Management of Bitten Mouth Mucosa
For bitten mouth mucosa, apply white soft paraffin ointment to the affected area immediately and then every 2-4 hours throughout the healing process to promote recovery and reduce discomfort. 1
Initial Assessment and Treatment
Immediate Management
- Apply white soft paraffin ointment (petroleum jelly) to the affected area immediately 1
- Continue application every 2-4 hours until healing occurs 1
- Clean the mouth with warm saline mouthwashes (4-6 times daily) or gently with an oral sponge 1
- Avoid alcohol-based mouth rinses as they can cause further irritation 1
Pain Management
- Use an anti-inflammatory oral rinse or spray containing benzydamine hydrochloride every 3 hours, particularly before eating 1
- For moderate pain, consider topical anesthetics:
- For systemic pain relief, use acetaminophen or ibuprofen as first-line agents 2
Prevention of Infection
Use antiseptic oral rinse twice daily to reduce bacterial colonization 1
- Options include:
- 1.5% hydrogen peroxide mouthwash (10 mL twice daily)
- 0.2% chlorhexidine digluconate mouthwash (10 mL twice daily)
- Consider diluting 0.2% chlorhexidine mouthwash by up to 50% to reduce soreness 1
- Options include:
Take oral swabs if bacterial or candidal secondary infection is suspected 1, 2
For suspected candidal infection, treat with:
- Nystatin oral suspension 100,000 units four times daily for 1 week, or
- Miconazole oral gel 5-10 mL held in the mouth after food four times daily for 1 week 1
Advanced Treatment Options
For Persistent Inflammation
- Consider using a topical corticosteroid four times daily 1, 2
- Options include:
- Betamethasone sodium phosphate 0.5 mg in 10 mL water as a rinse-and-spit preparation
- Clobetasol propionate 0.05% mixed with equal amounts of Orabase applied directly to the affected mucosa 1
- Options include:
Dietary Recommendations
- Maintain adequate hydration to keep the mouth moist 1, 2
- Avoid irritants such as:
- Acidic foods and beverages
- Spicy foods
- Hot foods and beverages
- Raw or crusty foods 2
- Choose soft, moist, non-irritating foods until healing occurs 2
Follow-up and Monitoring
- Inspect the oral mucosa daily for signs of healing or worsening 1, 2
- Monitor for signs of secondary infection:
- Increased pain
- Swelling
- Purulent discharge
- Fever
- Follow up within 3-5 days if symptoms are not improving 2
Special Considerations
- For recurrent biting injuries, consider consulting a dentist to eliminate sources of trauma (e.g., ill-fitting prostheses, fractured teeth) 1, 2
- For patients with dentures, remove them before performing oral care and defer wearing them as much as possible until the mucosa has healed 1
By following this management approach, most cases of bitten mouth mucosa will heal without complications. The key is prompt treatment with appropriate topical agents, good oral hygiene, and avoiding further trauma to the affected area.