Intra-oral lacerations represent a small percentage of lacerations, but the repair of them has some important differences relative to lacerations of the skin. Once serious airway compromise is excluded, careful assessment of concurrent oral injuries is necessary. Oral lacerations commonly occur from the impact of teeth on oral mucosa secondary to motor vehicle accidents, contact sports, industrial accidents, and personal violence; fortunately, lacerations that do not gape open often heal well without intervention. Larger, gaping oral lacerations benefit from wound closure to reduce infection and bleeding complications. Most lacerations can be repaired by the emergency clinician; however, there are rare circumstances where specialist referral may be necessary.
Minor wound management, methods of suture placement, repair of adjacent anatomic sites, and evaluation of dental or oropharyngeal trauma are discussed in detail separately:
Intra-oral lacerations often heal faster than wounds elsewhere in the body due to the extensive vascular supply in this area. Dental avulsion and luxation injuries associated with oral lacerations should be addressed immediately and prior to wound closure so that, if needed, reimplantation is performed as soon as possible and access to injured teeth is not compromised. Delay in reimplantation can decrease chances of tooth survival. Dental fractures can be repaired hours after injury, and oral lacerations should be addressed first. (See "Evaluation and management of dental injuries in children" and "Jaw fractures in children", section on 'Clinical evaluation' and "Facial trauma in adults", section on 'Temporomandibular joint'.)
Important anatomic considerations when repairing oral lacerations include: