Research focus

Tattoos and piercings

Three recent studies identify the affects tattoos and body piercings have on the nursing role. 

Tattoos and piercings are common types of body modification in the UK. This focus looks at three recent research studies relating to tattoos and piercings.

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The incidence of complications associated with lip and/or tongue piercings: a systematic review

The purpose of this review was to determine the incidence of complications associated with lip and tongue piercings. Papers reporting cross-sectional, cohort, case-control and case series studies were included. Outcome measures were gingival recession (receding gums) and tooth injury (chipped, cracked, worn or broken teeth). MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE were searched up to January 2015; 15 articles met the inclusion criteria. 

The incidence of gingival recessions was 50% in individuals with a lip piercing and 44% in those with a tongue piercing. Tooth injuries were observed in 26% of individuals with a lip piercing and 37% of individuals with a tongue piercing.  People with a lip piercing were more likely to develop gingival recession than those without.  People with a tongue piercing were more likely than those without to experience gingival recession and tooth injuries.  While the authors acknowledge potential selection bias in the included studies, the findings suggest the popularity of lip and tongue piercings is a cause for concern from a dental perspective.

Hennequin-Hoenderdos N, Slot D, Van der Weijden G (2016) International Journal of Dental Hygiene. 14, 1, 62-73.


Adverse effects of tattoos and piercing on parent/patient confidence in healthcare providers

The question of whether visible tattoos or piercings on a medical provider affects a patient’s perception of the provider’s capabilities and their trust in the care that would be provided were investigated in this paper. A survey using photographs of simulated practitioners was administered to participants in Hawaii. Participants were asked to rate their clinical confidence on a four point confidence scale for a provider with and without body modification. 

A total of 314 surveys were conducted: 53% of participants were female, 35% were ≤ 35 years, and 40% were ≥ 50 years. Regardless of gender or age, the non-tattooed provider had a higher mean clinical confidence score compared with the tattooed provider. In all 90% of participants felt comfortable or confident in non-tattooed providers, compared to 73% of participants who felt comfortable or confident in tattooed providers. Similarly, participants reported greater degrees of discomfort with greater degrees of facial piercing with 44% of participants fully trusting a provider with only an ear ring, compared to the 25% of participants who fully trusted a provider with both ear and nose rings.

The authors recommend replicating this study in other countries to enable geographical comparisons and to determine whether the results are unique to Hawaii.

Johnson S, Doi M, Yamamot L (2016) Clinical Pediatrics. 55, 10, 915-920.

Are tattooed adults really more aggressive and rebellious than those without tattoos?

One stereotype of people with tattoos is that they are more aggressive and rebellious than people without tattoos. However, studies examining differences in aggression and rebelliousness between tattooed and non-tattooed individuals are dated and have returned equivocal results. The purpose of this study was to re-examine this issue and to compare differences between tattooed and non-tattooed adults in terms of their self-reported aggression and rebelliousness. 

The study was conducted in London between 2014 and 2015. Participants were eligible to take part if they were over 18 years and resident in the UK. Volunteers were recruited from locations including underground stations and high streets.

Of the 378 people who took part, 25% possessed at least one tattoo. Tattoo status did not vary as a function of respondent sex. There was no significance in mean age between tattooed and non-tattooed individuals. Neither were there significant differences between tattooed and non-tattooed participants in the distribution of educational qualification, and ethnic group.

The study found tattooed participants had significantly higher reactive rebelliousness (a tendency to commit unpremeditated acts in response to frustrating events), anger, and verbal aggression than non-tattooed participants. However, effect sizes were small and there were no significant between-group differences in terms of proactive rebelliousness (a tendency to engage in negativistic behaviours for fun), physical aggression, and hostility. 

The authors acknowledge that self-reported data may not reflect real-world behaviour. However, they conclude the results suggest that while stereotypes may contain a kernel of truth, they likely present an outmoded picture of tattooed adults.

Swami V, Gaughan H, Tran U et al (2015) Body Image. 15, 149-152.

Caroline McGraw, City, University of London

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