Mouth Injury

Is this your child’s symptom?

• 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. Puncture wounds here can cause a deep space infection in the neck.

When to Call for Mouth Injury

Call 911 Now

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

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
• 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

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

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  Virtual Urgent Care
  
  
  

Care Advice for Minor Mouth Injuries

1. 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.
2. 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.
3. 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).
4. 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.
5. 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.
6. 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.
7. What to Expect:
   • 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
   • 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

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 07/03/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

How to heal a deep cut inside the lower lip: First aid and aftercare

A deep cut inside the lower lip may bleed a lot, which can make it difficult to tell whether stitches are necessary. Often, a person can take care of oral injuries at home with first aid.

Cuts inside the mouth heal faster than cuts elsewhere. They can still become infected, though, so getting the right medical care is important.

In this article, we look at the symptoms of a deep cut inside the lip, how to perform first aid, and when to see a doctor.

Cuts inside the lips typically bleed a lot and cause pain. Because of the blood, it can be hard to see how deep a cut is.

Shallow cuts usually heal on their own without stitches, while deep cuts may require medical attention.

Stitches may be necessary if the wound:

• is longer than half an inch
• has ragged or separated edges
• bleeds a lot for more than 5–10 minutes

If there is so much blood that seeing the wound is not possible, apply pressure with a cloth, keep it held down, and seek medical attention.

Also, seek medical attention if the cut:

• looks dirty
• was caused by an animal bite
• was caused by a puncture with a dirty object
• is extremely painful
• could have damaged other parts of the mouth or face

If a cut is not new but has any of the characteristics above, contact a doctor as soon as possible.

Cuts in the mouth can become infected, and symptoms include:

• swelling
• pus
• a fever

A doctor may treat the infection with antibiotics.

Whether a person is waiting for medical treatment or caring for an oral injury at home, first aid can help stem the flow of blood and reduce the risk of infection.

To perform first aid on a deep cut in the mouth:

1. Wash the hands thoroughly.
2. Apply pressure with a clean cloth or bandage for several minutes.
3. Once the bleeding slows or stops, rinse the mouth with cool water to remove any particles from the wound.
4. Try sucking on an ice cube to limit further bleeding and swelling.

If the bleeding does not slow or stop after 5–10 minutes, the person may need professional care.

How doctors treat a deep cut inside the lip will depend on the location and severity of the wound. But they usually begin by cleaning the wound with sterile water or saline and assessing the injury.

Depending on the cause of the cut, the doctor may:

• Administer a local anesthetic so that they can inspect the wound more closely without causing pain.
• Order medical imaging tests to look for foreign objects that may be stuck in the wound.
• Prescribe antibiotics if there is a possibility of infection.
• Order a tetanus shot for a puncture wound, if the person has not had a tetanus booster in the last 5 years.

The doctor may then seal the wound with stitches. They may also provide an antibiotic ointment to help the person keep the wound clean at home.

After receiving medical care, keeping the cut clean gives it the best chance of healing.

The doctor will have provided specific advice, but aftercare may involve taking oral antibiotics or applying an antibiotic product, such as an ointment, to the cut.

The person may also need pain relief medication, anti-inflammatory drugs, or both. Versions of these are available over the counter. If the cut is making eating difficult, stick to softer foods until the pain improves.

If the person has stitches, a doctor may need to remove them later on, depending on the type of thread material, or suture, involved.

Healing times can vary — but cuts inside the mouth tend to heal faster than those elsewhere. A 2018 study found that saliva helps with healing because it contains proteins that promote tissue repair.

Also, as the authors of research from 2013 explain, wounds heal quicker inside the mouth because of the humid environment. And cells in the oral cavity reproduce faster than those elsewhere, speeding up the healing process.

Complications of an injury to the inner lower lip include infection and scarring. Practicing first aid and keeping the wound clean can help prevent infection, but this remains a risk until the wound has fully healed.

It is important to follow a doctor’s guidance and to notify them if the wound seems infected or the person develops a fever.

While many injuries are unavoidable, a person can take a few steps to prevent serious cuts inside the mouth.

