What is the appropriate management for tongue lacerations?

From the Research

Tongue lacerations can often be managed conservatively, with most healing quickly due to the excellent blood supply, and the use of antibiotics is generally not necessary unless there are signs of infection. The management of tongue lacerations depends on the severity of the injury, with small lacerations (less than 1-2 cm) that are not actively bleeding and have well-approximated edges often healing without intervention 1. However, larger lacerations, those with active bleeding, or wounds with gaping edges typically require suturing, with absorbable materials like 4-0 or 5-0 chromic gut or Vicryl preferred, and simple interrupted sutures placed to approximate the wound edges. Some key points to consider in the management of tongue lacerations include:

• Local anesthesia (1-2% lidocaine with epinephrine 1:100,000) should be administered before suturing, though some practitioners may use topical anesthetics like benzocaine for minor cases.
• After treatment, patients should rinse with antiseptic mouthwash like 0.12% chlorhexidine twice daily for 5-7 days to reduce infection risk.
• A soft diet is recommended for 48-72 hours, and patients should avoid spicy, acidic, or hot foods that may irritate the wound.
• Patients should seek medical attention if they develop increasing pain, swelling, fever, or purulent discharge, which may indicate infection requiring antibiotics such as amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days. According to the most recent and highest quality study, the majority of tongue lacerations reported in the literature heal with excellent outcomes regardless of management method, and physician judgement along with patient and parental preference based on potential risks of the procedure should be used when deciding whether a tongue laceration requires primary repair 1. It's also worth noting that the use of prophylactic antibiotics for tongue lacerations is not generally recommended, unless there are signs of infection, as the risk of infection is low in otherwise healthy individuals 1, 2.