Facial Trauma
Causes of Maxillofacial Trauma:
There are a number of possible causes of facial trauma. Motor
vehicle accidents, accidental falls, sports injuries, interpersonal
violence and work related injuries account for many. Types of facial
injuries can range from injuries of teeth to extremely severe
injuries of the skin and bones of the face. Typically, facial
injuries are classified as either soft tissue injuries (skin and
gums), bony injuries (fractures), or injuries to special regions
(such as the eyes, facial nerves or the salivary glands).
Oral and Maxillofacial Surgeons are specially trained and highly
skilled in treating facial trauma. We are on staff at local area
hospitals and provide emergency room coverage for treating facial
injuries such as:
- Intraoral lacerations
- Fractured Teeth
- Fractured Facial bones
- Fractured Jaws
- Lip Lacerations
- Facial Lacerations
- Teeth that have been knocked out
One of the most common types of serious injury to the face occurs
when bones are broken. Fractures can involve the lower jaw, upper
jaw, palate, cheekbones, eye socket, and combinations of these
bones. These injuries can affect sight, the ability to breathe,
speak and swallow. Treatment often requires hospitalization.
Don't Treat Any Facial Injury Lightly:
Of course, not all facial injuries are extensive. The thing you
should remember, though, is that they are all complex. Even in the
case of a moderately cut lip, the expertise of the oral surgeon is
indispensable. If sutures are needed, placement must be precise to
bring about the desired cosmetic result. So a good rule of thumb is
that you shouldn't take any facial injury lightly. Not only that,
but facial injuries are in a critical area of the body. After all,
the functions of breathing, eating, speaking and seeing are located
there.
Facial Injuries:
Oral and Maxillofacial surgeons are trained to treat a wide variety
of injuries to the mouth, face and jaws. Oral and Maxillofacial
surgeons are specialists in the repair of lacerations to the lips
and face, and fractures to the teeth and facial bones. They are
often called to emergency rooms to evaluate and treat facial
injuries. Fractures (broken bones) can involve the lower jaw, upper
jaw, cheek bones, eye socket, and combinations of these bones.
Treatment frequently requires hospital treatment, however many of
the less serious injuries can be treated in the office.
Some of the signs and symptoms of facial fractures are:
- Pain
- Numbness of the lip, cheek, tongue, nose
- Inability to open the mouth
- Change in the bite
- Visible step-off between teeth
- Deep laceration over bone
The principles of treatment for facial bones are the same as for
a broken arm or leg. The parts of the bones must be lined up
(reduced) and held in position long enough to allow them to heal
(stabilization and/or fixation). This may require six weeks or more,
depending on the patient's age and the complexity of the fracture.
Simple fractures are treated by "closed reduction," which means
simple manipulation of the fractures segments without major surgery.
Injuries to the Teeth & Surrounding Dental Structures:
Isolated injuries to teeth are quite common and may require the
expertise of various dental specialists. Oral and Maxillofacial
Surgeons usually are involved in treating fractures in the
supporting bone or in replanting teeth which have been displaced or
"knocked out". These types of injuries are treated by one of a
number of forms of "splinting" (stabilizing by wiring or bonding
teeth together). If a tooth is "knocked out", it should be placed in
salt water or milk. The sooner the tooth is re-inserted into the
dental socket, the better for the survival of the tooth. Because of
this, the patient should see a dentist or Oral and Maxillofacial
surgeon as soon as possible. Never attempt to "wipe the tooth off",
since remnants of the ligament which hold the tooth in the jaw are
attached and are vital to the success of replanting the tooth. