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Paired Tongue Piercings 101

Last week we talked all about tongue piercings- information about oral health risks, healing, anatomy, and more! But this was all focused on your traditional single centered tongue piercing. What about other placements- like the very popular paired tongue piercings? Well, these piercings follow some of the same rules, but also have some extra considerations. So, let’s talk about paired tongue piercings!

A Note on Horizontal Placements

Of course, I can’t talk about tongue piercings without taking some time to address horizontal tongue piercings. There is no safe horizontal placement on the tongue- point blank. While even vertical tongue piercings carry risk to your teeth and gums horizontal placements are often even more damaging. They also effect the muscles of the tongue and can cause issues with speech. You can learn more about these risks here.

Paired tongue piercings are a fantastic alternative to horizontal tongue piercings. These piercings can give a somewhat similar look, while minimizing many of the major concerns that come with horizontal placements. If you have the anatomy for them, these are a fantastic alternative.

Anatomy, Always

In the last blog post we talked about general tongue piercing anatomy, and I would strongly suggest reading that before reading this blog, to help you better understand the differences in placement. With central tongue piercings, we are piercing in that septum in the middle of the tongue- softer, easier tissue to pierce though. And we can do multiples down that central septum if the clients anatomy allows- it’s honestly very similar to getting a single piercing with just a little extra accounting for swelling and placement.

When we think of paired tongue piercings however we often think of them bilaterally- one on either side of the tongue. However, in order to make this work that means we are no longer piercing through that soft septum in the center of the tongue. Rather we are going directly through the sections of muscle on either side. This means the piercing can have even more swelling than a traditional tongue piercing. And be even more uncomfortable during initial healing- after all we are now piercing directly through these muscles. And you might be thinking to yourself- isn’t the bad part about a horizontal piercing that it goes through the muscle? Why is this any different?

And that’s because we aren’t pinning muscles together in a way that impedes normal movement and function when we do these the way we are when we go horizontally across the tongue. While there are different sections of muscle on either side, when we pierce through them in a proper placement we are still allowing them their full range of motion and movement. With horizontal tongue piercings we are limiting their range of motion and movement, and more importantly their ability the roll, flex and form certain letters and sounds in a way we don't with vertical placements. With these paired piercings when done correctly, after initial swelling and healing, full range of movement and speech returns back to normal. There’s a little practice in getting used to the new jewelry, more so then with a centered tongue piercing, but not terribly much!


The other major anatomical consideration for these is blood flow- there are two primary points of blood flow running along the underside of the tongue as shown in this picture.


We need to avoid piercing through these- if these are hit it can cause serious damage and often requires a visit to the hospital. In order to do this there either needs to be enough space inside the veins for us to pierce, or outside them. This anatomy is somewhat uncommon, and many clients I see interested in this piercing I end up having to turn down because there’s simply no room for me to place these safely around the blood flow.

Beyond those factors, teeth, gums, and jaw structure are all important factors. We need to place these to minimize any harm or damage to your mouth and teeth. If it looks like these piercings could cause more serious harm, that should be something your piercer discusses with you!

Feelin’ Swell

Oral piercings are known for their swelling- and the tongue is no exception. If regular central tongues swell a lot, piercing off through the muscle swells even more. You will be pretty swollen for the first 3-5 days, and expect to have a lisp when you talk. Your piercer will pierce you with a longer bar which has plenty of room to accommodate for initial swelling. After the first few days this swelling will start to go down. Cold water, ice chips, ice pops (carefully), water ice, and cold treats can all help soothe swelling. However, once the swelling is down that long initial bar is going to be quite long. It can catch on your teeth and gums, you can bite it, and it can be tempting to play with. Because of this it’s very important you get this piercing downsized as soon as it’s ready for one! Don’t leave your jewelry long, especially not in tongue piercings. It’s not worth the damage it can cause to your teeth and gums. Swelling for these can be so much that I suggest clients get these pierced before the start of their weekend so they have some days off to allow it to go down and minimize talking. Downsizing can often happen pretty quickly depending on your anatomy and your piercer.

Safe Oral Products

While this heals, a big factor in it healing well is using oral products that are safe for the piercing. This means no products that are for whitening for contain whitening chemicals or abrasives like charcoal. Check ingredient lists too, because many toothpastes and mouthwashes hide whitening chemicals. Just like with a root canal or other major oral work, harsh chemicals like that can irritate and disrupt a healing wound. Yes, that also means you should discontinue actually whitening your teeth while this heals. Once it is healed is fine, but those chemicals are not awesome for your tongue while its healing. Alcohol free mouthwash is also going to be gentler while it’s healing.


I would strongly suggest investing in a tongue scraper as these are the most effective way to keep your tongue clean! They may be a little uncomfortable to use while the piercing is brand new but as it heals they will be comfortable to use again and are so amazing and keeping things really clean and healthy.

For other information about healing, and some of the myths about healing (like spicy foods, alcohol, and other things, check out this blog post about the myths and misinformations surrounding any oral piercings!



Jewelry Considerations

Tongue jewelry is going to be somewhat simple, and this is for a good reason. Tongue piercings have to be far more functional than other piercings. We are talking and eating and drinking with our tongue- it’s got a lot of work to do! But because of this we need jewelry that’s compatible with all of those things. The classic metal balls are a classic for a reason- simple, smooth, and easy to keep clean. For those looking to spike things up, a bezel set opal is a great choice. Bezel settings are smooth, low profile settings that are comfortable in the mouth. I generally don’t suggest anything more decorative for paired piercings just because of how they sit in the mouth and the surfaces they contact- better safe then sorry!

Another factor with tongue jewelry is plaque. Just like the plaque buildup we clean off our teeth, plaque will build up on oral piercings as well. And of all the oral piercings, tongues often get some of the worst buildup. Particularly the bottom bead, as it rests very closely to the salivary ducts on the bottom of the mouth, and food particles can easily become trapped there. Whatever jewelry you choose to wear remember that you’ll be dealing with plaque on it and need to clean it off regularly. Simple jewelry is going to be easier to clean. And the more complex, the more difficult.

Oral Health Risks

All oral piercings carry risks of harming your teeth and gums. But tongue piercings often carry some of the highest risks. I have a blog that goes in-depth about general risks of damage here which I strongly suggest reading. The largest common concerns with oral piercings are oral hygiene and care, properly fitted jewelry and placement, and being mindful with playing with jewelry. Good oral hygiene often solves the first one- bruising and flossing regularly. For tongues, opting for simpler jewelry thats easier to keep clean is also helpful. For placement and jewelry fit- seeing a reputable piercer is key as they will assess your tongue and mouth and place things accordingly. And a little self control helps with not playing with it.

But even with perfect hygiene, a perfect piercing with well fitting titanium jewelry, and a lot of self control you may still experience damage. Things like the wya you pronounce certain words, your accent, the language you speak, clenching your jaw, or grinding at night can all cause this jewelry to rub on your teeth and gums and cause potential damage. And these are factors that are out of our ability to control and minimize. Like any oral piercing, if you decide to get a tongue piercing you should be aware of and understanding about the risks of this damage. While good oral hygiene, good jewelry, and care can greatly minimize damage (I wore my tongue piercing for over a decade with no damage at all) it can’t ever prevent it 100% of the time. So be aware of that risk. See your dentist often, check in about your teeth, and be careful!

Paired tongue piercings are a more unique piercing that can replace a number of more harmful, more damaging tongue piercing placements. If you have the anatomy for these and are up for the healing process, I think these are a super fun, super unique set! Happy Healing.

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