The implication of a traumatic injury to a permanent molar tooth as a complication by tongue piercing with ornamental jewelry is reported. An appropriate restorative management of the fractured tooth is described. The dentist's role in prevention and treatment of unfavorable complications is outlined. The rationales for selection of specific treatment modalities, in view of the degree of damage to hard dental tissues, are discussed. The range of hard tissue injuries resulting from tongue jewelry varies from a simple crack propagating into the enamel to a fractured tooth. A variety of factors must be considered before employing the available restorative methods.