A seizure is a sudden, uncontrolled electrical disturbance in the brain that temporarily affects movement or behavior. During a generalized tonic-clonic seizure, the body’s muscles contract forcefully and involuntarily, risking injury. A common complication is biting the tongue or the inside of the cheek. This oral trauma occurs when the jaw muscles clench powerfully at the seizure’s onset. Understanding the correct, safe responses is important for minimizing serious injury during these events.
Essential First Aid for Seizures
The immediate priority when someone is having a tonic-clonic seizure is to ensure their physical safety and maintain an open airway. The person should be gently rolled onto their side, often called the recovery position. This lateral positioning helps prevent fluids, such as saliva or vomit, from entering the lungs and allows for better drainage. This simple action also helps reduce the risk of airway obstruction, a concern during and immediately after a seizure.
The head should be cushioned with a soft item, like a folded jacket or a pillow, to protect it from repeated impact against the floor or ground. Any rigid or sharp objects nearby should be moved away from the person’s immediate vicinity. This measure minimizes the chance of accidental trauma to the limbs or head during the uncontrolled movements.
While attending to safety, it is beneficial to note the precise duration of the seizure activity. Timing the seizure from the moment the uncontrolled movements begin until they stop provides important information for medical professionals. If the seizure lasts longer than five minutes, or if another seizure begins immediately after the first one ends, emergency medical services should be called immediately. Remaining calm and observing the sequence of events is the most helpful action a bystander can take.
Danger of Oral Intervention
A common impulse is to try and place an object into the person’s mouth to protect the tongue. Nothing, including fingers, spoons, towels, or any other item, should ever be forced between the teeth during a seizure. This intervention does not prevent tongue biting and introduces serious dangers.
The tongue injury typically occurs in the first few seconds of a generalized seizure when the jaw muscles spasm and clench powerfully. By the time a bystander attempts to intervene, the clenching phase has already passed, or the jaw is locked shut. Attempting to pry the jaw open or insert an object can result in broken teeth, fractured jaws, or severe lacerations to the gums and cheeks.
Furthermore, a foreign object in the mouth can easily be inhaled, creating a life-threatening airway obstruction. Attempting to insert fingers into the mouth also poses a significant risk of severe injury to the rescuer. The force of the jaw clench is immense and entirely involuntary, making it impossible to control. Focus must remain on external safety measures rather than attempting to manipulate the mouth internally.
Post-Seizure Care for Oral Injuries
Once the seizure movements have ceased, attention can turn to assessing any injuries that may have occurred. The person’s mouth can be gently checked for signs of a bite injury to the tongue or cheek. It is important to wait until the person is relaxed and responsive enough to cooperate with this inspection.
For minor tongue or lip lacerations, gently cleaning the area with a piece of gauze can help manage the blood present. Applying a cold compress or allowing the person to suck on an ice chip can help reduce swelling and discomfort if they are fully conscious. If the bleeding is profuse, does not stop quickly, or if a tooth appears broken or dislodged, professional medical attention is warranted. The caregiver should remain with the individual until they are fully alert and oriented, ensuring they recover safely from the post-seizure confusion.