Mouth and Dental Injuries

Topic Overview

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.

An injury could crack, chip, or break a tooth, or make a tooth change color. A tooth also may be loose or moved in position (dental luxation) or jammed into the gum (intruded).

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.

Use the Check Your Symptoms section to decide if and when you should see a doctor.

Check Your Symptoms

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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 Smoking.
• 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:

Acetaminophen, such as Tylenol Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, such as Advil or Motrin Naproxen, such as Aleve or Naprosyn 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. Do not give aspirin to anyone younger than age 20 unless your doctor tells 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:

• New symptoms develop.
• Signs of infection develop.
• Home treatment is not helping relieve discomfort.
• Symptoms become more frequent or severe.

Prevention

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.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your health professional diagnose and treat your condition by being ready to answer the following questions:

• How and when did the injury happen?
• Have you had a mouth or dental injury in the past? How was it treated? Do you have any problems now that were caused by the injury?
• What mouth or dental appliances do you wear?
• What first aid or home treatment measures have you tried? Did they help?
• What nonprescription medicines have you tried. Did they help?
• What makes the symptoms better or worse?
• What is your routine for taking care of your teeth and gums?
• Have you had regular dental care? When did you last see your dentist?
• Were alcohol or illegal drugs involved with your injury?
• Do you have any health risks?

Related Information

• Body Piercing Problems
• Burns
• Facial Problems, Noninjury
• Mouth Problems, Noninjury

Credits

Author	Susan Van Houten, RN, BSN, MBA
Editor	Alison Allen
Editor	Sydney Youngerman-Cole, RN, BSN, RNC
Associate Editor	Tracy Landauer
Primary Medical Reviewer	William M. Green, MD - Emergency Medicine
Primary Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	Steven K. Patterson, BSc, DDS, MPH - Dentist
Specialist Medical Reviewer	William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Last Updated	September 26, 2008