Objective: To investigate via a split-mouth cross-sectional study the prevalence of gingival recessions associated with lateral lower lip piercing in a population obtained from a nondental setting. Method and Materials: A split-mouth study was performed in a sample of 47 patients with one lateral lower lip piercing. Teeth in direct contact with the intraoral closure of the stud were defined as test teeth; contralateral teeth were selected as controls. Clinical examination included full-mouth plaque and bleeding indices, probing depth, recession, clinical attachment level, periodontal biotype, evaluation of hard tissues, occlusal trauma, stud characteristics, and mucosal inspection and palpation. Results: Midbuccal recession was noted in four test teeth compared with one control tooth (8.5% and 2.1%, respectively; P = .250). The canine and first premolars were the most affected. Tooth chipping occurred in one test tooth and no control teeth. Plaque levels were significantly higher in test than control teeth (P .001). Conclusion: Lateral lower lip piercing is associated with significantly higher plaque accumulation on adjacent teeth. A small percentage of lateral lower lip piercings may cause tooth chipping or buccal recession in adjacent teeth. Keywords: body piercing, gingival recession, tooth injuries