Most people walk in expecting the safety question to be about aftercare. It usually isn’t. By the time you’re rinsing your mouth at home, the two things that decide how this goes have already been settled: where the piercing sits in your tongue, and how long the bar in it is.
Here’s the short answer. Tongue piercings are reasonably safe for people with suitable anatomy, done by a licensed piercer, with the bar shortened on schedule. They’re a poor idea for some anatomy, and no one can tell which group they’re in by looking in a bathroom mirror. That’s not us being cagey. The structures that matter sit underneath the tongue, and they move depending on where along the tongue you’re looking.
We’ve been doing this in Austin since 2002, and the honest version of this conversation is the one we have at the counter every week. If you’re weighing a tongue piercing at either Austin location, this is what we’d tell you before anything else happens.
What Does a Piercer Actually Check Before Piercing a Tongue?
A tongue check is an anatomy assessment, not a formality. There are five things worth looking at, and we run through all of them before we agree to anything.
The Five-Point Tongue Check
- Reach. Can you extend your tongue past your teeth and hold it steady? If not, the piercing shouldn’t happen.
- Web. Where does the lingual frenulum attach? The lingual frenulum is the band of tissue connecting the underside of your tongue to the floor of your mouth. There has to be a usable room in front of it.
- Vessels. We inspect the underside of the tongue, often with a bright light, to map the veins and mark clear of them.
- Depth. How thick the tissue is through the intended channel. This sets the length of your initial bar.
- Bite. How your lower teeth close, whether they’re crowded, what dental work you already have, and where a bar end would rest when your mouth is closed.
There are only three honest outcomes: clear to pierce today, pierce with a changed placement or angle, or not a candidate. Nobody can give you that answer over text or from a photo.
Why You Can’t Check Your Own Tongue Anatomy in a Mirror
The blood supply sits closer to the middle than people assume, and it shifts along the length of the tongue.
A 2026 narrative review of lingual artery anatomy published in Surgical and Radiologic Anatomy reports that near the tongue tip, the deep lingual artery runs roughly 2.5 mm from the midline and about 4.2 mm below the top surface, which raises the chance of vascular injury during work on the front of the tongue.
A separate cadaver study of 18 healthy tongues found the arteries on both sides run downward and outward from the tip back to about 75 percent of the tongue’s length, sitting within 50 percent of the tongue’s width from the midline.
In plain terms: placement further back is generally safer than placement toward the tip, and the margins involved are a few millimeters. That’s why we look instead of guessing, and why we’re not going to walk you through checking it yourself.
What Makes Someone a Poor Candidate for a Tongue Piercing?
Frenulum position is the most common reason we change the plan or decline.
Axiom Body Piercing, a working studio that published a detailed breakdown of tongue placement in July 2025, lays out the same logic we use. The tongue has to be long enough to stick out of the mouth, and the frenulum has to end far enough back for the piercing to sit in front of it. When the frenulum runs close to the tip, there may not be room for the jewelry, or it forces the bar into extra contact with the lower gums. Their bottom line matches ours: if you can’t stick your tongue out, the piercing shouldn’t be done.
Angles matter too. The safest placement sits in the midline, between the two vessels running down each side, just in front of the frenulum, following the tongue’s natural curve. A steep angle only pushes the bottom end of the bar harder into your lower gums.
Other things that change our answer:
- Crowded lower front teeth. Less clearance for the bottom bar end at rest.
- Existing crowns, veneers, or large fillings on the lower front teeth. Repeated metal contact is a real concern.
- Braces or active orthodontic work. Talk to your orthodontist first. That’s their call, not ours.
- A grinding or clenching habit. More jewelry-on-tooth contact than average.
- Anything visibly irritated in the mouth that day. Texas rules prohibit piercing tissue showing infection or abrasion, so we’d ask you to come back.
If you want the anatomy question settled properly, walk in for an anatomy check at either shop and we’ll look and tell you straight. It takes a few minutes, and no, we won’t push you into a piercing we don’t think fits your mouth.
