Open Wound of the Mouth

First aid for a cut inside the mouth

1. Wash your hands and have the person sit up and lean forward so blood drains out rather than down the throat.
2. Rinse gently with cool water to see where the bleeding comes from.
3. Press firmly with clean gauze or a cloth directly on the wound. For the tongue, pinch the cut between gauze held by thumb and finger. Hold for 10 to 15 minutes without letting go to check.
4. Cool it: after bleeding stops, a cold compress on the outside of the face or an ice pop can reduce swelling.
5. Check the teeth for chips, looseness or a tooth missing. A knocked-out adult tooth should be rinsed briefly by the crown, put back in the socket or kept in milk, and taken to a dentist within 30 to 60 minutes.

Do not use aspirin for pain after a mouth injury because it increases bleeding, and never give aspirin to children or teenagers.

Types of mouth wounds

When a mouth cut needs stitches

The mouth heals remarkably well, and many cuts are left to heal on their own. A clinician is more likely to stitch a wound that:

• gapes open at rest or catches food
• is longer than about 1 to 2 cm or deep into muscle
• splits the edge or tip of the tongue, or forms a flap
• goes right through the cheek or lip
• keeps bleeding despite pressure

Absorbable stitches are used inside the mouth and dissolve in 1 to 2 weeks. Young children may need sedation for tongue repairs.

How a doctor assesses the wound

The doctor or dentist will look for foreign bodies, tooth fragments, damage to the salivary ducts in the cheek, nerve injury, and jaw fractures. They may order a dental or facial X-ray if teeth are broken or a fragment may be in the lip or tongue. Children with impaling injuries to the back of the throat may need a CT scan to check the large blood vessels of the neck. Tetanus status is checked. See dental trauma for injuries involving teeth.

Home care while it heals

• Rinse with salt water (half a teaspoon of salt in a cup of warm water) after meals and at bedtime, starting the day after the injury.
• Eat soft, cool foods for a few days. Avoid spicy, acidic, salty, crunchy or very hot foods that sting.
• Keep brushing your teeth gently, avoiding the wound.
• Pain relief: acetaminophen (paracetamol) or ibuprofen following the label dose. Topical numbing gels for adults can help before meals. Avoid benzocaine gels in children under 2.
• Do not smoke or vape, which slows healing.
• Children should avoid sucking on the area or playing with it with their tongue.

Normal healing vs infection

A healing mouth wound normally turns white or yellowish within a day or two. This is a layer of healing tissue (fibrin), not pus, and it can look alarming. Swelling peaks around day 2 and then settles.

Signs of infection, which is uncommon, include:

• pain and swelling increasing after day 3
• fever
• pus, a foul taste or smell
• red, hot swelling spreading to the face or under the jaw

Infection is treated with antibiotics. Spreading swelling under the tongue or jaw is urgent because it can affect breathing. See cellulitis or abscess of the mouth.

How long a mouth wound takes to heal

• Small bites and scrapes: 3 to 7 days
• Tongue cuts: often within a week, even when deep
• Larger or stitched wounds: 1 to 3 weeks
• Wounds that leave a sore that has not healed after 2 to 3 weeks should be checked, as a persistent mouth ulcer has other possible causes

Preventing mouth injuries

• Use a mouthguard for contact sports, hockey, skateboarding and martial arts.
• Do not let children run or walk with sticks, pencils, toothbrushes or lollipops in their mouths.
• Use car seats and seat belts.
• See a dentist about sharp or broken teeth or rubbing braces that cause repeated cheek bites.

Frequently asked questions

Does a cut in the mouth need stitches?

Most do not. The mouth heals quickly, and small cuts close on their own. A cut that gapes, is longer than about 1 to 2 cm, splits the tongue edge, goes through the cheek or lip, or keeps bleeding after 15 minutes of pressure should be seen for possible stitches.

How long does a cut inside the mouth take to heal?

Small cuts usually heal in 3 to 7 days. Deeper wounds or those that needed stitches take 1 to 3 weeks. A sore that has not healed after 2 to 3 weeks should be examined by a dentist or doctor.

Why is my mouth cut white?

A white or yellow coating on a healing mouth wound is normal. It is a layer of fibrin and new tissue, not pus. Infection is suggested by increasing pain after a few days, swelling, fever, foul taste or discharge.

How do I stop a cut tongue from bleeding?

Sit up and lean forward, then squeeze the cut firmly between gauze or a clean cloth held between your thumb and fingers for 10 to 15 minutes without checking. Sucking on ice afterward helps. Get emergency care if bleeding continues beyond 20 minutes.

Is a torn frenulum serious?

In toddlers who fall, a torn frenulum under the upper lip bleeds a lot but usually heals without treatment within a week or two. It needs a dental check if teeth are involved. In babies who are not yet mobile, it can be a sign of abuse and should be assessed by a doctor.