Position Summary
Body modifications in and around the mouth should be avoided because they can cause bleeding, infection, nerve and tooth damage and other health issues,including potentially fatal consequences. Governments must legislate a uniform age of consent and safety standards to ensure that body modifications can only be performed on consenting adults by adequately trained and indemnified persons in a safe environment.
1. Background
1.1. In Australia body piercing, tongue splitting, oral tattooing and other modifications have gained increased popularity since the 1980s and have extended to a wide range of locations on the body.
1.2. Piercing in and around the oral cavity has become reasonably common practice in Australia. Common sites include the tongue, lips, lingual frenum and cheeks.
1.3. Intra-oral and peri-oral piercings are invasive procedures that carry significant localand systemic health risks. Complications include infection, swelling, bleeding, nerve damage, chipped teeth,gum recession, alteration to speech and swallowing, allergy and the swallowing or inhalation of lost or damaged piercings.1
1 1.4. Tongue splitting procedures carry the risk of swelling, infection and of causing medium to long-term difficulties with speaking and eating. Maintaining good oral health and hygiene may also become more challenging after a tongue split.
1.5. There are no uniform laws regulating Higher Risk Personal Appearance Services performed on minors in Australian States and Territories, but body modification practitioners may perform such services on adults in all jurisdictions.
1.6. In the UK, the Court of Appeal found that tongue splitting, when performed by a body modification practitioner for no medical purpose, constitutes grievous bodily harm even if someone has given consent, and is therefore illegal.2
1.7. Typically, body modifications and piercings are performed without the use of local anaesthetic.
Definitions
1.8. A DENTIST is an appropriately qualified dental practitioner, registered by theBoard to practise all areas of dentistry.
1.9. BOARD is the Dental Board of Australia
1.10. BODY MODIFICATION(or body alteration)is the deliberate permanent alteringof the human anatomy or human physical appearance.
1.11. DENTAL PRACTITIONER is a person registered by the Australian Health Practitioner Regulation Agency via the Board to provide dental care.
1.12. HIGHER RISK PERSONAL APPEARANCE SERVICES are those body modification services involving skin or mucous membrane penetration procedures wherethe release of blood or other bodily substances is an expected result. Examples of these services include body piercing, skin implants, tongue splitting, and tattooing.
1.13. INTRA-ORAL PIERCING is a piercing where both ends of the piercing apparatus are within the oral cavity. Examples of intra-oral piercing include tongue and frenum piercing.
1.14. MEDICAL PRACTITIONER is a person registered by the Medical Board of Australia to be able to use the title Medical Practitioner and be recognised to receive Medicare and other benefits.
1.15. PERI-ORALPIERCING is a piercing where one end of the piercing apparatus is located within the oral cavity and the other end penetrates the skin surface.An example of this type of piercing is a lip stud or ring (labret).
1.16. VALID CONSENT to treatment means consent to treatment which is voluntarily given by a competent person based on full disclosure and understanding of information and includes authorisation for a specific treatment plan by a specific health care provider.
2. Position
2.1. If modifications are to occur, then valid consent must be obtained prior to undergoing higher risk personal appearance services, including the provision of information that is written in plain language. The information should also include details on health risks, usual post-insertion care, and signs and management of complications. Appropriate time should be taken to allow for consideration of risks prior to the procedure.
2.2. State and Territory governments should introduce uniform legislation to ensure that persons under the age of 18 years cannot undergo higher risk personal appearance services.
2.3. Governments must regulate higher risk personal appearance Services to ensure adequate safety standards are in place to protect the public.
2.4. Persons who provide higher risk personal appearance services must be adequately trained and indemnified in the event of an adverse outcome.
2.5. An appropriate review appointment following a higher risk personal appearance service must be scheduled to check the healing process.
2.6. Individuals who have undergone any form of oral body modification should regularly visit a dentist to manage the consequences of damage to the oral cavity.
References
1. Oral manifestations arising from oral piercings: A systematic review and meta-analyses Passos, Pedro Fernandes et al. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 134, Issue 3, 327 - 341
2. Surgeons warn against tongue splitting due to high risks. Br Dent J 225, 283 (2018). https://doi.org/10.1038/sj.bdj.2018.712
