Injuries to the face may often result in fractures to the facial bones, the upper jaw (maxilla) or the lower jaw (mandible). Common causes include motor vehicle accidents, interpersonal violence, sports injuries, and falls. Many fractures are diagnosed and referred by emergency rooms to the oral and maxillofacial surgeon, some people present directly.
- Cheekbone Fractures
Cheekbone fractures commonly have a relatively pain free depressed appearance. The area under the eye may initially be swollen but later appear flat. A step in the edge of the eye socket can sometimes be felt. Sometimes there is limitation in jaw opening. On occasion visual disturbances may accompany this injury including bleeding in the lateral white of the eye. These injuries are best treated by either early intervention or delayed intervention of several days, sometimes surgically and sometimes nonsurgically for the less intense injuries. Suspicion of any such injury should be professionally evaluated.
- Upper Jaw Injuries
Injuries to the upper jaw may range from severe, when the entire mid-face is disjoined from the skull, to a more simple injury involving only the tooth-bearing segment of the mid-face. Bite is often disturbed and feels spongy. Often times the front teeth do not come together in this type of injury, resulting in the back teeth seeming too long. There is usually pain and swelling. Repair may be surgical, with immediate ability to chew restored, or by wiring the teeth together with a temporarily impaired eating ability. Suspicion of any such injury should be professionally evaluated.
- Lower Jaw Injuries
Injuries to the lower jaw may involve the joint, neck of the lower jaw, angle, or body. The bite usually feels different and numbness may be associated in the lip. Sometimes bleeding in the tissue of the floor of the mouth is present, and usually there is pain and swelling. Repair may be surgical, with immediate ability to chew restored, or by wiring the teeth together with a temporarily impaired eating ability. Suspicion of any such injury should be professionally evaluated.
Failure to treat broken facial bones or jaws may result in failure to heal, inability to chew and function, infection, or jaw joint problems, and further difficulty to repair by delaying treatment. Treatment of jaw fractures in simpler cases may be accomplished in the office with local anesthesia and intravenous sedation. Very little discomfort or memory is associated with such a procedure. More serious fractures require treatment in a hospital operating room, under general anesthesia. Some treatments allow immediate return to chewing function, while others require the jaws to be wired together for several weeks while the bones heal. Medications for comfort, oral hygiene, and prevention of infection will be given as well as routine care and diet instructions.