Children's Hospital Colorado

Mouth Injury

Urgent or Emergency Care?

If you believe your child needs immediate attention and you have concerns for a life-threatening emergency, call 911. Not sure what counts as urgent and what's an emergency when your child is sick or injured? When it can't wait, know where to take your kids.

Help Me Decide

  • 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.

Call 911 Now

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

Go to ER Now

  • Minor bleeding (more than oozing) won't stop after 10 minutes of direct pressure
  • Injury to back of the mouth caused by long object (such as a pencil)
  • Large deep cut that will need many stitches

Call Doctor Now or Go to ER

  • Gaping cut of tongue or inside the mouth that may need stitches
  • Gaping cut of the lip that may need stitches
  • Severe pain and not improved 2 hours after taking pain medicine
  • Trouble swallowing fluids or spit
  • Can't fully open or close the mouth
  • 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

Call Doctor Within 24 Hours

  • Mouth looks infected and no fever
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Minor mouth injury

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

Care Advice for Minor Mouth Injuries

First Aid - Bleeding Mouth
  • Apply direct pressure to the entire wound with a sterile gauze dressing or a clean cloth.

Disclaimer

The information contained in these topics is not intended nor implied to 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.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

And when in doubt, call your child's doctor NOW or go to the closest emergency department.

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