Background. Intraoral piercings have been studied for over 50 years, with a primary focus on their impact on oral and overall well-being. As their popularity has grown significantly, understanding the changes that may occur in the oral mucosa following piercings has become an imperative requirement for dentists. Despite numerous studies, a clear, structured synthesis of these mucosal changes is still limited, emphasizing the importance of understanding them in dental practice. Aim of the study. The primary objective of this study is to synthesize and systematize the mucosal changes associated with intraoral piercings reported in the specialized literature. Secondary objectives aim to assess the risks that arise according to the locations of oral piercings and, implicitly, to provide an overview of the mucosal defense mechanisms associated with periodontal, hyperplastic, or inflammatory changes in the mucosa. Methods. This study is a narrative review that synthesizes existing literature published from the beginning of the 21st century to the present, focusing on the impact of intraoral piercings on the oral mucosa. Relevant English-language publications were identified through PubMed and Google Scholar, using terms such as “intraoral piercing”, “oral mucosa”, and “oral complications”, combined with Boolean operators “AND” and “Or” The reviewed literature included case reports, narrative reviews, cross-sectional studies, systematic and meta-analyses describing oral mucosal changes associated with intraoral piercings. Publications focused exclusively on extraoral piercings or unrelated to oral mucosal changes were not considered relevant for this review. Results. Intraoral piercings are consistently associated with trauma to the oral mucosa. Direct effects include inflammatory, hyperplastic, and atrophic changes. Indirect effects involve alterations in hard tissues and the periodontium, such as gingival recession, enamel wear, tooth fractures, and periodontal lesions. Conclusions. Intraoral piercings should not be considered merely as cosmetic jewelry but as a genuine risk factor. Understanding the impact of a piercing on the oral mucosa is an indispensable skill for a dentist in current practice, given the increasing number of people wearing oral jewelry and the incidence of mucosal changes.

DOI: https://doi.org/10.62838/ASMJ.2026.2.02