MINORS MANUAL
Oral cavity injuries affect the internal structures of the mouth, including the buccal mucosa, tongue, gums, palate, and tissues surrounding the teeth. These injuries can result from trauma, bites, sharp objects, sports accidents, or even dental procedures. Due to the rich vascularisation of the oral cavity, these wounds often bleed heavily but tend to heal quickly because of the mucosa’s high regenerative capacity.
Diagnosis
Diagnosis is made through visual inspection of the oral cavity, assessing the location, depth, and extent of the injury. It is important to determine if the wound compromises significant structures such as teeth, the tongue, the palate, or the frenulum, and to rule out the presence of foreign bodies or associated maxillary or dental fractures.
Differential Diagnosis
Pathology | Key Characteristics |
|---|---|
Simple laceration | Superficial cuts in the mucosa, without deep structure involvement |
Bite injuries | Irregular margins, higher risk of infection |
Dentoalveolar fracture | Gingival bleeding, dental mobility or instability |
Stomatitis | Inflammation and pain in the oral mucosa, no history of trauma |
Emergency Management
Haemorrhage control: Apply direct pressure with sterile gauze until bleeding stops. Use local haemostatic agents if necessary.
Irrigation and cleaning: Clean the wound with sterile saline solution to remove foreign bodies and reduce the risk of infection.
Assess depth and extent: Minor lacerations tend to heal on their own, but wounds that affect deep structures, impair speech or chewing, or show tissue separation may require suturing.
Suturing: Deep wounds or those involving the frenulum or the base of the teeth may require absorbable sutures. Smaller wounds often heal without intervention.
Antibiotic prophylaxis: Consider antibiotics for contaminated wounds or bites, especially in patients at high risk of infection.
Pain management and aftercare: Administer analgesics and recommend saline rinses to promote healing and prevent infection.
Definitive Treatment
Definitive treatment depends on the severity of the wound. Most oral injuries heal by secondary intention due to the rapid regeneration of mucosal tissue. However, extensive wounds or those compromising key structures may require surgical intervention or suturing by a maxillofacial surgeon to restore proper functionality and prevent long-term complications such as scarring or functional limitations.
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