Mouth and Tongue Lacerations

What are they?

Mouth and tongue lacerations are cuts or tears that happen in a child’s mouth. They are very common and usually occur during play or a fall. Very often the injury comes from the child’s own teeth. Sometimes the injury is the result of an object in the child’s mouth (like a Popsicle stick or a pencil).

With a few exceptions, mouth and tongue lacerations are not very serious. Because of the large amount of blood vessels in the area, however, these kinds of cuts usually bleed a lot. That usually frightens both the child and the parent! The bleeding is messy and frightening, but is never dangerous. It stops fairly quickly, usually within 10 to 15 minutes. Because the mouth is moist and flexible, bleeding often starts and stops for up to 24 hours, so do not be surprised to find a little blood on your child’s pillow or bedding in the morning.

Brain injury or concussion is very rare in children with a mouth or tongue laceration, but it can occur. Injuries to the jaw are also unusual, but can happen. Very rarely a major blood vessel can be injured if there was something in your child’s mouth at the time of the accident. Tooth injuries are more common, and can cause problems later if they are not fixed. Your doctor carefully examined your child’s nervous system and mouth before sending you home, but sometimes signs of injury develop later. Follow the instructions below to be sure that you recognize any of those signs if they develop.

Most doctors prefer not to put stitches in mouth or tongue lacerations unless they are very deep, because this is uncomfortable for the child and is rarely necessary. In fact, putting sutures in this area can cause an infection. Most commonly, after a careful examination, the doctor will not do anything to the cut, which often surprises parents. These cuts heal surprisingly fast, and are often almost completely better within 48 hours. During that time, avoid sour or salty food and drinks like citrus juices. Offer your child soft foods like mashed potatoes, noodles, yogurt, pudding, or ice cream. If drinking liquids seems to hurt, you might try using a straw to get the liquid past the cut.

When doctors do put stitches in the mouth or tongue, they are almost always the kind that are absorbed and do not need to be removed. Your doctor will have given you specific instructions about that. Care for the child with stitches in his or her mouth just as you would above. If your doctor prescribed antibiotics, be sure to give them as instructed. Use the entire prescription, even if there does not seem to be any infection. Let your doctor know right away if you child gets a fever, swelling around the stitches, or pus coming from the cut.

Loose teeth are common when a child gets a mouth or tongue laceration. Your doctor checked to be sure that no teeth were in danger of coming out. Most teeth that are just loose in their socket will tighten up again within a day or two. If a tooth seems to stay loose, or if you find that a tooth was broken or seems to be pushed either in or out of the gums, call your dentist right away. An X-ray may be required to be sure the jaw or the tooth root are not injured. Many dentists will remove a child’s baby tooth if it is damaged, to prevent damage to the adult tooth underneath.

Mouth and tongue lacerations usually heal very fast and rarely get infected. If your child develops a fever or has swelling, redness, or pus in or around the cut, call your doctor right away.

Many children vomit a few times after a mouth or tongue laceration, because of the blood they have swallowed. Vomiting can also be a sign of a concussion or more serious head injury. If vomiting seems to be getting worse instead of better, or if your child develops vomiting after the first few hours, call your doctor.

Being excessively sleepy can also be a sign of a head injury. Call your doctor if your child is sleeping longer than usual or is difficult to awaken.

Children usually do not complain of mouth or tooth pain after the first day following a mouth or tongue laceration. If your child complains of pain with eating or drinking after the first 24 hours, or seems to have trouble chewing, get in touch with your doctor to be sure there’s not a hidden fracture of a tooth or jaw bone.

One of the reasons we tell children not to run with something in their mouths is because the carotid arteries, the big arteries to the brain, are very close to each side of the back of the mouth. If a child gets a deep injury to either side of the mouth very far back, the carotid artery can be bruised or damaged. This is very unusual, but can be dangerous if not treated. Some children with this kind of an injury develop "Horner’s Syndrome," a drooping of one side of the child’s face, an appearance of a bulging eye, or a small pupil on the same side of the face as the injury. Other children may complain of worsening headache, have trouble speaking or walking, or become sleepy or disoriented. If any of these things happen, please take your child directly to the emergency room.

Having an injured child at home can be tiring and frustrating. As badly as you feel for your child, you yourself may feel out of control, inadequate, or even angry – these are normal feelings. Parents often feel stressed to the breaking point, especially when there are other children or adults to take care of. One of the best things you can do for your child is to be sure you take care of yourself. If possible, try to have other adults take care of your child for an hour or two each day so you can get some rest or just some quiet time. If you get so stressed that you are worried about your child’s safety, call your local Parents’ Anonymous Hotline or visit the Parents Anonymous website to find a group near you.