Sir, a 45-year-old male presented to the emergency medicine department from an ambulance with a 12-hour history of a grossly swollen tongue. The patient was experiencing difficulty in swallowing and shortness of breath. The severity of the swelling posed a risk to his airway and an anaesthetic opinion was promptly obtained. After administration of steroids and antihistamines the airway was assessed as safe and the patient was seen by the maxillofacial team.

He had a gastric band fitted, took no regular medications and had no known allergies. He could not recall eating any foodstuffs or taking any medications that could have triggered an allergic reaction. On further questioning the patient remembered that he had his tongue pierced ten years ago. The piercing was a stainless steel tongue bar with a spherical bead at either end of the bar. The tongue bar was removed by the patient soon after placement, but when the bar was removed only one of the beads was retrieved. To investigate further, a lateral soft tissue radiograph was taken. This revealed a spherical bead embedded in the body of the tongue (Fig. 1).

Figure 1
figure 1

Lateral view of tongue with spherical bead in situ

Full size image

The patient was admitted for intravenous antibiotics. Soon after admission, he had incision and drainage of the tongue with removal of the embedded bead under local anaesthetic.

There are a variety of complications associated with tongue piercings including pain, swelling, prolonged bleeding, chipped, fractured or abraded teeth, gingival recession and mucosal trauma.1,2,3 There is also a reported case of a Ludwig's angina that developed secondary to a tongue piercing.4 The case we present demonstrates the risks that a dormant foreign body can pose in the tongue. As dental professionals we have an important role in educating patients about the risks of tongue piercings. If a patient discloses that they have an unwanted part of a piercing embedded in the oral cavity, referral to a local maxillofacial unit should be instigated promptly so that removal can be arranged and future complications avoided.