F E AT URE D E N TAL RIS K


Dr Selina Master of the Faculty of Dental Surgery looks at tongue splitting and other forms of oral “body modification” and the growing risk to public health


CUT ON THEDOTTED LINE B


ODY modification for cosmetic purposes has become increasingly popular over the last few years and as many as 10 per cent of the adult population have had some form of body piercing. It is particularly common in women between the ages of 16 and 24. Tongue splitting is a form of body modification which creates a forked effect with the tongue, similar to a lizard or


snake. Online sites recommend tongue splitting as a “disguisable and discreet body modification” which is “super-fast, simple and very reversible”. One site suggested that it was simple to perform, and that all you have to do is “just cut on the dotted line”. Is tongue splitting legal in the UK? In March this year, the Court of


Appeal found tongue splitting to be unlawful when performed by a body modification practitioner for cosmetic purposes – a ruling which applies to England and Wales. However, the Faculty of Dental Surgery at the Royal College of


Surgeons (FDS) and the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) are concerned that the legal status of tongue splitting remains unclear in other parts of the UK and they highlight an urgent need for the law to be strengthened and enforced across the whole of the UK.


GBH BY CHOICE The Court of Appeal’s judgement on tongue splitting found that such procedures, when undertaken by a body modification practitioner for no medical purpose, constitute grievous bodily harm (GBH) even if someone has given consent. It is very important for patients to be aware that even if they agree to a tongue split with the associated risks, a body modification practitioner in England and Wales will still be breaking the law if they perform the procedure. Initially, tongue splitting involved tying string around a tongue


piercing and pulling it until the tongue split. However, this process was inevitably painful and lengthy. These days the most common procedure involves use of a scalpel to cut down the centre of the tongue – the sides are then separately stitched. Alternatively, a laser may be used to separate and cauterise the tongue. The “High Priestess” method requires the tongue to be pierced


before a scalpel is placed in the hole created by the piercing and used to slice the tongue. As a result, the tongue bleeds for about 15 minutes into a bag which is tied under the recipient’s neck. Understandably, there is a paucity of data available on how and where these procedures are being performed. Tongue splitting comes with some obvious clinical risks:


• Haemorrhage. There is a risk of significant blood loss if major veins or arteries are severed. The person carrying out the procedure may not be appropriately acquainted with the anatomy of the tongue. • Infection. As with oral piercings, there is a danger of infection if the equipment used is not suitable or appropriate and, particularly, if it is not adequately sterilised. • Nerve damage. Similarly, damage to nerves within the tongue is a


12 / MDDUS INSIGHT / Q4 2018


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