prolong the overall healing process. The body’s natural response to irritation is inflammation, which slows down tissue repair. This constant agitation means the piercing is less likely to heal smoothly and more likely to develop complications such as scar tissue or migration. The combination of hardware and jewelry makes it harder to properly manage the swelling and keep the area sterile.
Required Consultations and Jewelry Modifications
If someone decides to proceed with a tongue piercing despite the increased risks, obtaining professional consultation is a mandatory first step. Written approval from the orthodontist is highly recommended, as they can assess the specific setup of the braces and the potential impact on the treatment plan. A reputable piercer will require this clearance before agreeing to perform the procedure while the patient is undergoing active orthodontic care.
The choice of jewelry material is important to minimize damage to the teeth and the braces. Standard metal jewelry, like surgical steel, should be avoided in favor of flexible, biocompatible plastics such as Polytetrafluoroethylene (PTFE) or Bioplast. These materials are softer, reducing the likelihood of chipping teeth or breaking a bracket. The initial barbell used for the piercing must be significantly longer than the healed size to safely accommodate the initial swelling of the tongue.
Following the initial healing period, the jewelry must be downsized immediately by the piercer. This switch to a shorter bar is important because a barbell that is too long will move excessively, increasing the risk of mechanical damage to the braces and surrounding tissues. Piercing placement is also important; it is advised that the piercing be situated further back on the tongue to minimize contact with the front teeth and their brackets. Failure to use appropriate, properly sized, and flexible jewelry will likely lead to complications and may result in the orthodontist insisting on the removal of the piercing.