Mouth
injuries are common, especially in children, and may involve the teeth, jaw,
lips, tongue, inner cheeks, gums, roof of the mouth (hard or soft palates),
neck, or
tonsils. Sometimes mouth injuries look worse than they
are. Even a small cut or puncture inside the mouth may bleed a lot because
there are many blood vessels in the head and neck area. Home treatment of minor
mouth injuries can help stop bleeding, reduce pain, help healing, and prevent
infection.
Teeth may be injured during a fall or a sport
activity. A tooth may be knocked out (avulsed). You may be able to replace a
permanent tooth in its socket (reimplant) if it has been knocked out or torn
away from the socket. Immediate
first aid and dental care are needed when a permanent
tooth has been knocked out.
Other
dental injuries may be caused by
grinding your teeth, especially at night. Your teeth
may hurt, chip, or become loose. Biting surfaces may become flat and worn down.
A broken or loose dental appliance or an orthodontic
wire or bracket may poke or rub the inside of your mouth and make your mouth
sore.
An injury to your mouth or lips may cause a large, loose
flap of tissue or a gaping wound that may
need stitches. A smaller wound on the lip may be
stitched for cosmetic reasons. If an object, such as a piece of broken tooth or
an orthodontic wire, gets stuck in a wound, you may need to have it removed by
a health professional.
The piece of skin between your lips and
gums or under your tongue (frenulum) may tear or rip. Usually this type of injury
will heal without stitches. It is generally not a concern unless the tear was
caused by physical or sexual
abuse.
An injury to the roof of your
mouth, the back of your throat, or a tonsil can injure deeper tissues in your
head or neck. These injuries can happen when a child falls with a pointed
object, such as a pencil or Popsicle stick, in his or her mouth.
Review the Emergencies and Check Your Symptoms sections to determine if
and when you need to see a health professional.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
If you have any of the following
symptoms, evaluate those symptoms first.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Immediate
first aid and dental care are needed. If you are
unsure whether the tooth was a baby (primary) tooth or a permanent tooth,
answer 'yes' to the question.
Call your health professional immediately if you answer "Yes" to
the following question.
Has a
permanent tooth been completely knocked out?
Note: If you are not able to contact your dentist, go to the
nearest hospital emergency room immediately. A permanent tooth may be put back
in the socket (reimplanted) if it is knocked out or torn away from its socket.
The best results occur if your tooth is put back in its socket by a dentist
within 30 minutes. For information on how to transport the tooth, see
first aid for a tooth that has been knocked out.
Call your health professional today if you answer "Yes" to
the following question.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Deep cuts are likely to need stitches and should
generally be stitched within 6 to 8 hours after the injury to reduce the risk
of infection. This risk increases the longer the cut remains untreated. Some
cuts may be able to be stitched up to 24 hours later.
Call your health professional immediately if you answer "Yes" to
any of the following questions.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Suspect an object is in a wound if you are
unable to find all the pieces of a broken tooth or broken dental appliance.
Your dentist may have to
X-ray your mouth to see whether an object is in the
wound.
Call your health professional immediately if you answer "Yes" to
the following question.
Were you cut by something dirty and your last tetanus shot was longer
than 5 years ago?
Note:
Something is dirty if it has dirt, soil, spit, or
feces on it. Examples include a garden tool, a dirty nail, or a piece of glass
that has been buried in the dirt.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Be sure to answer the other questions in the Check
Your Symptoms section to determine if grinding your teeth has caused an injury
that needs treatment sooner than 1 to 2 weeks.
You need an appointment within the next 1 to 2 weeks if you answer "Yes" to
any of the following questions.
If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.
Review
health risks that may increase the seriousness of your
symptoms.
If you have any of the following
symptoms, evaluate those symptoms first.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Immediate
first aid and dental care are needed. If you are
unsure whether the tooth was a baby (primary) tooth or a permanent tooth,
answer 'yes' to the question.
Call your health professional immediately if you answer "Yes" to
the following question.
Has a
permanent tooth been completely knocked out?
Note: If you are not able to contact your dentist, go to the
nearest hospital emergency room immediately. A permanent tooth may be put back
in the socket (reimplanted) if it is knocked out or torn away from its socket.
The best results occur if your tooth is put back in its socket by a dentist
within 30 minutes. For information on how to transport the tooth, see
first aid for a tooth that has been knocked out.
Call your health professional today if you answer "Yes" to
the following question.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Deep cuts are likely to need stitches and should
generally be stitched within 6 to 8 hours after the injury to reduce the risk
of infection. This risk increases the longer the cut remains untreated. Some
cuts may be able to be stitched up to 24 hours later.
Call your health professional immediately if you answer "Yes" to
any of the following questions.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Suspect an object is in a wound if you are
unable to find all the pieces of a broken tooth or broken dental appliance.
Your dentist may have to
X-ray your mouth to see whether an object is in the
wound.
Call your health professional immediately if you answer "Yes" to
the following question.
Were you cut by something dirty and your last tetanus shot was longer
than 5 years ago?
Note:
Something is dirty if it has dirt, soil, spit, or
feces on it. Examples include a garden tool, a dirty nail, or a piece of glass
that has been buried in the dirt.
Review
health risks that may increase the seriousness of your
symptoms.
Note:
Be sure to answer the other questions in the Check
Your Symptoms section to determine if grinding your teeth has caused an injury
that needs treatment sooner than 1 to 2 weeks.
You need an appointment within the next 1 to 2 weeks if you answer "Yes" to
any of the following questions.
If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.