Which Tongue Piercings Do Professional Piercers Refuse to Do?
Some placements circulating on social media are declined by reputable piercers across the industry. This is one area where the trade is fairly united.
Snake eyes. A horizontal piercing through the tip. Piercer Cozmo Faris, who served as the professional reviewer on Byrdie’s tongue piercing guide, states plainly that this placement is very unsafe and will most likely result in permanent muscle, nerve, and tooth damage. It ties the two halves of the tongue tip together with a single bar.
Faris also notes that any tongue piercing that would require a curved bar shouldn’t be done in the first place.
Horizontal placements generally. Piercer Jacquelyn Dohoney of Big Deluxe Tattoo & Piercing in Salt Lake City, quoted in the same guide, explains that horizontal placements are the most painful because they pass through the area holding most of the nerves, and that forcing jewelry through the tips of both muscles makes healing very difficult.
Where that leaves you: the standard midline vertical piercing is the one with the longest track record and the widest professional support. Venom piercings, which are two vertical piercings placed either side of the midline, need enough tongue width to keep both channels clear of the vessels, so they’re an anatomy-dependent yes rather than a default one.
What Does the Research Say About Tongue Piercings and Teeth?
Damage is well documented, and it clusters in a predictable place.
The freshest overview is a narrative literature review by Rojas-Rueda and colleagues, published in Clinics and Practice on September 18, 2025. They screened 257 papers covering January 1990 through April 2025 and analyzed 19 of them. They found dental fractures, gum recession, enamel wear, tissue overgrowth, and both local and systemic infections.
The sentence in that review that matters most is about cause. The authors attribute worsening complications to a foreign object in the mouth combined with poor oral hygiene, habitual trauma, and long-term tissue contact. Not the act of piercing. What happens over the following years.
The numbers, with their limitations stated:
A 2022 systematic review and meta-analysis by Passos and colleagues in Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology pooled studies of people with oral piercings and found gum recession in 33 percent, tooth wear or abrasion in 34 percent, dental fracture in 34 percent, unspecified dental damage in 27 percent, and tooth chipping in 22 percent.
Those are observed rates within study populations, not your personal odds. The review itself rated the certainty of that evidence as very low, and we’d rather tell you that than quote the percentages as though they were a forecast.
Looking at tongue piercings specifically, a 2016 systematic review by Hennequin-Hoenderdos and colleagues, cited on the American Dental Association’s oral piercing page, reported gum recession in up to 44 percent of people with tongue piercings and tooth damage in 26 percent.
Which teeth take it: a 2024 European systematic review by Difloe-Geisert and colleagues in the International Journal of Dental Hygiene pooled eight studies covering 236 tongue piercings across 408 patients. Teeth next to the piercing showed more gum recession in four of four studies that measured it, deeper gum pockets in three of five, and more attachment loss in three of four, compared with control teeth in the same mouths. Time since placement was linked to localized damage in four of seven studies. A 2023 systematic review in Diagnostics found the highest rates of gum problems around the lower central incisors.
The pattern is consistent. The lower front teeth are where a bottom bar end rests, and that’s where the damage shows up.
Why Bar Length Decides How This Ends
This is the part almost nothing online covers properly, and it’s the single most useful thing we can tell you.
The foundational study here is Campbell, Moore, Williams, Stephens, and Tatakis, published in the Journal of Periodontology in 2002. It’s the only research that isolates bar stem length as a variable, which is why both the ADA and the American Academy of Pediatric Dentistry still cite it in their current policies. The team examined 52 US adults with tongue piercings, average age 22, grouping them by years of wear and by bar length, with length defined as 1.59 cm or more.
