A tongue laceration is a cut or tear in the muscular tissue of the tongue. This injury is common, particularly among young children who accidentally bite their tongue during trauma. Even a small cut can appear alarming because the tongue has a remarkably rich and extensive blood supply, known as high vascularity. This high vascularity causes profuse bleeding but also contributes to the tissue’s rapid healing capacity.
Immediate Steps and First Aid
The first action to take after a tongue injury is to control the bleeding, which is best achieved through direct, firm pressure. Use a clean cloth or a piece of sterile gauze and press it directly onto the wound site. Maintain this consistent pressure for a full 10 to 15 minutes without lifting the material to check the wound, as interrupting the process can prevent a stable blood clot from forming.
Encourage the injured person to gently spit out any excess blood rather than swallowing it, as ingesting blood can lead to nausea or vomiting. Once the bleeding has slowed or stopped, the mouth should be rinsed with clean, cold water or a mild saline solution to clear the area of blood and debris.
To help reduce immediate swelling and pain, apply a cold element to the area. This can be done by having the person suck on ice chips, a popsicle, or crushed ice wrapped in a clean cloth. Monitor the injury for any swelling that could affect the ability to breathe, as maintaining a clear airway is the highest priority after oral trauma.
Recognizing When Professional Medical Care is Necessary
Most minor tongue lacerations heal quickly on their own without intervention due to the constant presence of saliva and the tongue’s excellent blood flow. However, certain characteristics signal the need for professional medical evaluation and likely require stitches, or sutures, for proper closure. Seek immediate care if the bleeding remains heavy and cannot be stopped after 15 minutes of continuous direct pressure.
A laceration that is long, deep, or gaps open when the tongue is at rest usually warrants repair. Wounds longer than one to two centimeters, those that pass completely through the tongue (through-and-through lacerations), or injuries involving a large, mobile flap of tissue should be assessed. Lacerations located on the highly active tip or side edges of the tongue also require evaluation.
The decision to suture is based on the need to align the muscle layers for optimal function and minimize scarring. Medical professionals typically use absorbable sutures for tongue repair, which dissolve over several weeks, eliminating the need for removal. They will also check for associated injuries, such as broken teeth or signs of more extensive head or jaw trauma.
Managing Healing and Preventing Complications
The tongue is one of the fastest-healing tissues in the body, with minor cuts often showing significant improvement within just a few days. Full healing usually occurs within seven to ten days. If the laceration was repaired with absorbable sutures, the threads themselves may take four to eight weeks to fully dissolve. Careful aftercare is necessary throughout this recovery period to prevent irritation and infection.
Dietary adjustments are important, requiring a shift to soft, bland foods that require minimal chewing for the first few days. To prevent irritation and delay, strictly avoid:
- Hot, spicy, crunchy, or highly acidic foods, such as citrus juices.
- Using straws, which can create suction that may disturb a clot or newly closed wound.
Staying well-hydrated with cool water is also beneficial.
Pain management can be accomplished using over-the-counter medications like acetaminophen or ibuprofen, following dosage instructions carefully. Aspirin should not be given to children or adolescents due to the risk of Reye’s syndrome. Maintaining excellent oral hygiene is also important, including gentle brushing of the teeth and regular rinsing with a mild saltwater solution after meals to keep the wound clean.
Signs of a possible complication should prompt a call to a healthcare provider. These signs include increased swelling, pain that worsens instead of improving, the appearance of pus or a foul discharge from the wound, or a fever. Persistent difficulty with speaking or swallowing beyond the initial days should also be evaluated to ensure the laceration is healing correctly.