inspected for any missing, displaced, mobile, tender, or fractured teeth These findings are discussed in more detail in subsequent sections Radiographic examination Radiographs are a valuable supplement to the clinical examination However, in a child with acute orofacial/dental injuries this may be difficult and reserved for a dental office A chest radiograph may be required if an avulsed tooth is not located Panoramic radiographs or computed tomography (CT) scans may be indicated to assess for jaw fracture SOFT TISSUE INJURY CLINICAL PEARLS AND PITFALLS The soft tissues and bones of the lower and midface are well vascularized and bleed profusely when injured Lacerated soft tissues must be evaluated for any debris, foreign body, or tooth fragment Current Evidence Hemorrhage is best controlled by direct pressure and when needed, by ligating any vessels that are easily seen However, vessels of the face often retract when severed making them difficult to visualize If there is extensive blood loss, the patient should be assessed for signs of shock (see Chapter 10 Shock ) The injured area should be thoroughly examined for a foreign body such as a tooth fragment This may include obtaining a soft tissue radiograph or bedside ultrasound before suturing when a foreign body is suspected Infection and poor wound healing are potential sequelae of such an oversight Goals of Treatment The primary goal for treatment of soft tissue injury is to achieve hemostasis The highly vascular tissue in and around the mouth can lead to significant blood loss with seemingly mild injuries Recognizing any embedded foreign materials (e.g., debris, or tooth fragments) is essential to allow wound healing and reduce the likelihood of complications Injuries to the buccal mucosa and inner lip are rarely of cosmetic concern given rapid wound healing with minimal risk of scarring Vermilion border injuries require meticulous alignment for optimal cosmetic outcome, while select intraoral lesions may not require any repair at all Clinical Considerations