The aim of the present study is to verify the knowledge of risks and complications of oral piercings, and to observe the main complications associated with piercings, using a sample from central Italy of patients wearing intraoral piercings. Through piercing and tattoo studios selected randomly in Rome, Latina and Campobasso, and a tattoo and piercing convention in Latina, a group of 387 individuals with oral piercings were selected and asked to complete an anonymous questionnaire. After filling in questionnaires, 70 individuals of the 387 selected agreed to be visited to allow the observation of the integrity of their teeth and gums (especially close to the oral piercing), oral hygiene conditions, piercing cleaning, bad habits and gingival recession. Among the respondents, 46.8% said they had not been informed about these risks, 48.5% claimed not to clean the piercing, 70.6% stated that they had not been made aware of gingival problems that can arise, 60.4% subjects stated that they were not informed about the complications of piercings concerning teeth, 52.8% had insufficient oral hygiene conditions, 42% showed signs of generalised gingivitis, 20% had 3–4 mm recessions and 22% had tooth fracture(s) due to piercing. From this study, it emerged that oral piercings can represent a risk to oral health and that there is a widespread lack of awareness of the complications and correct methods of maintaining oral piercings. Periodic checks by both dentists and dental hygienists, for patients with oral piercings, could play a decisive role in preventing, intercepting and treating the complications that they can cause.