Stanford Children’s Health recommend:

• not walking or running with objects inside the mouth
• not biting or chewing on sharp objects, such as pencils
• wearing oral protective gear while playing sports

Also, chewing food slowly and not multitasking during mealtimes may reduce the risk of biting the inner lips or cheeks by accident.

Cuts inside the mouth can bleed a lot, but they do not always need stitches. Shallow cuts often heal on their own, and first aid at home can stem the bleeding and reduce the risk of infection.

However, if a cut is large, deep, or ragged, or if significant bleeding continues after the person has applied pressure for 5–10 minutes, swift medical care may be necessary.

A doctor can treat a deep cut inside the lip and take steps to prevent infection. If necessary, they can administer stitches.

The doctor may also prescribe antibiotics or give a tetanus shot if there is a risk of infection.

If the cut looks infected or was caused by an animal, seek professional treatment right away.

Wounds with infection (purulent): treatment, treatment, ointments

It is dangerous when even a small wound becomes infected with pathogens. Doctors call this situation wound infection . Infection of tissues can create problems not only at the site of the damage itself, but, unfortunately, have serious consequences for the entire body as a whole.

Household injuries and cuts are a high risk group for infection with pathogens ¹ . At first it may seem that a small damaged area will not cause problems. But with improper and untimely processing, conditions are created for the infection to join. Therefore, as a rule, such complications occur when the rules for caring for wounds and surgical sutures are not followed. It is important to remember that the presence of other chronic infectious processes may increase the risk of complications ¹ .

In general, doctors identify several key factors that complicate wound healing and contribute to infection ¹

• The number of copies of microbes that simultaneously entered the wound (doctors call it microbial contamination).
• Reduced protective properties of the body, for example, due to hypothermia or the presence of chronic diseases (eg diabetes, radiation sickness).
• Impaired circulation in an injured part of the body (for example, when applying a hemostatic tourniquet).
• Traumatic conditions such as traumatic shock or massive blood loss.
• Large wound, presence of remnants of foreign bodies.

Symptoms of infection in the wound

The main symptoms of infection are redness, swelling, soreness, increased temperature of the soft tissues in the area of ​​the wound and injury.

Reproduction of pathogenic bacteria in the wound forms an immediate inflammatory response. The more serious the problem, the more the body tries to protect itself from it. Therefore, the reaction can develop over a larger area than the site of the wound and damage. All this is accompanied by symptoms of general intoxication: fever, nausea, chills, weakness .

It should be remembered that the body’s acute response to a pathogen does not always proceed in the same way. Next, we single out the key dangerous microbes, in relation to which the body reacts in each case quite specifically:

Under the influence of gram-negative flora and intestinal anaerobes , an abundant purulent discharge is formed with an admixture of blood and a fetid odor, sometimes of a cloudy hue.

The first signs of purulent inflammation occur 2-3 days after surgery or injury. If the patient receives antibiotic therapy, the first symptoms may occur after 4-6 days.

Important! After getting a wound outside the home, it is better to play it safe and get a tetanus vaccine. Unfortunately, advanced form of tetanus in 40-45% of cases is associated with a lethal outcome ³ .

Further, the purulent process has several stages of progression. Over time, an abscess is formed – a purulent focus, delimited by a capsule of connective tissue. The formation of an abscess prevents the spread of infection to healthy tissues and the entry of pathogens into the bloodstream.

Phlegmon , or a diffuse purulent-inflammatory process, spreads through loose cellular spaces beyond the wound. When the pathogen enters the bloodstream, bacteremia and sepsis develop (general infectious infection of the body).

Wound infection complication if ignored

Bacteremia

Bacteremia is a condition in which bacteria enter sterile blood. The danger lies in the fact that they circulate in the bloodstream, which is a further factor in the spread of infection throughout the body. In such situations, endocarditis (inflammation of the inner lining of the heart), osteomyelitis (purulent-necrotic bone process) and other dangerous diseases that threaten the patient’s life.

