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Mouth Injury

Mouth Injury  
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First Aid - Bleeding Mouth
First Aid - Bleeding Mouth

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 (upper labial frenulum) 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).
 If not, see these topics
  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
  • 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
  • Can't fully open or close 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.)
  • You think your child needs to be seen urgently
  Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  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 the Bleeding - Upper Lip and Frenulum:
    • Cuts of the inside of the upper lip are very common.
    • Usually the piece of tissue that connects the upper lip to the upper gum (upper labial frenulum) is torn.
    • The main symptom is oozing tiny amounts of blood.
    • This cut always heals perfectly without sutures.
    • For bleeding from the frenulum, press the overlying outer lip 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).
    • It's safe to look at it after 3 days.
  2. Stop the Bleeding - Lower Lip:
    • Most children who fall and bite their lower lip cause cuts to both the outside and inside of the lip.
    • Two cuts occur because the lower lip is trapped between the upper and lower teeth during the fall (especially in children with an overbite).
    • These small cuts do not connect with each other.
    • For bleeding from the lip, press the overlying outer lip against the teeth for 10 minutes.

  3. Stop the Bleeding -Tongue:

    • 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.
    • For initial bleeding from the tongue, try to squeeze or press the bleeding site with a sterile gauze (or piece of clean cloth) for 5 minutes if it's practical.
    • Cuts of the tongue normally tend to ooze a little blood for several hours (Reason: rich blood supply)
    • For persistent oozing of blood, can apply a moistened tea bag for 10 minutes. (Reason: tannic acid released from the tea bag may stop the oozing).
  4. Local Cold:  Put a piece of ice or popsicle on the area that was injured for 20 minutes.
  5. Pain Medicine: If there is pain, give acetaminophen (e.g., Tylenol) or ibuprofen.
  6. 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.
  7. Expected Course: Small cuts and scrapes inside the mouth heal up in 3 or 4 days. Infections of mouth injuries are rare.
  8. 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.

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.

Last Reviewed: 11/14/2011

Last Revised: 11/14/2011

Content Set: Pediatric HouseCalls Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.

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