Objectives: To investigate the complications of oral and facial piercing and its frequency in an extensive series of cases. Method and Materials: A sample of 2,266 consecutive patients requiring dental care over a period of 1 year was included in this cross-sectional observational study. A total of 83 piercing wearers were identified. Demographics, piercing site, clinical complications, adverse effects of piercing, motivation, and setting of piercing were determined through an interview and intraoral examination. Results: The 18- to 27-year age bracket showed a significantly higher prevalence of piercing wearers (mean years of wear 2.9 ± 3.8). Esthetic reasons were the most frequent stimulus for piercing insertion (86.7%). Up to an 80.8% of the devices were inserted in a tattooing studio. Forty-nine patients (59.0%) reported postoperative or late piercing complications. Postoperative pain (40.9%; 95% CI = 29.7 to 52.1) was significantly more frequent than infection (10.8%; 95% CI = 3.5 to 18.1) or postpiercing bleeding (7.2%; 95% CI = 1.0 to 13.4). When oral locations were compared to facial sites, the former had caused significantly more problems (X2 = 10.1; P = .001), pain (OR = 0.96; 95% CI = 0.08 to 0.97) and swelling (OR = 0.20; 95% CI = 0.06 to 0.68) being the most frequent undesirable effects associated with oral piercing. Conclusions: Complications associated with oral and facial piercing are frequent, and many of them might well be avoided if effective legal and hygienic measures were adopted. Educational interventions targeted to the population between 18 and 27 years of age are advisable, particularly when dealing with oral piercing. Keywords: adverse effects, body piercing, complications, epidemiology, facial, oral