Their findings:
| Group | What the study found |
| Pierced under 2 years | No lingual gum recession and no tooth chipping in any subject |
| Pierced 4 or more years | Gum recession in 35 percent |
| Long bar, worn 2 or more years | Gum recession in 50 percent |
| Short bar, worn 4 or more years | Significantly higher rate of tooth chipping |
Co-author Dr. Dimitris Tatakis, professor of periodontology at the Ohio State University College of Dentistry, explained the mechanism in the journal’s own release on the study: long-stem bars are more likely to reach and damage the gums as the tongue moves than short bars are.
On the chipping side, the researchers attributed the higher rate among short-bar wearers to habitual biting, since a shorter bar is easier to position between the teeth.
Campbell et al., Journal of Periodontology, 2002
Read those two rows together and you get the honest picture:
- A bar left too long grinds at your lower gums.
- A shortened bar you keep biting chips your teeth.
Downsizing on time fixes half the problem. Not playing with the jewelry fixes the other half. Neither one alone is enough, and that nuance almost never appears in the risk lists you’ll find elsewhere.
The Association of Professional Piercers, a nonprofit founded in 1994 with more than 1,000 members, makes the same point about behavior in their oral piercing guidance: playing with oral jewelry is the most frequent cause of tooth and gum damage. The ADA’s page, last updated August 2026, cites a 2023 review by Malcangi and colleagues reaching the same conclusion, that biting, rolling, stroking, and sucking on the jewelry are the main causes of damage to the teeth.
What Is Downsizing, and What Happens If You Skip It?
Downsizing is the jewelry change where the long initial bar is swapped for a shorter one after swelling comes down.
Your first bar is deliberately longer than you’ll eventually need. Standard practice, as described in widely referenced piercing documentation, is that the tongue can swell to roughly double its size within about two days, and the initial jewelry has to leave room for that. Once the swelling drops, that extra length becomes the problem the Campbell data describes.
We call this window the downsize window, and we set the timing at your check rather than promising a fixed date. The APP notes that tongue piercings generally heal in six to eight weeks, compared with six to nine months or longer for a navel piercing, but healing speed and swelling vary a lot between people.
Dohoney puts the consequences of skipping it bluntly in the Byrdie guide: without the switch to a shorter bar, you’re looking at chipped teeth, biting the jewelry, gum recession behind the teeth, and even swallowing the jewelry.
This isn’t just the piercing industry saying so. The ADA’s own oral piercing page tells pierced patients to return to their piercer after swelling subsides to have the longer piece replaced with a shorter one, to limit damage or irritation to oral tissues. A dental association pointing readers back to a piercer is about as clear as endorsement of the step gets.
Should You Downsize It Yourself?
We’d say no, and so would most of the trade. Sydney-based piercer Samantha Josephine’s framing is the useful one: a healing tongue piercing is an open wound inside your mouth. Handling it with unsterile hands and unmeasured jewelry during healing is how irritation and infection start.
There’s also a practical reason. Getting the new length right depends on measuring your post-swelling tissue, which is a fitting, not a guess. Bring it in and we’ll size it against what’s in your file.
The 14 gauge is the standard size for tongue jewelry, per Dohoney, with larger sizes used only when a client specifically wants a heavier piece. When you’re choosing what goes in after healing, our implant-grade titanium and gold jewelry is sized and fitted in person for exactly this reason.
What Texas Law Requires Before Anyone Pierces Your Tongue
Texas has specific rules on this, and they’re worth knowing because they give you a way to judge any studio you walk into.
Under 25 Texas Administrative Code §229.406(i), before a body piercing, every client must be informed verbally and in writing about the possible risks. The rule names them: discomfort or pain, scarring, bleeding, swelling, infection, nerve damage, and increased risk for adolescents at certain stages of development.
That’s not a courtesy. It’s a legal requirement. A shop that hands you jewelry without that conversation isn’t following state rules.
