A Guide to Soft Tissue Trauma
When most people think about dental emergencies, they think about the usual types of incidents. So the list usually includes teeth knocked out, severe toothache, lost fillings and chipped teeth. However, most people do not realise that tissue injuries to the mouth area can also be dealt with by an emergency dentist.
Often, when you damage your teeth, there is an accompanying trauma to the face or mouth which also requires medical attention. For example, if you fall over and knock a tooth out, it is hard to imagine how you could also avoid suffering a few other cuts and bruises. Therefore, it is often natural for dentists to treat some of these additional wounds and therefore essential that they have the necessary medical skills to at least provide emergency attention, before you can visit a hospital.
What constitutes a soft tissue trauma?
Soft tissue traumas that most dentists can deal with include things like puncture wounds and lacerations to areas such as the tongue, cheeks and lips. For example, it is not unusual when someone falls over and hits their face for them to bite their tongue also.
Areas around the lips, cheeks and face can be very sensitive. They are also likely to bleed heavily if you injure them, as they enjoy a strong blood supply. This two facts normally combine to create quite a traumatic picture when there is tissue damage in this area. Even if the injury is not as bad as it looks (and in many cases it is not), it can bleed heavily and leave the patient disorientated, worried and concerned.
Of course, not every injury can be dismissed for being worse than it looks. We’ve all bitten down on our tongue at some point while eating, so we all know how painful this can be. This is because many areas of our mouths have a lot of nerve endings, as well as a lot of blood vessels, so they are very sensitive. Therefore, while this type of injury can be bloody and yet not as bad as feared, they can also be bloody and much worse than feared.
This is one of the major reasons why emergency dental treatment is recommended in the cases of soft tissue trauma. If the patient is disorientated and bleeding, it is often difficult to ascertain just how bad the injury is. Therefore, professional expertise should be called upon as soon as possible. Similarly, an injury to the face, mouth or jaw may include damage to the teeth, even if it is not visible damage. If this is the case, then an emergency dentist will be able to identify the hidden issues and deliver the appropriate treatment.
What can you do to stem the blood flow?
If you (or someone you are with) suffers from a soft tissue trauma, the first challenge will usually be to stem the bleeding. First, dentists recommend rinsing your mouth with warm water to clean any debris and excess blood away from the wound. If possible, you should then use a piece of gauze or a cotton wool pad to apply pressure to the wound. Hopefully, after around 10 minutes the blood flow will have been reduced, if not stopped. Alternatively, you could try applying ice to the wound for a few minutes.
One of the difficulties with mouth wounds is that they are often difficult to reach properly. This is why it helps if you can contact an emergency dentist. They are used to working within tight spaces to clean and suture wounds.
What can your dentist do?
If your injury is bleeding heavily, you should try to reach an emergency dentist as soon as possible. You could also try visiting your local hospital Accident & Emergency, as they will often have oral surgeons on duty who can look at the more serious cases of injury.
In the majority of cases, however, your dentist will be able to ensure that you receive adequate medical attention. Usually, you will receive a full evaluation that begins with x-rays. These x-rays are taken to determine what level of injury you have sustained and whether there may be any deeper, underlying issues behind the soft tissue trauma. These could include issues such as head injury, concussion or jaw injuries, which could all cause complications and require more treatment in the future if they go undetected.
Your dentist will be able to clean the wound and suture the cut if it is big enough. The sutures used will probably be dissolvable, so once the cut has healed you will not need to return to have them taken out. However, your dentist may well wish to schedule you in for further appointments in the future, to evaluate your condition and to check on the health of your teeth.
In some cases, your dentist will need to refer you to different specialists for further work. Injuries to the face and mouth, unfortunately, can be very visible and people who suffer from serious injury can feel highly self-conscious. Therefore, you may require further cosmetic surgery to minimise scarring. Alternatively, you may need to visit an oral and maxillofacial surgeon to correct underlying issues to do with the jaw or bite, for example.
What about burns?
As during those times when we bite our own tongues, we’ve all accidentally burnt our lips or mouth on some hot food or drink. So we all know how painful it can be. When a mouth burn is serious, therefore, it can be very painful and it requires immediate attention.
Your dentist will be able to evaluate the extent of the burns and the appropriate course of action. In many cases, the primary issue is not the burn but the after effects. When an area inside the mouth is burnt, it often blisters because the area is so sensitive. The fact that patients have to carry on eating and drinking (it is something we have to do to stay alive!) means that the blisters and burn area are often further aggravated so that they have difficulty healing quickly and effectively.
If this is the case, your dentist will probably ask you to return for regular appointments so that the affected area can be checked to see whether it is healing properly. If the area does not heal properly, there is a danger of an infection forming which can spread. Your dentist may refer you to your local GP for ongoing treatment.
Is there anything else to think about?
Often, dental tissue trauma can be a tricky subject. The reason for this is that it is often part of a multiple set of injuries. For example, tissue trauma in the mouth may be accompanied by injuries to the face, neck or shoulders. The patient may have an avulsed or partially dislodged tooth. Alternatively, there may even be internal injuries that you are not currently aware of. These sorts of situations require careful as to how to proceed.
One type of injury which is common when you sustain damage to the mouth or face is a concussion. Many people sustain concussions in all different types of ways, from accidents at home through to sporting injuries on the field of play. Concussions can range from being very mild through to serious conditions that can threaten the health of the brain. Therefore, it is often helpful if the condition is understood so that it can be treated immediately. Usually, if a trauma to the head shows signs of a serious concussion, it will require a doctor to look at the patient immediately – regardless of other dental injuries.
As we mentioned, many concussions are only mild and the treatment for them is easily prescribed: a couple of days of rest. But how do you establish whether a concussion is mild or serious. In many cases, the symptoms are fairly similar. However, in more serious cases, there can be a blood clot building on the brain which can ultimately be life-threatening.
Essentially, a concussion is a bruise on your brain. As with other parts of your body, a bruise can be sore but not a long-term medical problem. However, on occasions, the bruise on your brain can lead to sustained bleeding and swelling. This issue does not necessarily relate to the severity of the bump on the head. Sometimes, even a relatively minor accident can lead to brain damage without the proper care and treatment.
The most important aspect of concussion injuries is to monitor the patient carefully. Rest is important. However, you should make sure that the patient does not fall unconscious, as this may be an indication of a more serious injury on the brain. Similarly, it is also important to remember that the effects of a concussion sometimes only register after a period of time after the accident. If the patient has heavily dilated pupils or they become incapable of walking, this can be an indication that the bleeding on their brain has continued.
These are the primary indications to watch out for with a concussion and they should encourage you to seek immediate medical assistance. In fact, with any type of concussion, it is important to get expert medical advice even if it is after the event and the patient feels better. This can help to avert any longer-term medical issues that may result.