The most common symptoms experienced after oral piercing include pain, swelling, and increased salivary flow. More severe risks include blockage of the airway after accidental swallowing of jewellery, prolonged bleeding, nerve damage at the piercing site, difficulties with chewing, swallowing and speech, localised tissue overgrowth, metal hypersensitivity, chipped or cracked teeth, scar tissue formation, and jewellery that interferes with dental X-rays. Piercing oral structures also presents a high risk of infection because of the vast number of bacteria that inhabit the mouth.

When a tongue piercing is first done, a great deal of swelling occurs, which usually lasts as much as a week (some people find this first week very painful to the point where sleeping is difficult, but most people experience very little pain from tongue piercing). Total healing time is about a month, during which aftercare is limited to regular rinses with non-iodised salt water.