Tongue splitting risks significant blood loss and nerve damage, warn surgeons

Cosmetic body modification enthusiasts are being warned that they are at serious risk of haemorrhage, infection and nerve damage by undergoing tongue splitting¹, an extreme procedure where the tongue is cut in half to create a distinctive “forked” effect. Dental and plastic surgeons have issued new advice for anyone who is considering, or already has, a tongue split or oral piercing. The surgeons also say it is better if people do not to have these procedures at all.

In a joint statement, the Faculty of Dental Surgery (FDS) at the Royal College of Surgeons (RCS) and the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) warn that following a recent Court of Appeal ruling, body modification practitioners in England and Wales offering tongue splitting are now likely to be doing so illegally. The professional bodies are concerned that the legal status of tongue splitting in the rest of the United Kingdom remains unclear. There is also ambiguity around the use of some alternative methods of achieving a tongue split, for example using multiple piercings to achieve the same effect.

FDS and BAPRAS warn that oral piercings such as tongue and lip piercings also carry a risk of adverse consequences such as inhalation and ingestion, tooth fracture, gum damage, infection, oral lesions, adverse reactions to local anaesthetic and swelling that can lead to breathing difficulties. Over half of tongue piercings and one in five lip piercings performed on young adults (age 16-24) are believed to result in complications. 

While body modification practitioners are known to offer tongue splitting as a service alongside regulated procedures such as tattooing and piercing, there has been uncertainty over the legal status of tongue splitting for some time - it is not covered under any existing legislation, so is in effect entirely unregulated. However, in England and Wales, a Court of Appeal judgement recently found tongue splitting to be illegal, constituting grievous bodily harm, when performed by a body modification practitioner for cosmetic purposes, even in instances where consent has been obtained. 

Key Statistics

• Half (50.1%) of tongue piercings performed on young adults are thought to result in complications.
• In nearly a quarter (24.3%) of tongue piercings, a health professional had to provide further help.
• Similarly, one in five (20.5%) lip piercings led to a complication, with 11.2% of cases requiring further help.
• As many as 10%² of adults in England have had some form of body piercing.
• Around 1.5% of adults (aged 16 and over) in England have a tongue piercing, and 0.6% have a lip piercing.
• The proportion of 16 to 24 year olds with a tongue piercing is 6.5% and a lip piercing is 2.7%
  
  

Selina Master, Junior Vice Dean of the Faculty of Dental Surgery at the Royal College of Surgeons, said: 

“As dental surgeons, we’ve seen some of the horrific consequences of these procedures. It’s so important that people realise they are putting themselves at serious risk of significant blood loss, infection, nerve damage and problems being able to breath or swallow.  

“In England and Wales, practitioners who offer tongue splitting are doing so illegally as the law currently stands. There is an urgent need for the law in other parts of the UK to be clarified. The FDS and BAPRAS are also concerned that despite the legal debate, the demand for tongue splitting procedures may continue but simply be driven underground.

“We would strongly advise people not to have oral piercings or tongue splits, however if they do, it is crucial they see their dentist on a regular basis so that the impact on their oral health can be closely monitored. Never try to carry out one of these procedures on yourself, or others.”

Commenting on tongue splitting, the President of BAPRAS, Mr David Ward, said: 

“No reputable surgeon would undertake this procedure as it carries high risks, both at the time of the procedure and long-term, there are no medical reasons for doing it, and in England and Wales, and maybe elsewhere in the United Kingdom, is probably illegal. Patients undergoing surgery for cosmetic reasons undergo thorough pre-operative assessment, often including psychological evaluation, but practitioners performing tongue splitting will not have the training and skills required for such appraisals, putting their customers at very significant risk.”

At the start of this year Wales became the first country in the United Kingdom to ban tongue piercing for anyone under the age of 18. There is no national age limit in other parts of the United Kingdom, although some councils have put these in place locally.

Notes to editors

1. Tongue splitting: The first stage of a tongue split usually involves performing a tongue piercing, after which several approaches can be used to complete the procedure. Often this will involve the use of a scalpel to cut the tongue from the point of the piercing to the tip. Alternatives include using a cauterisation tool to burn the tongue in half, or else a hard thin wire looped between the piercing and the tip of the tongue, which will make a cut gradually.

2. The full joint statement is attached and available on request. 

3. Spokespeople available for interview:

• Dr Selina Master MBE FDSRCS – Junior Vice Dean of the Faculty of Dental Surgery
• Dr Samantha Pegg – legal expert at Nottingham Law School 

4. Angie Bone, Fortune Ncube, Tom Nichols, Norman D. Noah, “Body piercing in England: a survey of piercing at sites other than the earlobe”, British Medical Journal, 2008, 336, p. 1426.

5. The Faculty of Dental Surgery (FDS) at the Royal College of Surgeons of England is committed to enabling dentists and specialists to provide patients with the highest possible standards of practice and care.

6. The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) is the voice of plastic surgery in the UK, advancing education in all aspects of the specialty and promoting understanding of contemporary practice. 

7. For more information, please contact the RCS Press Office: telephone: 020 7869 6047; email: pressoffice@rcseng.ac.uk; for out of hours media enquiries: 07966 486832.