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.
• 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.
• 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 in the mouth).

See More Appropriate Topic (instead of this one) If

• Main injury is to teeth, see TOOTH INJURY

WHEN TO CALL YOUR DOCTOR

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

• Major bleeding that can't be stopped
• 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.
• Split open or gaping cut 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 9am and 4pm) 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.
   • 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:
   • Offer a soft diet.
   • 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 "Call Your Doctor" symptoms.