Lacerations and Soft Tissue Injuries

The soft tissues are often involved during traumatic injuries to the orofacial area and maybe bruised or lacerated by the impact of teeth against the tissue.  Usually application of pressure with gauze to the injured site should provide adequate hemostasis.  If hemostasis cannot be obtained or the laceration is so severe that the edges are not well opposed, sutures are recommended.

	Lips often cushion the teeth during a fall, bearing the brunt of the injury and resulting in bruises and lacerations.  If a laceration is present it should be carefully examined to determine whether a foreign object such as a tooth fragment or gravel has been introduced into the wound.
	The maxillary labial frena may tear as a result of a fall.  This type of injury is common during falls experienced while learning to walk.  However, such an injury occurring in infants who do not walk or crawl is probably due to an object being forced into the child’s mouth and should be investigated as a result of child abuse.
	Trauma to the tongue can result in laceration or puncture.  Careful examination of the injury is important since the necessity for suturing is dependant on the extent of injury.
	Impalement of the soft palate is commonly found in the child who falls while hold an object in the mouth – a stick, pencil or pen, straw or toothbrush.  Most impalement injuries heal spontaneously and do not require treatment, however the area should be thoroughly explored for foreign body objects and a prophylactic antibiotic should be prescribed to avoid infection complications.