Intra-oral lacerations form a small percentage of lacerations. However, in comparison to skin laceration repair, the repair of intra-oral lacerations has some significant differences.

After ensuring that the patient does not have any serious airway damage, the surgeon will evaluate the concurrent oral injuries. The cause of intra oral lacerations is typically the impact of the teeth on oral mucosa because of accidents, car crashes, contact sports, personal violence, and industrial accidents.

In general, lacerations that do not open up usually heal properly without medical intervention. However, lacerations that are gaping require wound closure to minimize the chances of infection and complications due to bleeding.

Judicious surgeon Dr. Landon D. McLain provides treatments for intra oral lacerations to patients in Huntsville, Madison, Florence, Decatur, Scottsboro, Cullman, Athens, Alabama, and surrounding locations in magnificent Yellowhammer State.

 

Anatomical Considerations

Typically, intra-oral lacerations heal more rapidly than injuries in other parts of the body because of the substantial vascular supply in this region. Oral laceration related dental avulsion and luxation injuries should be treated right away and before sealing the wound.

This is necessary as it allows for prompt reimplantation and access to the injured teeth is not restricted. The chances of tooth survival may reduce due to delays in reimplantation. Fractures in the teeth can be repaired hours after the injury. However, oral lacerations must be treated right away.

Some significant anatomic considerations in the repair of oral lacerations are as follows:

• Uncontrolled tongue lacerations can cause substantial airway damage and hemorrhage. These should be treated as soon as possible.
• Tongue and oropharynx inflammation can lead to further airway damage hours after the injury in case the injury occurs in the veins of the tongue or floor of the mouth.
• Intraoral mucosa lacerations may be related to injuries to the parotid duct, salivary glands, teeth, submandibular duct, lips, and jaw.
• A clear fluid discharge is seen when the glandular parotid tissue is involved.

 

Wound Repair

Indications for Primary Closure

A majority of buccal mucosa and gingival lacerations are not separated widely and can heal quickly without intervention. These wounds do not require primary closure.

Primary closure or wound repair during the time of presentation is the preferable treatment after intra-oral lacerations:

• Wounds that are deep enough to entrap food particles
• Wounds that are larger than two cm in length
• Wounds with a tissue flap between the chewing (occlusal) surfaces of the teeth

 

Wound Preparation

The patient can be made comfortable with the use of local or regional anesthesia before starting irrigation and cleansing of the wound. Small children, as well as patients with wounds that are significantly contaminated, may also require procedural sedation to tolerate the wound preparation.

 

Procedure

Intraoral laceration closure techniques differ on the basis of the structures involved:

Buccal Mucosa and Gingival Lacerations

After ensuring that there is no significant injury to the facial nerve or buccal mucosa or gingiva, the substantial gaping wounds of the buccal mucosa or gingival can be sealed by the placement of deeply buried sutures in the submucosal area. If necessary, interrupted sutures on the mucosal surface may also be placed.

 

Gingival Avulsion

These wounds occur on the maxillary ridge causing a flap of tissue or the gingiva overlying the mandibular. At times, the flap may seem too small or retracted to approximate. In general, direct pressure with wet gauze can extend the tissue for reapproximation. While less common, sometimes the patient may require blunt dissection to mobilize the flap.

Accomplished surgeon Dr. Landon D. McLain receives patients from Huntsville, Madison, Florence, Decatur, Scottsboro, Cullman, Athens, Alabama, and other neighborhoods and towns in this part of the southeast for intra oral laceration treatments.

McLain Surgical Arts is a leading cosmetic surgery practice headed by Dr. Landon D. McLain MD, DMD, FACS in Huntsville, AL. Dr. McLain is a double board certified cosmetic and oral & maxillofacial surgeon, offering a variety of procedures such as dental implants, wisdom teeth extraction, breast augmentation, liposuction, rhinoplasty, tummy tuck, facelift, Botox, and laser skin resurfacing. For more information or to schedule a consultation call 256.429.3411 or click here.

Now taking patients from Huntsville, Scottsboro, Decatur, Madison, Athens, Florence, Cullman, AL and surrounding areas.