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  • Mouth Injury

    Definition

    • Injuries to the lips and mouth
    • Includes inner cheeks and the roof of the mouth (hard and soft palate)
    • Front of the mouth includes the tongue. Also, includes the flap under the upper lip (frenulum).
    • Back of the mouth includes the tonsils and the throat
    • Tooth injuries are not covered here

    Types of Mouth Injuries

    • Tongue. Cuts of the tongue or inside of the cheeks are the most common mouth injury. Usually, due to accidentally biting them during eating. Bites of the tongue rarely need sutures. Even if they gape open a little, the cuts usually heal quickly. If the edges come together when the tongue is still, it needs no treatment.
    • Upper Lip. Cuts and bruises of the upper lip are usually due to falls. The piece of tissue joining the upper lip to the gum is the frenulum. A tear of the upper frenulum is very common. It always heals without sutures. However, it will rebleed every time you pull the lip out to look at it.
    • Lower Lip. Cuts of the lower lip are usually caused by the teeth. They occur when catching the lip between the upper and lower teeth while falling. Most of these cuts do not connect (don’t go through the lip). These do not need sutures unless the outer cut is gaping.
    • Serious injuries are those to the tonsil, soft palate, or back of the throat. Examples of these injuries include falling with a pencil or toothbrush in the mouth.

    When to Call Us for Mouth Injury

    Call 911 Now (your child may need an ambulance) If:

    • Major bleeding that can’t be stopped
    • Trouble breathing
    • You think your child has a life-threatening emergency

    Call Us 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 of the lip that may need stitches
    • Pain is SEVERE and not improved 2 hours after taking pain medicine
    • Trouble swallowing fluids or spit
    • Injury to back of the mouth caused by long object (such as a pencil)
    • Can’t fully open or close the mouth
    • Fever and mouth looks infected. Signs are increasing pain or swelling after 48 hours. Note: It’s normal for a healing wound in the mouth to be white.
    • You think your child needs to be seen urgently

    Call Us Within 24 Hours (between 9 am and 4 pm) If:

    • You think your child needs to be seen, but not urgently
    • Mouth looks infected and no fever

    Call Us During Weekday Office Hours If:

    • You have other questions or concerns

    Parent Care at Home If:

    • Minor mouth injury

    Care Advice for Minor Mouth Injuries

    Stop the Bleeding – Upper Lip and Frenulum:

    • Cuts of the inside of the upper lip are very common.
    • Often, the piece of tissue that connects the upper lip to the upper gum is torn. This tissue is called the upper labial frenulum.
    • The main symptom is oozing tiny amounts of blood.
    • This cut always heals perfectly without sutures.
    • For bleeding from the frenulum, use direct pressure. Press the outer lip against the teeth for 10 minutes.
    • Caution: Once bleeding has stopped, don’t pull the lip out to look at it. Reason: The bleeding will start up again.
    • It’s safe to look at it after 3 days.

    Stop the Bleeding – Lower Lip:

    • Most children who fall and bite their lower lip have 2 cuts. They have cuts to both the outside and inside of the lip.
    • Catching the lower lip between the upper and lower teeth causes the 2 cuts. This tends to happen in children with an overbite.
    • These small cuts do not connect with each other.
    • For bleeding from the lip, use direct pressure. Press the outer lip against the teeth for 10 minutes.

    Stop the Bleeding -Tongue:

    • Bites of the tongue rarely need sutures.
    • Even if they gape open a little, tongue cuts usually heal quickly. If the edges come together when the tongue is still, it needs no treatment.
    • For tongue bleeding, try to press on the bleeding site with a sterile gauze. You can also use a piece of clean cloth. Do this for 5 minutes if it’s practical.
    • Cuts of the tongue normally tend to ooze a little blood for several hours. This is due to the rich blood supply in the mouth.
    • For constant oozing of blood, can use a moistened tea bag for 10 minutes. (Reason: tannic acid released from the tea bag may stop the oozing).

    Cold:

    • Put a piece of ice or popsicle on the spot that was injured.
    • Do this for 20 minutes.

    Pain Medicine:

    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.

    Soft Diet:

    • Try to get your child to drink adequate fluids.
    • Goal: Keep your child well hydrated.
    • Cold drinks, milk shakes, popsicles, slushes, and sherbet are good choices.
    • Solids. Offer a soft diet. Also avoid foods that need much chewing. Avoid citrus, salty, or spicy foods.
    • Rinse the wound with warm water right away after meals.

    What to Expect:

    • Small cuts and scrapes inside the mouth heal up in 3 or 4 days.
    • Infections of mouth injuries are rare.

    Call Your Doctor If:

    • Pain becomes severe
    • Mouth looks infected (mainly increasing pain or swelling after 48 hours)
    • Fever occurs
    • Your child becomes worse

    Disclaimer: This information is not intended 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.
    Copyright 1994-2013 Barton D. Schmitt, M.D.

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