A tongue piercing is typically made through the center of the tongue, placing it between the tongue�s main muscles and away from any nerve or vascular centers. On rarer occasions, a piercing may be offset to one side or there may be multiple piercings of the tongue, but the anatomy of the tongue makes this much more complicated than the ordinary, centered variety. It is especially important that tongue piercings be administered only by a trained professional, as nicking a nerve or major blood vessel can cause partial paralysis or excessive bleeding, neither of which is conducive to a pleasant piercing experience.

Typically, a tongue piercing is filled with a straight barbell. The barbell used immediately after piercing (starter jewelry) will be significantly longer than that which makes the best long-term fit because the piercer must account for the swelling to come in the four to six weeks of normal recovery. Swelling of the tongue tends to last three days to a week after the piercing, depending upon the speed of healing and the individual physiology of the piercee as well as the gauge of the piercing. It is important to have your starter jewelry replaced in any piercing of the mouth, as excessively loose jewelry can cause permanent damage to the teeth. If you have particular trouble with your piercing, an over the counter anti-inflammatory can help to reduce the discomfort and swelling of your tongue.

Caring for a tongue piercing, especially in the first weeks of recovery, can be daunting, as any food or drink or other particles that enter the mouth can become lodged in the wound or around the jewelry. This can slow recovery and lead to unpleasant swelling and pain or possibly even infection. For this reason, one should take special notice of the aftercare directions for tongue piercings.

Perhaps the most important part of caring for your new tongue piercing is the regular use of an oral antiseptic. Be sure to find an antiseptic that is free of alcohol, because the high alcohol content of most antiseptics (e.g. Listerine, Scope) can damage the recovering tissue of your piercing as well as they can the bacteria you want to remove. Medical-grade oral rinses are sometimes available for this purpose. Rinse after every meal for thirty seconds to one minute as appropriate. Over-use of an oral antiseptic can irritate your piercing and your mouth (not to mention your taste buds), so use your best judgment.

Sea salt soaks or oral saline solutions are sometimes considered an alternative to a mouthwash, but they are better used in conjunction. To make your own sea salt solution, use about a quarter of a teaspoon of non-iodized sea salt to an eight-ounce glass of water. Rinse with this solution after drinking anything but bottled water or after smoking tobacco to clear away any residue.

Brushing your teeth regularly should be the most important part of your aftercare routine as it removes plaque (which is essentially bacterial buildup) from your teeth and gums. This is also how you clean your jewelry. Brush the area immediately surrounding the piercing and the ball protruding from each side to prevent the buildup of plaque around the site of your piercing, but be sure to do so gently. Over-brushing or using an old or stiff brush can cause unnecessary irritation of the area and slow its healing. It is usually recommended that one buy a fresh brush for this, as the bristles will be softer and the risk of bacterial infection will be lower. A frayed brush is thought to hold more bacteria between uses than a new one.