Part 2 Body Modification art
I spoke about this tradition as a form of anatomical transformation of one’s physical form. For now, let’s focus on the face and head, and adorning them with dermal anchors, barbells, and closed rings.
The Dentist & Oral Surgeon Perspective:
ALL hardware is removed prior to radiography and treatment, this includes any removable dentures, eyeglasses, necklaces, earrings, and any other piercings from neck to the superior helix of the ear. Proceeding will create an image that is obscured and riddled with artifacts, essentially hiding the anatomy. In an attempt to show an example, I sifted through many records for a few hours and then gave up looking. Here is a great example I found here. Panoramic images obscured with artifacts from piercings. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520258/Medicolegal implications may arise beyond this issue of misdiagnosis or poor surgical outcome.
My policy is clear, no imaging until the hardware is removed. Many times, we received push-back from patients who are reluctant to remove the piercing and use the excuse that it’s no removable. However, that is not the case and a “captive bead” ring is easily removed by expanding it with a tool that tattoo artists have in their armamentarium to insert and remove the ring. TOOLS TO REMOVE HARDWARE on this YOUTube video. https://youtu.be/v7b3iYQI8uATherefore, there is no excuse to allow any hardware to remain during imaging.
SURGICAL RISKS:
Besides the obvious obstruction of anatomical features, and the medicolegal implications of missing a diagnosis or the potential risk of being accused of lets say displacing a tooth into the sinus, these metal objects pose multiple risks when kept in place within a surgical field. For example when patients insist the piercing stay in place during their appointment for fear of the orifice closing. Removing the barbell for a short period for the procedure should not cause closure of the piercing site. But more importantly if it’s not removed, any gauze or cotton pack in the mouth may wrap around the head of the bur and ultimately around the exposed barbell and potentially pull it out. Or the risk of being hung up on the hardware by suture material. While in place, objects that traverse the oral cavity and the skin allow saliva, bacteria laden fluid, to traverse the skin ultimately creating a contaminated skin wound. Swishing the oral cavity with Chlorhexidine 0.12%, an antibacterial agent, will not be sufficient to bathe the hardware and the adjacent tissues to adequately expose and disinfect.
OTHER RISKS:
As I eluded to in Part 1, tongue splitting is not a procedure for the faint of heart because there is no form of anesthesia during the procedure and the patient must be cooperative for the entire procedure. Additionally, the operator must be knowledgeable of the vasculature anatomy to avoid a major hemorrhage complication, particularly with a long-split encroaching on the posterior aspect of the tongue. Bleeding and the associated surgical trauma create swelling which can create a condition for increased risk of post-op infection, even in an area with a lower risk such as the tongue.
POLICY SUGGESTION ON REMOVING HARDWARE:
Create a written policy that your staff is knowledgeable of and can explain to patients. In addition I recommend posting it on your website so that patients can read it first hand as to why we are only asking to do the very best for them.
The Girldoc😉
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520258/
https://youtu.be/v7b3iYQI8uA
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| 2 weeks post-op visit |
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| Imaging by H Liang, DJ FLint and BW Benson. Dentomaxillofacial Radiology 2011 Jul; 40(5): 328–330. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520258/ |
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| Imaging by H Liang, DJ FLint and BW Benson. Dentomaxillofacial Radiology 2011 Jul; 40(5): 328–330. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520258/ |
I spoke about this tradition as a form of anatomical transformation of one’s physical form. For now, let’s focus on the face and head, and adorning them with dermal anchors, barbells, and closed rings.
The Dentist & Oral Surgeon Perspective:
ALL hardware is removed prior to radiography and treatment, this includes any removable dentures, eyeglasses, necklaces, earrings, and any other piercings from neck to the superior helix of the ear. Proceeding will create an image that is obscured and riddled with artifacts, essentially hiding the anatomy. In an attempt to show an example, I sifted through many records for a few hours and then gave up looking. Here is a great example I found here. Panoramic images obscured with artifacts from piercings. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520258/Medicolegal implications may arise beyond this issue of misdiagnosis or poor surgical outcome.
My policy is clear, no imaging until the hardware is removed. Many times, we received push-back from patients who are reluctant to remove the piercing and use the excuse that it’s no removable. However, that is not the case and a “captive bead” ring is easily removed by expanding it with a tool that tattoo artists have in their armamentarium to insert and remove the ring. TOOLS TO REMOVE HARDWARE on this YOUTube video. https://youtu.be/v7b3iYQI8uATherefore, there is no excuse to allow any hardware to remain during imaging.
SURGICAL RISKS:
Besides the obvious obstruction of anatomical features, and the medicolegal implications of missing a diagnosis or the potential risk of being accused of lets say displacing a tooth into the sinus, these metal objects pose multiple risks when kept in place within a surgical field. For example when patients insist the piercing stay in place during their appointment for fear of the orifice closing. Removing the barbell for a short period for the procedure should not cause closure of the piercing site. But more importantly if it’s not removed, any gauze or cotton pack in the mouth may wrap around the head of the bur and ultimately around the exposed barbell and potentially pull it out. Or the risk of being hung up on the hardware by suture material. While in place, objects that traverse the oral cavity and the skin allow saliva, bacteria laden fluid, to traverse the skin ultimately creating a contaminated skin wound. Swishing the oral cavity with Chlorhexidine 0.12%, an antibacterial agent, will not be sufficient to bathe the hardware and the adjacent tissues to adequately expose and disinfect.
OTHER RISKS:
As I eluded to in Part 1, tongue splitting is not a procedure for the faint of heart because there is no form of anesthesia during the procedure and the patient must be cooperative for the entire procedure. Additionally, the operator must be knowledgeable of the vasculature anatomy to avoid a major hemorrhage complication, particularly with a long-split encroaching on the posterior aspect of the tongue. Bleeding and the associated surgical trauma create swelling which can create a condition for increased risk of post-op infection, even in an area with a lower risk such as the tongue.
POLICY SUGGESTION ON REMOVING HARDWARE:
Create a written policy that your staff is knowledgeable of and can explain to patients. In addition I recommend posting it on your website so that patients can read it first hand as to why we are only asking to do the very best for them.
The Girldoc😉
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520258/
https://youtu.be/v7b3iYQI8uA
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