The piercing of intraoral structures to accommodate different types of jewelry has increased in popularity in the last few years. The association of an intraoral piercing with localized periodontitis is not well documented in the literature. A 22-year-old male presented to our clinic with a tongue stud placed through the mid-dorsum of his tongue. The inferior sphere was coated with plaque and calculus. Teeth #24 and #25 exhibited 6 mm interproximal probing depth and recession, horizontal radiographic bone loss, and tissue indentations consistent with the shape of the inferior ball of the tongue stud directly on the lingual surfaces of both teeth. The treatment consisted of an adult prophylaxis, flap curettage of the mandibular anterior region, oral hygiene instructions, and removal of the tongue stud. At our follow-up visit, the patient's oral hygiene had improved, he has removed the jewelry, and the attachment loss appears to have stabilized.