Whether you’re considering the common single-stud tongue piercing or want something completely out there, a tongue piercing can be personalized in terms of placement, jewelry, and style. “Tongue piercings are a great way to add some decoration to your mouth, as they sit like a pearl inside a clam, and your options for jewelry are limitless,” says piercer Samantha Josephine. “Once your piercing has healed and you become used to it, it is a no-fuss piercing that you can enjoy for years.” We spoke to Josephine along with piercers Josephine and Jacquelyn Dohoney, and dermatologist, Erum Ilyas, MD, about all things tongue piercings, what they entail, and if you should get one. Keep reading for everything you need to know about tongue piercings.

What Is a Tongue Piercing?

A tongue piercing is any body modification that involves piercing a piece of jewelry through the tongue. There are multiple types of tongue piercings:

• Midline piercing: The most common type of tongue piercing, it’s a vertical piercing involving a needle going straight through at one point from top to bottom in the center of the tongue.
• Venom piercing: A vertical piercing on each side of the tongue.
• Horizontal piercings: Your piercer will run the needle through the tongue from side to side instead of top to bottom:
• Snake eyes piercing: A horizontal tongue piercing toward the top of the tongue that looks like a snake’s head (Note: According to piercer Cozmo Faris, this is a very unsafe piercing that will most likely result in permanent muscle, nerve, and tooth damage).
• Frenulum piercing: A horizontal piercing of the web of skin beneath the tongue.
• Surface piercing: The least common type of tongue piercing, it’s a horizontal piercing with a curved barbell.

What to Expect

The way a tongue is pierced involves clamping the appendage with forceps to hold the tissue. Then, a needle—typically a 14 gauge, says Dohoney—is pushed through the tongue to create the actual piercing. “Sometimes we will use a larger needle if the client requests a larger gauge piece of jewelry, but 14 gauge is standard,” says Dohoney. Then, the jewelry is pushed through behind the needle to complete the piercing process.

Pain

While the tongue may seem like a sensitive spot to pierce, thanks to its responsiveness to tastes and touch, it’s actually a relatively low-pain placement choice. Because the needle is just going through connective tissue rather than cartilage or skin, there’s less of a “pain” feeling, and it’s considered fairly tolerable. In fact, Josephine says that “the clamps tend to be more uncomfortable than the piercing itself.”

“It’s more like a weird pressure; it hurts more to bite your tongue,” agrees Dohoney. “A double vertical is a little more painful because it goes directly through the tongue muscle. A horizontal is the most painful because it’s done in an area where the majority of the nerves are.” You may also feel some soreness in the days after your piercing, especially considering the placement. You use your tongue on a daily basis, whether it be for eating or talking, so you’ll certainly feel a bit of pain as your tongue heals while you use it.

Healing Time

Fortunately, tongue piercings tend to heal quickly, taking anywhere from four to eight weeks, according to Dr. Ilyas. However, be advised that horizontal piercings will take longer than vertical ones.

“Most people heal in four [weeks],” says Dohoney. “A horizontal tongue piercing forces the jewelry through the tip of both muscles. With the constant movement of the two muscles that have been forcefully stuck together, it makes it incredibly difficult to heal.”

It’s also common to see slight swelling about two days into the healing process. This may last until the tenth day or so, but it will eventually go down. Keep track of when the swelling is over, though, as you have to change out the jewelry when it does.

Aftercare

Because the tongue is used so often on a day-to-day basis, and because it’s easy to infect a tongue piercing, it’s extremely important to follow proper aftercare procedures. “It is important that you remember that this is an open wound in your mouth during healing time,” says Josephine. So talk to your piercer about what they recommend, even if you’ve done your research.

Do

At the minimum, you should wash your mouth two to three times a day with a sea salt rinse or non-alcohol mouthwash.

Don’t

• Do not smoke or use a straw during the healing process because the motion will drastically increase swelling.
• Avoid salty, spicy, hot, or sour foods, which can cause irritation.
• Steer clear of dairy, as it leaves a thick film on the tongue that may encourage bacterial growth, Josephine tells us.
• “The biggest thing is to stay away from any ‘extracurricular activity’ like wet kissing or oral sex,” says Dohoney.