Home Treatment
First aid steps
If you need to see a health
professional for your injury, call to arrange for your care and follow these
steps for:
A tooth that has been completely knocked out. A permanent tooth can sometimes be put back into its socket
(reimplanted). The best results occur if a dentist puts the tooth back in the
socket within 30 minutes. Chances of successful reimplantation are unlikely
after 2 hours.
Bleeding in the mouth. Return any skin
flap to its normal position. If necessary, hold the flap in place with a clean
cloth or gauze.
A tongue or piece of tongue that has been cut off. Wrap the piece of tongue in a clean cloth or sterile gauze, if
available. Put the wrapped piece of tongue in a bag of ice to keep it cool. Do
not put the tongue directly on the ice. Do not immerse the tongue in ice water.
Go to the emergency room right away. Take the bag with you.
A broken tooth or dental appliance. Find any pieces of tooth or the broken dental
appliance and take them with you when you go to see your dentist. Your dentist
will want to check for missing pieces of tooth or dental appliance that may
have been left in a wound, swallowed, or inhaled into the lungs
(aspirated).
To reduce pain and promote healing
Apply a
cold compress to the injured area, or suck on a piece of ice or a Popsicle as
often as desired.
Rinse your wound with warm salt water immediately
after meals. Saltwater rinses may promote healing. To make a saltwater solution
for rinsing the mouth, mix
1 tsp (5 g) of salt to
1 cup (250 mL) of warm
water.
Eat soft foods that are easy to swallow. Soft foods include:
Milk and dairy products, such as milk
shakes, yogurt, custards, ice cream, sherbets, or cottage
cheese.
Meat and meat substitutes, such as tender meats or chicken,
tuna, eggs, or smooth peanut butter.
Fruits and vegetables, such as
well-cooked or canned fruits and vegetables; well-ripened, easy-to-chew fruits;
and baked, mashed, or well-cooked sweet potatoes.
Avoid foods that might sting, such as salty or
spicy foods, citrus fruits or juices, and tomatoes.
Do not smoke or
use other tobacco products. For more information, see the topic
Quitting Tobacco Use.
Do not drink
alcohol.
If a jagged tooth or orthodontic wire or bracket is poking
you, roll a piece of melted candle wax or orthodontic wax and press it onto the
part that is poking you. Use a pencil eraser to press a broken wire toward your
teeth. These are only temporary measures to use until you can see your dentist
or orthodontist to fix the problem.
Try a topical medicine, such
as Orabase or Ulcerease, to reduce mouth pain.
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your pain:
Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
Safety tips
Be sure to follow
these safety tips when you use a nonprescription medicine:
Carefully read and follow all
directions on the medicine bottle and box.
Do not take more than
the recommended dose.
Do not take a medicine if you have had an
allergic reaction to it in the past.
If
you have been told to avoid a medicine, call your doctor before you take
it.
If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
To protect a slightly loose tooth:
Teeth that are slightly loose but still in their normal position should tighten
up in 1 to 2 weeks.
Eat a diet of soft foods for 1 to 2 weeks.
Be gentle when you brush or floss.
Wear a mouth guard
or face protection if you participate in sporting activities.
To remove objects or food stuck between teeth
Use dental floss to remove objects or
food stuck between your teeth. Guide the floss carefully between your teeth and
avoid "snapping" the floss, which can cut your gums.
Do not use
anything sharp to remove an object that is stuck between your teeth or under
your gums.
To remove a very loose baby tooth in a child
First, tilt your child's head forward and down
so that when the tooth comes out, it doesn't fall to the back of the throat,
causing your child to choke or swallow the tooth.
Grasp the tooth
with gauze or a washcloth, and pull firmly with a twisting motion.
Symptoms to Watch For During Home Treatment
Use the Check Your Symptoms section to
evaluate your symptoms if any of the following occur during home
treatment:
Many mouth and dental injuries can be
prevented by taking the following steps.
Have regular dental checkups. If your gums and
teeth are healthy, you are more likely to recover from an injury quickly and
completely. For more information, see the topic Basic Dental
Care.
Use a seat belt to prevent or reduce injuries to the mouth
during a motor vehicle accident. Always place your child in a
child car seat to prevent injuries.
Wear a
mouth guard while participating in sports. A mouth
protector can be made by a dentist or purchased at a store that sells athletic
supplies.
Wear a helmet and face guard in sports during which a
face, mouth, or head injury could occur.
If you wear an
orthodontic appliance, such as a retainer or headgear, follow your
orthodontist's instructions about proper wear and care of it. Learn as much
about your orthodontic appliance as you can.
Remove headgear and wear a protective mouth
guard when playing sports.
Remove headgear before engaging in rough
play.
Do not eat foods that are hard, chewy, crunchy, or
sticky.
Do not pick at or pull on your braces.
Use
orthodontic wax to protect the inside of your mouth from poking
wires.
Store the appliance in the case provided by your
orthodontist.
If you
grind your teeth, ask your dentist whether he or she
recommends a mouth guard.
If you have
seizures or other medical problems that may increase
your risk of falls, ask your health professional if and when he or she
recommends that you use a helmet and face guard to protect your head and mouth.
Additional steps to prevent mouth and dental injuries in
children include the following:
Don't allow your child to walk or run with
objects in his or her mouth.
Be gentle when placing a bottle or
spoon in a baby's or child's mouth. An object that is jammed into the mouth can
tear the skin between the lips and gums or under the tongue
(frenulum).
If your child has protruding teeth, have them examined
by a dentist. Protruding teeth are more likely to be injured.
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