Other provisions that affect your visit:
| Rule | What it means for you |
| 25 TAC §229.406(f) | No one may be pierced who appears to be under the influence of alcohol or drugs |
| 25 TAC §229.406(g) | No piercing on tissue showing rashes, boils, infection, or abrasions |
| 25 TAC §229.406(j)(4) | Your permanent record must log the type of jewelry used, plus the manufacturer’s catalog or ID number where available, kept at least two years |
| Health & Safety Code §146.002 | The studio must hold a current DSHS license, displayed prominently and tied to that specific address |
That record-keeping rule is genuinely useful and almost nobody mentions it. Your exact initial bar is documented in your file. When you come back for the downsize, that’s the reference point, which is one more reason to return to the shop that pierced you.
On jewelry materials, the Texas Department of State Health Services sets a floor for what can go into a new piercing: surgical implant-grade stainless steel at 316L or 316LVM minimum, solid 14k or 18k gold, niobium, titanium at 6AL4V minimum, platinum, or an approved dense low-porosity plastic. It has to be free of nicks, scratches, or irregular surfaces and sterilized before use. That’s the legal minimum, not a marketing line, and it’s a fair question to ask any studio.
The American Academy of Pediatric Dentistry, whose oral piercing policy was revised in 2025, opposes oral piercings but specifically encourages state regulations requiring body modifications to be performed by licensed professionals who inform patients about risks and aftercare through an informed consent process. Texas already requires both.
Is Tongue Splitting Legal in Texas?
No. Tongue splitting is prohibited in Texas under Health and Safety Code §146.0126, which defines it as cutting a human tongue into two or more parts. The prohibition took effect September 1, 2003. Separately, 25 TAC §229.413 bars anyone from performing it in a licensed tattoo or body piercing studio.
It’s a different procedure from a tongue piercing, with a different legal status. We don’t offer it and no licensed Texas studio can.
Can a Minor Get a Tongue Piercing in Texas?
Only with parental consent meeting specific requirements. Under 25 TAC §229.406(e), a person under 18 needs written, notarized consent from a parent, managing conservator, or guardian, and that adult must also be physically present during the piercing, with identification for both the minor and the adult.
Worth knowing: under §229.406(l), a minor who falsely claims to be 18 or presents a document saying so to a studio commits a Class B misdemeanor.
How to Tell Whether an Austin Studio Is Doing This Properly
You can judge a lot in the first five minutes. Here’s a comparison of what a proper tongue consultation looks like next to what a rushed one looks like.
| What happens | Sound process | Reason to pause |
| Before jewelry is chosen | Piercer looks under your tongue, usually with a light, and checks frenulum position | Placement marked from the top only |
| Bite assessment | Piercer looks at your lower front teeth and how they close | Nobody looks at your teeth |
| Risk disclosure | Verbal and written, covering nerve damage and bleeding, per Texas rules | Verbal only, or a form with no conversation |
| Initial bar | Deliberately longer to allow for swelling, length logged in your record | Standard length used regardless of tissue depth |
| Downsize plan | Explained and scheduled before you leave | Not mentioned |
| License | Current DSHS license displayed on the wall | Not visible |
| Declining work | Studio will say no to unsuitable anatomy and to snake eyes | Will pierce anything you ask for |
The last row is the strongest signal. A studio that has never turned anyone away isn’t screening.
There’s a reason we’re this specific about the disclosure step. In a 2024 Australian study by Masood, Walsh, and Zafar published in Oral Diseases, covering 54 pierced adults and 35 body-piercing professionals, only 13 percent of the pierced group said they had been informed about oral piercing complications. The same study found 76 percent play with their jewelry, and 41 percent of people with oral piercings now advise others against getting one.
That’s an Australian sample, not a US one, and we’re not going to pretend it maps directly onto Texas. But the gap it describes matches what we see: people arrive having read a lot about aftercare and almost nothing about placement or downsizing.
Some perspective in the other direction, too. A 2024 US study by Cirks and colleagues in Pediatric Emergency Care, using national injury surveillance data from 2011 to 2020 for people aged 24 and under, estimated 338,972 body piercing injuries nationally, of which 71 percent involved ears. Most piercing-related emergency visits in that age group aren’t oral at all.
