Oral piercing may be hip, but if the effect includes crooked teeth and life-threatening complications, it’s too high a price to pay, especially if you are going to shell out thousands of dollars in orthodontic treatment later.

A case report by researchers from University of New York at Buffalo, published in the Journal of Clinical Orthodontics, reported a 26-year-old woman who developed a diastema (space between teeth). For seven years, she had tongue piercing and habitually pushed the barbell-shaped stud between her upper central incisors (frontal upper teeth), causing a large space to form. Another study involving high-school students in Buffalo, New York who wear oral piercings revealed that three-quarters of these students played with their piercings.

A separate finding by the Mayo Clinic that involved college students found that 17% of all body piercings had complications both mild and severe. Tongue piercing has been associated with bleeding, fractured or chipped teeth, gum trauma, scar formation, eating problems and speech difficulty. Ugly teeth is just the visible side effect; life-threatening infection from viruses such as hepatitis B and C and HIV can also be acquired through unsterile instruments. The lead author of the case report, Dr. Sawsan Tabbaa from the UB School of Dental Medicine, warned that in worst cases tongue piercing could result in brain abscesses.

Oral piercing has been the subject of many studies spanning different countries. A study of 10,503 in England, published in the British Medical Journal, reported that tongue piercing is the fourth-most popular type of body piercing. The study also found that one in 100 piercings resulted in hospital admission.

Another analysis on 400 young adults, conducted by Dr. Liran Levin from the School of Dental Medicine at Tel Aviv University, found that about 15% to 20% of teens with oral piercings are at high risk for both tooth fractures and gum disease. He also warned that piercing of the oral cavity can cause death. Inflammation of the area can cause edema (swelling), which disturbs the respiratory tract (airway).