Sepsis

Sepsis (translated from Greek means “putrefaction”) is a systemic inflammatory reaction in response to the penetration of microorganisms into the bloodstream. In this case, a large number of microbes enter the blood or the microbes are extremely aggressive in nature.

Systemic inflammatory response syndrome (SIRS) Confirmed by the presence of two or more signs ² :

• body temperature more than 38°C or less than 36°C
• heart rate more than 90 beats per minute
• respiratory rate more than 20 per minute or hyperventilation is present (occurs when intensive breathing and causes a decrease in carbon dioxide in the blood)
• leukocytosis (increase in the number of leukocytes) more than 12*10 ⁹ /l or leukopenia (decrease in the number of leukocytes) less than 4*10 ⁹ /l, or the presence of immature forms of leukocytes more than 10%

Diagnosis of sepsis is established by the presence of the presence of a focus of infection and two or more signs of SIRS.

Severe sepsis is diagnosed in the presence of sepsis and multiple organ failure.

Septic shock is a variant of septic reaction, which is based on serious disorders of blood circulation, metabolism and pathological changes in cells. The patient is immediately admitted to the intensive care unit!

Local complications of wound infection:

Acute

purulent edema, phlegmon

Chronic

ni, bacterial gangrene, osteomyelitis

Local complications of wound infection can occur both independently and in the result of treatment. For example, purulent flow is formed at some distance from the original source of infection due to a violation of the outflow of pus from the wound as a result of blockage of drains or “blind” suturing of the wound.

Treatment of a wound with infection

In the treatment of infected wounds, adequate debridement is performed ³ . Traditionally, antiseptic solutions are used for this purpose: methylene blue, a solution of furacilin, iodine, hydrogen peroxide. These medicines stop the growth and reproduction of bacteria ^4.5 . However, 3% hydrogen peroxide solution only temporarily reduces the number of microorganisms, and may also impede wound healing ⁶ . modern antiseptics , such as povidone-iodine ( Betadine ^® ).

Betadine® (povidone-iodine) for the treatment of wound infections

Povidone-iodine is active against gram-positive and gram-negative bacteria, protozoa, viruses, fungal infections. Experience with the use of povidone-iodine solution in surgical practice indicates a decrease in the likelihood of wound suppuration when using solution Betadine ^® before surgical treatment or suturing. The use of various dosage forms of povidone-iodine in the treatment of problematic wounds reduces the amount of purulent discharge, swelling and pain in the focus of inflammation ⁷ . In this case, the cleansing and healing of wounds occur more actively than when using other antiseptic agents ⁷ .

Instruction

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In surgery, povidone-iodine (Betadine ^® ) is used in the form of ⁹ :

• 10% solution for external use
• 10% ointments
• for use in drainage systems A 10% solution is diluted 10 to 100 times.
• vaginal suppositories (suppositories), 200 mg

Solution Betadine ^® disinfect the surgical field, treat the hands of medical personnel before surgery.

Solution and ointment Betadine ^® is used for disinfecting care and treatment of postoperative wounds and sutures.

According to studies in the treatment of infected wounds under wipes soaked in solution or ointment Betadine ^® , during the first 5-7 days the edema and the amount of purulent discharge decreased, there was a decrease in pain ⁸ .

Vaginal suppositories Betadine ^® (suppositories) is prescribed before planned operations in gynecology or after surgical treatment to prevent purulent complications.

How to treat wounds, see a short video with surgeon Fedor Yanovich Kraskovsky

Prevention of wound infections

To prevent infection of household wounds, it is necessary to treat the damaged area immediately after the injury with an aqueous solution of an antiseptic agent. Alcohol solutions can only treat the edges of the damaged area and the area around the wound.

In a planned surgical intervention, preoperative preparation is important – the elimination of foci of chronic infection in the patient’s body. Before invasive manipulations (injections and surgery), the skin of the patient and staff is carefully treated with special disinfectants.

A short course of antibiotics is prescribed to prevent suppuration after surgery. If a purulent complication still appears, timely sanitation of the focus of infection is carried out. Treatment of purulent wounds is carried out in specialized medical institutions.