Serious complications from tongue piercings are documented but uncommon. The ADA records cases including Ludwig’s angina, a fast-spreading infection in the floor of the mouth, along with jewelry becoming embedded in tissue and requiring surgical removal. If you develop severe swelling, difficulty breathing or swallowing, or a fever after any oral piercing, that’s a medical situation. See a doctor or dentist, not a piercer.
For questions about your own teeth, existing dental work, or gum condition, your dentist is the right person to ask. We can tell you what we see in your tongue. We can’t tell you what’s happening under your gumline.
Get Your Tongue Checked Before You Commit
If you take one thing from this: the safety of a tongue piercing is mostly decided by anatomy and bar length, and both of those are settled in the chair rather than at home.
What we’d suggest, in order:
- Read how to prepare for a piercing so you show up in good shape.
- Come in for a check. We’ll look, tell you which of the three outcomes applies to you, and explain why.
- If you go ahead, we’ll log your initial bar and set your downsize window before you leave.
- Follow the oral piercing aftercare instructions for rinsing and eating during healing.
- Come back for the downsize. That’s the appointment that protects your teeth.
We’ve run our piercing team out of two Austin shops since 2002, and Mason, Daniel, Drew, and Darren have all had the “not with that frenulum” conversation more times than they can count. It’s not a fun answer to give, but it’s a useful one.
Piercings are walk-in at both locations. Pricing varies by studio, jewelry choice, and day of the week, so check current rates with us directly. Bring your ID.
Frequently Asked Questions
Can I get a tongue piercing if I’m tongue-tied? Probably not in the standard position. When the lingual frenulum extends close to the tip, there often isn’t room for the jewelry to sit in front of it, and forcing it increases contact with your lower gums. Some cases can be worked around with a modified placement. Come in and we’ll look before you make plans either way.
How do piercers avoid the vein in my tongue? By inspecting the underside directly, often with a bright light, and marking placement between the vessels that run down each side. Given that anatomical research places the deep lingual artery within a few millimeters of the midline near the tip, this is a look-first procedure, not a measure-from-a-chart one.
Can gums grow back after a tongue piercing? Gum tissue that has receded doesn’t regrow on its own. That’s why the timing of your downsize matters, and why the Campbell study’s finding of no recession in anyone pierced under two years is worth taking seriously as a window to act in. If you’re already seeing recession behind your lower front teeth, see a dentist. Only they can assess whether treatment is warranted.
Can I get a tongue piercing with braces? Ask your orthodontist first. We can assess your tongue anatomy, but active orthodontic work changes tooth position over time, which changes where a bar end will sit. That’s a conversation for the person managing your treatment.
Does downsizing actually prevent tooth damage? It addresses one of the two mechanisms. Campbell’s 2002 data links long bars worn two or more years to a 50 percent recession rate, so shortening the bar reduces gum contact. It doesn’t stop chipping, which the same study links to biting a shorter bar. You need both the downsize and the habit change.
How do I know if my current bar is too long? If you can feel the bottom end resting against your lower gums when your mouth is closed, or you find yourself clicking it against your teeth, bring it in for a fitting. We won’t ask you to assess or adjust it yourself.
Should I see a dentist after getting a tongue piercing? Yes, and mention the piercing at your checkup. Dental professionals are asked by both the ADA and the AAPD to monitor patients with oral piercings for gum recession and tooth wear. They can spot early changes around your lower incisors well before you’d notice anything.
Are snake eyes piercings safe? No, and we don’t do them. Piercer Cozmo Faris, reviewing Byrdie’s tongue piercing guide, states the placement is very unsafe and likely to cause permanent muscle, nerve, and tooth damage. Any studio willing to do one on request is telling you something about their screening standards.
What happens if I’ve had my tongue pierced for years and never downsized? Come in and get it fitted properly. The research links duration of wear to localized gum damage, so there’s no benefit to waiting longer. Also book a dental checkup, because a dentist is the only person who can tell you whether existing damage has occurred.
