When most people think of a tongue piercing, they conjure up an image of a single barbell inserted through the middle of the tongue, front and center. Despite the long-standing myth that says if the piercer accidentally impales a certain vein in the tongue you will bleed to death, standard tongue piercing are very common and quite popular. The myth, as it turns out, is only partially rooted in reality; there is an arterial vein in your tongue which, if nicked, can cause excessive bleeding. However, it would have to bleed unnoticed for hours and hours, without clotting and without applying pressure, in order for the person to bleed so extensively that he or she actually comes close to bleeding to death.

Aside from the standard tongue piercing, there are about half a dozen other types available today.

A frequent variation of the single, center piercing is the same piercing in duplicate or triplicate. A double center (sometimes called a second tongue piercing) is a pretty common idea which features two barbells in the center of the tongue, one behind the other.

For those that care little for the aesthetic value of symmetry, there's the off-center tongue piercing. Sometimes called a sublim or a venom (pluralized into venoms or "snakebites" if there's one on each side), an off-center tongue piercing is more complicated than a standard tongue piercing because the muscle tissue is thicker on the sides. Some people say that venoms hurt much more than a standard tongue piercing, which is pierced in the center between the two muscles, while others report feeling no difference. The piercer must also take into account the size of your mouth, how close your teeth crowd together and how far back the webbing under your tongue recedes to determine whether or not an off-center tongue piercing will fit comfortably in your mouth.

Then, of course, there's a combination of any of the above, for example an off-center and a double center, resulting in four separate piercings that form a diamond shape in the middle of the tongue.

Not to be confused with venoms, a horizontal tongue piercing looks as though it is two separate barbells but in actuality it is just one barbell pierced horizontally through the tongue.

A frenulum piercing is a hoop or barbell that is pierced through the small flap of webbing underneath the tongue that connects it to the mouth. Not everyone is a candidate for this type of piercing as the web may be too small or too thin to safely wear jewelry. Your piercer will let you know whether or not a frenulum piercing is for you.

A common modification in the piercing world is stretching or gauging. All piercings are done with a standard sized needle; 20- or 18-gauge for ears, 14-gauge for tongue, etc. However, due to the elasticity of skin, most piercings can be gradually stretched over time to eventually hold thicker jewelry at a lower gauge. Tongues are no exception. Gauging is done by gradually upgrading the size of the jewelry little by little, coaxing the hole to fit larger jewelry until you have achieved the desired size.