Wound care

How to properly treat wounds to avoid complications in damaged skin areas.

Read more

Frequently Asked Questions

What can be used to treat a household wound?

Wash the wound immediately after injury.

The main task at this stage is to mechanically remove contamination with a large amount of liquid and reduce the “microbial number” – the number of bacteria in the wound. For this, a solution of chlorhexidine, an isotonic solution of sodium chloride 0.9%, or pure cooled boiled water is suitable. After that, it is necessary to treat the wound with a 10% solution of Betadine ^® and apply a clean bandage, with a small wound channel, you can use a medical plaster.

A 10% undiluted solution of Betadine ^® can be used to treat wounds and abrasions.

In case of large wounds and bleeding, it is recommended to seek immediate medical attention.

What is the best choice for “cauterization” of abrasions?

The majority of the first-aid kit has a “brilliant green”, a solution of fucorcin or a 5% alcohol solution of iodine. However, it is worth remembering that an alcoholic solution of iodine is not applied directly to the wound, and brilliant green and fukortsin leave a bright spot behind them. Moreover, the burning sensation caused by alcohol solutions causes discomfort when used in both children and adults.

A modern means for cauterizing abrasions is an iodine-containing aqueous solution on a polymer basis – Betadine ^® . It is devoid of the disadvantages of old-generation alcohol-containing antiseptics: it does not permanently stain the skin, does not sting when used even on fresh wounds. In addition, it has a wide spectrum of action against most infectious agents.

How can a patient reduce the risk of wound infection?

In case of domestic injuries, it is necessary to properly treat the damaged area of ​​the skin.

During surgical procedures, strictly follow the doctor’s recommendations for the treatment and care of the wound.

If you experience throbbing pain, increased swelling in the area of ​​manipulation or fever in the area of ​​the wound and fever – consult a doctor.

Moshkova Elena Mikhailovna

Dermatovenereologist, Head of the CDO for the provision of paid services, St. Petersburg State Budgetary Institution of Healthcare “City Dermatovenerological Dispensary”, St. Petersburg

Read on the topic

Ointment for wound healing

What are the types of healing ointments and how to choose the most effective one.

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Wound care

How to properly treat wounds to avoid complications in damaged skin areas.

More

Povidone iodine

Characteristics and properties of povidone iodine. What is povidone-iodine used for? Instructions for use of the solution, ointment, suppositories Betadine ^® with povidone-iodine.

Read more

References

1. Piksin I.N., Pigachev A.V., Kistkin A.I., Ippolitov I.Yu. Wounds and wound infection”// Textbook// Saransk 2012.
2. Rudnov V.A. Clinical guidelines for the diagnosis and treatment of severe sepsis and septic shock in medical institutions of St. Petersburg// Bulletin of anesthesiology and resuscitation 2016;13(5):88-94.
3. Klyuchevsky V.V. Injury surgery//Guide for paramedics, surgeons, traumatologists// JSC Rybinsk Printing House 2004, Yaroslavl.
4. Instructions for medical use methylene blue, radar.
5. Instructions for medical use of furatsilin, RLS.
6. Instructions for medical use hydrogen peroxide, radar.
7. Kudykin M.N. Povidone-iodine as the basis for the treatment of infected wounds// BC, No. 34 dated 12/18/2013.
8. Mikhalsky V. V., Bogdanov A. E., Zhilina S. V., Prvidentsev A. I., Anikin A. I., Ulyanina A. A. Use of the drug Betadine in the treatment of infected wounds / / Breast cancer No. 29 dated 12/23/2010.
9. Instructions for medical use LP Betadine ^® (solution, ointment, suppository) RU P N015282/03, RU P N015282/02, RU P N015282/01.
10. BC No. 25 dated 12/15/2005 “Is it worth it to actively use a 3% hydrogen peroxide solution during surgical interventions?” N. Troshin.

THERE ARE CONTRAINDICATIONS. SEEK A PROFESSIONAL TO CONSULT

Skin:

• Apply a thin layer to the affected skin area

Instruction

Skin:

• Undiluted
• As a compress

spoons

Manual

How to clean a cat’s wound ?

