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A fully healed plastic tongue piercing from two angles.

A tongue piercing is a piercing through the tongue. The swelling will occur (3-7) days afterwards and can be extremely uncomfortable. Cold, Slurpee-style drinks and sucking on ice will help to mitigate the swelling and soreness, as will ibuprofen. This swelling must be accounted for by using a longer piece of initial jewelry, which is later replaced by a shorter piece of jewelry to prevent the healed piercing from damaging the teeth and gums.

A tongue piercing usually takes 4-6 weeks to fully heal. Aftercare for tongue piercings is more complicated than most other piercings, as the healing piercing will come into contact with anything that enters the mouth, including food and smoke. For these reasons, many certified piercers suggest as after care guidelines, not to smoke, and to rinse the mouth thoroughly with antiseptic mouthwash. The piercer should recommend either an alcohol-free mouthwash or diluting a regular mouthwash, as the alcohol will irritate the piercing and slow healing. It is especially important not to play with the piercing during the healing period, because that will severely inhibit the proper healing of the hole.

Straight barbells with plastic and metal beads

Tongue piercings are most often pierced with straight barbell style jewelry. Due to the amount of action and movement that the tongue is involved with (speech, eating, kissing, etc.), jewelry size and comfort is especially important. Barbells that are too thin are prone to migration, causing discomfort and irritation. Tongue piercings can often be easily stretched to accommodate larger jewelry. The beads at the end of the barbell can be made of many decorative materials, including plastic, but the environment of the mouth can cause cracking and discoloration in the jewelry over time. "No-see-um beads", flat beads matching the color of the tongue, are sometimes worn to conceal this piercing, often in places of employment.

An uncommon version of this piercing will be close to the tip of the tongue, and a captive bead ring may be worn in it. This placement and jewelery choice is uncommon because it is much more likely to cause discomfort and damage the teeth and gums.

There is a history of ritual tongue piercing in both Aztec and Maya cultures, with illustrations of priests piercing their tongue and then either drawing blood from it or passing rough cords, designed to inflict pain, through the hole. There is no evidence of permanent or long term tongue piercing in Aztec culture, however, despite the practice of many other permanent body modifications.

Permanent or long term piercing of the tongue is part of the resurgence of body piercing in contemporary society. The ready availability of high quality, surgical steel barbell style jewelery is associated with the emergence of this piercing in the 1980s. As with many piercing innovations, the origin of this piercing is associated with Gauntlet, the first professional body piercing studio in the United States, formerly located in Los Angeles, California. Elayne Angel, the first person awarded the Master Piercer's certificate by Jim Ward, body piercing pioneer and founder of Gauntlet, is commonly associated with the promotion and popularity of this piercing.

A common misconception is that since the mouth is dirty (see staphylococcus and streptococcus), tongue and oral piercings are more prone to infection and will take longer than other piercings to heal. While it is true that the human mouth, and foods can contain numerous bacteria, saliva is highly effective at both protecting from infection and promoting healing. For this reason, oral piercings tend to actually heal faster (4-6 weeks) than many other piercings, which can take many months depending on location, as long as appropriate care to prevent infection is taken. Mouthwash is frequently used to diminish chances of infection.

Popular names for tongue piercing include tongue ring, a misnomer, as only rarely are rings worn in tongue piercings.

After accommodating for swelling

Before accommodating for swelling

There is a minor risk of heavy bleeding if a vein is hit; however, a qualified piercer should have no problem avoiding blood vessels. Some bleeding is normal, but a medical professional should be contacted if it cannot be controlled.

The piercing has a tendency to heal a bit crooked as a result of the frenulum's placement in the exact center of the tongue. This is usually undetectable by anyone except the piercing's owner, but in some cases it can be quite pronounced.

Tooth and gum damage are risks, but they can be minimized by proper placement, the use of properly-sized jewelry, and avoiding playing with the piercing. A bar that is very large-gauge or too long can greatly increase the risk of chipped teeth or gum erosion, and excessive impacts of the metal against the teeth can cause micro-fractures in the tooth enamel.

Because of the tongue's exceptional natural healing ability, piercings can close very quickly. Even completely healed, very-large-gauge holes can close up completely in a matter of just a few days.