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Mouth Injury

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Definition

  • Injuries to the lip, flap under the upper lip (frenulum), tongue, inner cheeks, floor of the mouth, roof of the mouth (hard and soft palate), or back of the mouth (tonsils and throat) 

Types of Mouth Injuries 

  • Cuts of the tongue or inside of the cheeks (due to accidentally biting them during eating) are the most common mouth injury. Bites of the tongue rarely need sutures. Even if they gape open a little, if the edges come together when the tongue is quiet, the cut should heal quickly.
  • Cuts and bruises of the upper lip are usually due to falls. A tear of the piece of tissue connecting the upper lip to the gum is very common and always heals without sutures. It will rebleed, however, every time you pull the lip out to look at the bleeding site.
  • Cuts of the lower lip are usually caused by catching it between the upper and lower teeth during a fall. Most of these cuts do not connect (don't go through the lip). These do not need sutures unless the outer cut is gaping.
  • Potentially serious mouth injuries are those to the tonsil, soft palate, or back of the throat (as from falling with a pencil or toothbrush in the mouth).

When to Call Your Doctor for Mouth Injury

Call 911 If…

 
  • Your child has bleeding that can't be stopped
  • Your child has difficulty breathing
 

Call Your Doctor Now (night or day) If

  • You think your child has a serious injury
  • Minor bleeding won't stop after 10 minutes of direct pressure
  • Gaping cut of tongue or inside the mouth that may need stitches
  • Gaping cut through border of the lip where it meets the skin
  • Severe pain
  • Difficulty swallowing fluids or saliva
  • Caused by a pencil or other long object and injury to back of the mouth
  • Mouth looks infected (fever, spreading redness, increasing pain or swelling after 48 hours) (Note: Any healing wound in the mouth is normally white for several days.)
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
 

Parent Care at Home If

  • Minor mouth injury and you don't think your child needs to be seen
 

Home Care Advice for Minor Mouth Injuries

  1. Stop Any Bleeding:
    • For bleeding of the inner lip or tissue that connects it to the gum, press the bleeding site against the teeth for 10 minutes.
    • Caution: Once bleeding from inside the lip stops, don't pull the lip out again to look at it (Reason: the bleeding will start up again).
    • For bleeding from the tongue, squeeze or press the bleeding site with a sterile gauze or piece of clean cloth for 10 minutes.
     
  2. Local Cold: Put a piece of ice or popsicle on the area that was injured for 20 minutes.
  3. Pain Medicine: If there is pain, give acetaminophen (e.g., Tylenol) or ibuprofen.
  4. Soft Diet:
    • Encourage favorite fluids to prevent dehydration. Cold drinks, milkshakes and popsicles are especially good.
    • Offer a soft diet. (Avoid foods that need much chewing.)
    • Avoid any salty or citrus foods that might sting.
    • Rinse the wound with warm water immediately after meals.
     
  5. Expected Course: Small cuts and scrapes inside the mouth heal up in 3 or 4 days. Infections of mouth injuries are rare.
  6. Call Your Doctor If:
    • Pain becomes severe
    • Area looks infected (mainly increasing pain or swelling after 48 hours)
    • Fever occurs
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

References

  1. AAP Committee on Child Abuse and Neglect. Oral and dental aspects of child abuse and neglect. Pediatrics. 2005; 116(6): 1565-1568.
  2. Gassner R, Tuli T, Hachl O, et. al. Craniomaxillofacial trauma in children: a review of 3,385 cases. J Oral Maxillofac Surg. 2004;62:399-407.
  3. Gordy FM, Eklund NP, DeBall S. Oral trauma in an urban emergency department. J Dent Child (Chic). 2004;71:14-16.
  4. Holtrop T. An unusual injury to the mouth. Consult Pediatr. 2006;5(10):615-616.
  5. Lamell CW, et al. Tongue lacerations in children. Pediatr Dentistry. 1999;21:31-38.
  6. McHugh T. Pneumomediastinum following penetrating oral trauma. Pediatr Emerg Care. 1997;13:211-213.
  7. Nowak AJ, Slayton RL. Trauma to primary teeth: Setting a steady management course for the office. Contemp Pediatr. 2002;19(11):99-118.
  8. Schoem SR, et al. Management of oropharyngeal trauma in children. Arch Otolaryngol Head Neck Surg. 1997;123:1267-1270.
  9. Ud-din Z, Aslam M. Should minor mucosal tongue lacerations be sutured in children? Emerg Med J. 2007;24:123-124.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 12/16/2009 10:20:57 AM

Copyright 1994-2011 Barton D. Schmitt, M.D.

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