I don't think you would want to dermal punch a tongue piercing. What kevo said makes sense.
You could get it pierced at 6 gauge and get it stretched right away to 4 gauge though
I got mine pierced at 8 and stretched to 6, because the 6 gauge needle scares me lol.
All my stretches have been pretty easy.. until I got to this damn 0 gauge one that doesn't seem to be happening. I've gotten to the point where I can almost pull the jewelry out of my tongue (with the balls on the barbell) but still can't get the 0ga taper in :rolleyes: