• Mouth Injury

    Facial trauma can range from minor injuries (cuts and abrasions, bruises, bloody noses and knocked-out teeth) to more severe injuries, such as a fracture of one or more of the facial bones. A person with a facial injury may also have a head, neck or spinal injury, such as a concussion.

    Emergency Steps

    1

    Check the scene safety, form an initial impression, obtain consent and put on PPE, as appropriate.


    2

    Check for signs and symptoms.

    • Loose or missing teeth*
    • Blocked airway from blood or loose teeth*
    • Signs & symptoms of head, neck or spinal injury*
    • Bleeding

    *Note: Signs and symptoms with a * require immediate emergency medical treatment.


    3

    Call 9-1-1 and get equipment if the person requires immediate emergency medical treatment.


    4

    Give Care.


    General Care

    1. Make sure the person is able to breath.
    2. If head, neck, or back injury suspected, leave in position found unless you must move for safety, to perform CPR or to control bleeding.
    3. If no head, neck or back injury, place them in a seated position leaning slightly forward, or on their side in the recovery position.
    4. Have them hold a gauze pad at the bleeding site and apple direct pressure to stop bleeding.
    5. Give care for the specific injury found.
    6. Continue checking them as appropriate to determine if additional care is needed.
    7. Keep person from getting bold or overheated.
    8. Give care or shock, if necessary.
    9. Reassure person you will help and that EMS has been called (if appropriate).
    10. Watch for changes in condition, including breathing and responsiveness, and give care as appropriate and trained.

    General Care: Lip & Tongue Injuries

    1. If injury penetrates lip, place a rolled gauze pad between the lip and gum.
    2. Place another gauze pad on outer surface of the lip.
    3. If the tongue is bleeding, apply a gauze pad and direct pressure.
    4. Apply a cold pack wrapped in a dry towel to the lips or tongue to help reduce swelling and ease pain.

    General Care: Missed or Knocked Out Tooth

    1. Place a rolled gauze into the space left by the tooth to control the bleeding.
    2. Have them gently bite down to maintain pressure.
    3. Try to locate and save the tooth for the dentist/healthcare provider.
    4. If tooth is found, pick it up by the crown only, not the root.
      1. Place in balanced salt solution such as Hank’s Balanced Salt Solution (e.g., Save-A-Tooth®), or in an oral rehydration salt solution, or wrap it in cling film.
      2. If not available, place the tooth in cow’s milk or saliva, never tap water.
    5. Have them seek dental or emergency care as soon as possible for possible reimplantation.

    Mouth Injury FAQs

    What might suggest that a person has a head, neck or spinal injury?

    Signs & symptoms of a head, neck, or spinal injury include the following:

    • Significant cause of injury
    • Change in behavior, alertness or confusion
    • Head, neck, or back pain or visible injury
    • Weakness, tingling, numbness or unable to feel or move body part
    • Seizures
    • Inability to do things they used to do (e.g., walking)
    • Heavy bleeding or deformities of head, neck, or back
    • Bruising around eyes or behind ears
    • Blood or other fluid in nose or ears
    • Impaired breathing, vision, or balance
    • Nausea or vomiting
    • Damaged safety helmet
    • Signs & symptoms of shock

    If I find a tooth, but don’t have the correct solution or cling film, is there something else I can use?

    Yes, if a balanced salt solution such as Hank’s Balanced Salt Solution (e.g., Save-A-Tooth®), an oral rehydration salt solution or cling film is not available, place the tooth in cow’s milk or saliva. Never place the tooth in tap water.

    For a knocked-out tooth, how quickly must the person get emergency dental care?

    The sooner the tooth is reimplanted, the better the chance that it will survive. Ideally, reimplantation should take place within 30 minutes.

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