A comprehensive review of oral and perioral piercing is presented. This contemporary phenomenon has many implications for the piercee and for the oral healthcare professional. Oral and perioral piercing, which have become prevalent recently, both have historical antecedents. The implications of piercing are described in detail including sites at the tongue, lips, cheeks, frenum, and uvula. Complications occurring immediately after, soon after, and long after the piercing are detailed with special emphasis on the possible deleterious effects on hard and soft oral tissues. Suggestions are provided for patient education including a pamphlet for downloading. Appropriate jewelry selection is described and accompanied with a video clip demonstrating removal of jewelry during the dental appointment and a suggested technique for keeping the piercing hole patent while the jewelry is out. Reviewing this information should educate the oral healthcare professional to be prepared for the patient presenting with an oral or perioral piercing.