1. Cat Wound Treatment
2. Cat Superficial Wound Treatment
3. How to Treat Deep Cat Wounds?
4. Treatment of purulent wounds
5. Care and feeding patterns for cats with wounds

Cat Wound Treatment

Wounds in pets are a fairly common occurrence that every cat owner has to deal with. Such damage occurs as a result of the pet’s sloppy behavior in everyday life, fights with their neighbor relatives or representatives of the canine family. Naturally, a lot depends on the origin of the wound: its size, the nature of the damage to the skin, depth, and the possibility of infection. It is on these factors that the choice of tactics for treating wound surfaces will depend, which will alleviate the suffering of the animal, prevent the development of purulent formations and accelerate the healing of damaged tissues.

Treatment of superficial wounds in a cat

Most often in everyday life, for one reason or another, cats receive shallow skin wounds, which their owners can easily manage on their own at home. First of all, an animal that has been injured should be calmed by picking it up and making it feel completely safe. Only after this is it possible to further treat the wound in a cat.

So, how can you treat a cat’s wound? This question worries many pet owners, especially if they are faced with a similar problem for the first time. Treatment of superficial skin lesions in cats should begin with a thorough washing of the wound surface with disinfectants or bactericidal agents. This is necessary to prevent the development of an inflammatory process in the wound with its subsequent suppuration. For reliable disinfection, it is better to use a hydrogen peroxide solution or chlorhexidine solution, which are usually present in any home first aid kit.

When deciding how to treat a cat’s wound at home, one should remember about Levomekol ointment. This external agent has not only an excellent bactericidal effect, but also has an analgesic effect, and also helps to accelerate the regenerative processes of the skin and its rapid healing. It is important to remember that before treating wounds in pets, it is necessary to remove all hair from the skin surfaces in the area of ​​damage, and after applying disinfectants, carefully apply a gauze bandage or bandage the wound if it is on the paw.

How to treat deep wounds in a cat?

Deep and open wounds in cats should be treated by a veterinarian. As a rule, such a laceration in a cat occurs as a result of his skirmish with dogs, therefore, it often needs to be surgically sutured in a veterinary office or clinic. Naturally, before visiting a specialist, the damaged surface should be treated with an antiseptic to avoid infection of soft tissues. After surgical suturing of the edges of the wound, the specialist without fail prescribes outpatient treatment to the animal using external agents that promote the healing of damaged skin and prevent the penetration of infectious agents into its deep layers.

Treatment of purulent wounds

Treatment of purulent wounds in cats is a complex and time-consuming process that pursues several goals at once: elimination of the focus of inflammation, preventing the spread of infection to neighboring tissues or its entry into the blood, as well as high-quality care for a pet, which will allow him to cope with the disease faster. It is better to entrust the entire process of treating an infected wound in an animal to an experienced veterinarian, who, before treating a purulent wound in a cat, will assess the extent of the spread of inflammation and make the only right decision regarding further tactics and the choice of therapy.

As a rule, in case of suppuration of wounds in cats, a specialist prescribes injectable antibiotics of general action to the animal. Additionally, the wound surface must be treated with an antiseptic solution several times a day, followed by application of ointments to the surface of the wound, drawing out pus and promoting healing of damaged skin surfaces. In some cases, when the infection cannot be stopped by conservative methods, the animal owner is offered surgical excision of the infected tissues or amputation of the pet’s limb damaged by the pathological process.

Care and feeding habits for cats with wounds

A cat that has been diagnosed with a wound should be kept calm until all injuries are completely healed. Such a pet is not recommended to be let out on the street, and it is also necessary to protect it as much as possible from contact with other animals. An important place in the process of rehabilitation of a cat with a wound is feeding. It should be balanced and aimed at fighting infection:

• foods with an irritating effect should be removed from the cat’s diet: smoked meats, sausages, sweets;
• it is necessary to increase the amount of vegetables, which contain vitamins and microelements necessary for stimulating the immune system;
• , you can additionally give a sick cat synthetic vitamin complexes prescribed by a veterinarian.

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