Intraoral piercing has increased in popularity in the last few years. This type of jewelry has been associated with periodontal and muco-gingival defects such as attachment loss and gingival recession. This case report described a 25-year-old female presented to the clinic of Periodontics at Witten/Herdecke University in Witten, Germany, with a tongue stud placed through the mid-dorsum of her tongue. The lower left central (LL1) and lower right central (LR1) incisors exhibited 6 mm and 5 mm lingual probing depth, 4mm and 3.5mm lingual recession respectively and localized radiographic bone loss in the mid-half of the roots. The treatment strategy consisted of removal of the tongue piercing, professional prophylaxis, oral hygiene instructions and an open-flap surgery of the lingual anterior region of the mandible with the application of enamel matrix derivative (EMD) and bone graft material. Results: At the 1-, 3-and 7-month recall visits, the patient's oral hygiene has been improved, and the attachment loss appears to have stabilized. It is clear that the tongue piercing might be a risk factor for local periodontal complications.