Oral & Dental Health Basics

Traumatic Injuries of the Lips and Tongue

What Is It?

Trauma to the lips, tongue and the inside of the mouth is quite common. The soft flesh of the lips and their exposed location make them particularly vulnerable to injury. With a blow to the face, the lips can be crushed against the teeth, causing bruising or lacerations. A person's own teeth can cut the inside of the lip or cause a puncture wound that penetrates the skin.

A tongue laceration often happens when a fall or blow causes someone to bite down on his or her tongue.

Any laceration inside of the mouth usually bleeds heavily because of the rich supply of blood to the area.

Symptoms

Symptoms include bruising, swelling, or cuts on the lips or tongue.

Diagnosis

Your health care professional will ask about your recent trauma and do a thorough physical exam of the area. If the lips are injured, he or she will check the teeth and bone for damage, and will check whether any pieces of chipped tooth are in the cut.

Expected Duration

The healing time for a lip or tongue laceration will depend on the severity of the cut. However, the extensive network of blood vessels in the mouth area promotes quick healing.

Prevention

Many lip and tongue injuries occur while participating in athletic or recreational activities and could be prevented through the use of a safety mouth guard. Mouth guards are made of soft plastic that is adapted to fit the shape of the upper teeth, protecting both the lips and teeth. Preformed guards are available in sporting goods stores or a dentist can create a custom-fit guard.

Routinely using seat belts and car seats can reduce the risk of trauma as a result of car accidents.

Treatment

At home, you can clean injured skin surfaces with mild soapy water and a soft clean cloth. To clean cuts inside the mouth, rinse with salt water or a hydrogen peroxide solution (one part hydrogen peroxide and one part water). Be sure not to swallow this peroxide rinse. However, do not be concerned if it foams. The peroxide is reacting to the bacteria normally found in the mouth.

If your lip is swollen or bruised, apply a cold compress. If there is bleeding, apply pressure with a clean cloth for at least five minutes. To help limit swelling, bleeding and discomfort, wrap crushed ice in clean gauze or a clean piece of cloth, and hold it inside the cheek.

Certain injuries will require medical attention from an oral or maxillofacial surgeon. It is particularly important to have an experienced surgeon stitch cuts that cross the vermilion border — the line that forms the junction between the skin and the fleshy part of the lip. Experience is required to make sure this boundary looks right as it heals because even a small irregularity will be permanently noticeable.

The doctor will first thoroughly clean the wound with lots of salt water or a hydrogen peroxide rinse to remove bacteria. Puncture wounds to the lip will then be closed from the inside out. Suturing all layers reduces the chance of scarring and helps make sure that the muscles around the lip maintain their ability to move.

Small puncture wounds in the tongue usually heal without the need for any treatment other than cleansing with antiseptic or hydrogen peroxide rinses. Although large cuts may require stitches, they tend to be hard to keep in place for any length of time because the tongue is so mobile during talking and chewing.

Because the mouth is rich with bacteria, an antibiotic often is prescribed following a lip or tongue laceration to ward off infection.

When To Call A Professional

Seek medical care if:

  • Bleeding cannot be controlled with pressure and a cold compress.
  • A laceration crosses the border between the lip and facial skin.
  • The lip is punctured.
  • An infection develops after an injury — Signs of any infection — redness, tenderness, fever and drainage of pus — usually will be evident approximately four days after the injury.

If a tooth is loose, visit your dentist.

Prognosis

The outlook is excellent. The rich blood supply in the oral cavity promotes rapid healing, often with minimal scarring.

©2002-2005 Aetna, Inc. All rights reserved.

Reviewed by the faculty of Columbia University College of Dental Medicine

5/31/2005




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