Side Effects

“Pain, tenderness, and drainage can be seen when the area is not properly cared for,” says Dr. Ilyas. “In terms of complications, there are both short and long-term consequences.”

• Swelling: Swelling is when the area around your tongue piercing grows in size and doesn’t go back down. This is a super common side effect of a tongue piercing due to the amount of daily activity a tongue goes through, no matter if it’s freshly pierced or not. If you’re not careful to take all recommended aftercare precautions, swelling is quite easy to cause.
• Infection: Infections are when bacteria get into the piercing site and grow—it’s a symptom of a lack of proper aftercare. Infection symptoms normal for tongue piercings include swelling, tenderness, bleeding, and pain. It’s normal to see slight swelling over the first week and notice some redness in the first day or two, but anything that seems abnormal on a tongue piercing is probably the sign of something worse. “If it’s not cared for, you can get an infection, including yeast infections, also known as thrush,” notes Dohoney.
• Dental erosion: Dental erosion is when the tooth is slowly worn away by the tongue piercing. You can easily damage your teeth thanks to constantly having a piece of metal rub against the inside of them.
• Teeth fractures: Research shows that there’s a strong correlation between enamel fractures and cracking and oral/tongue piercings. It’s mostly caused by the piercing getting clamped in between the teeth.

How to Change Out a Tongue Piercing

“Changing tongue piercings to a shorter barbell is highly recommended once it heals,” says Dohoney. “If you don’t, you will have issues with chipping your teeth, biting the jewelry, gum recession behind the teeth, and even swallowing the jewelry.”

Changing out a tongue piercing is completely possible, and in most cases, can be done by yourself at home. To do so, stick out your tongue, grab the two beads on either side of the barbell, and twist until one comes off. Then, pull the bar out and place your new piece of jewelry through the hole. Twist the new jewelry’s beads until tight, and you’re all set.

However, it’s a good idea to see your piercer for the first jewelry change, says Josephine, to be sure you’re causing as little trauma to the still-healing wound as possible and to avoid any potential infection thanks to incompetence or accident. “The mouth is filled with virulent bacteria, so it is important to be cautious,” agrees Dr. Ilyas.

Cost of a Tongue Piercing

Like any piercing, the price of a tongue piercing will vary depending on your specific circumstances—that includes your geographical location, the shop/piercer you choose, the exact piercing, and more. In general, a tongue piercing will run from $35 to $100. Also, don’t forget that piercings come with two charges: the actual piercing and the jewelry. Be prepared to pay a good price for quality jewelry—something you definitely shouldn’t skimp on.

Jewelry Used for a Tongue Piercing

“The most common jewelry used is a ball-shaped piercing, with cone and cylindrical being far less common,” says Dr. Ilyas. A barbell is, at the basic level, a metal bar with a small bead affixed on both ends; typically one is removable and one isn’t. A barbell is inserted in a tongue piercing by pushing it through behind the needle. For tongue piercings, barbells must be straight: “Any tongue piercing that would require a curved barbell just shouldn’t be done in the first place,” says Faris.

Regarding materials, Dohoney uses surgical-grade stainless steel barbells or implant-grade titanium barbells —whichever clients prefer.

• Implant-grade stainless steel: The most common type of metal used to make jewelry for piercings is stainless steel, specifically implant-grade. There are very few problems with using stainless steel, and it comes in so many variations, so it’s tolerated by most. However, those with a nickel allergy should avoid this metal, as it might irritate their skin.
• Titanium: Titanium doesn’t contain nickel so it won’t cause any irritation to the piercing site or other allergic reaction. Titanium also comes in various colors and styles, is lightweight, and won’t corrode.

Whatever you decide, know that choosing your jewelry material is incredibly important. Studies have shown there is a significant correlation between piercings and allergies to nickle and cobalt.