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is very painful A common site for this is the lower lip ( e-Fig 105.1 ) Rarely is this type of injury associated with infection Standard over-the-counter pain medications and keeping a soft, bland diet are sufficient until the wound heals, typically in to weeks Electrical Burns Electrical burns occur when children bite on electrical cords The saliva in the mouth acts as a conductor to complete the circuit Although the commissure of the mouth is most likely affected, the tongue, alveolar ridge, and floor of the mouth are occasionally involved Most children with these injuries can be managed as an outpatient A bland, soft, cold diet is initially recommended If a child refuses oral intake, dehydration may ensue and the administration of intravenous fluids may be required Meticulous oral hygiene using a toothbrush with or without toothpaste should be performed three to four times per day, as well as hydrogen peroxide and water (1:1) rinses in a cooperative child With severe burns of the lips and mouth, labial artery bleeding may occur to days after the injury Although admission to the hospital for wound management has been utilized, the delayed presentation of this late complication makes this impractical The clinician should instruct the parent on the method for digitally compressing the artery if bleeding were to occur To prevent scarring down of the commissure, electrical burns of this area require the fabrication of an intra- or extraoral device to separate the upper and lower segments during healing ( eFig 105.2A,B ) TRAUMATIC DENTAL INJURIES CLINICAL PEARLS AND PITFALLS Avulsed permanent teeth must be reimplanted immediately while primary teeth are generally not reimplanted Displaced teeth should be repositioned as soon as possible Teeth with exposed pulpal tissue require urgent dental treatment Fractured posterior teeth may have an associated mandibular fracture Current Evidence The International Association of Dental Traumatology has detailed, evidencebased guidelines for the management of dental trauma which are updated periodically and can be found online (see References) Focused recommendations
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