Mouth Injury

When To Call

Call 911 Now

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

Go to ER Now

• Minor bleeding (more than oozing) won't stop after 10 minutes of direct pressure
• Injury to back of the mouth caused by long object (such as a pencil)
• Large deep cut that will need many stitches

Call Doctor or Seek Care Now

• Gaping cut of tongue or inside the mouth that may need stitches
• No past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
• Gaping cut of the lip that may need stitches
• Severe pain and not better 2 hours after taking pain medicine
• Trouble swallowing fluids or spit
• Can't fully open or close the mouth
• Age less than 1 year old
• 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 has a serious injury
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Mouth looks infected and no fever
• Dirty cut or hard to clean and no tetanus shot in more than 5 years
• Clean cut and no tetanus shot in more than 10 years
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Minor mouth injury

Care Advice

Upper Lip and Frenulum Bleeding - How To Stop:

• 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.

Lower Lip Bleeding - How to Stop:

• 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.
• Most of 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.

Tongue Bleeding - How to Stop:

• 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 for Pain:

• Put a piece of ice or popsicle on the spot that was injured.
• You can also use a cold wet washcloth.
• Do this for 20 minutes.

Pain Medicine:

• To help with the pain, give an acetaminophen product (such as Tylenol).
• Another choice is an ibuprofen product (such as Advil).
• Use as needed.

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
• You think your child needs to be seen
• Your child becomes worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Photos

FIRST AID Advice - Bleeding Wound of the Mouth

• Apply direct pressure to the entire wound with a sterile gauze dressing or a clean cloth. Once the bleeding has stopped, cover with an adhesive bandage or gauze.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.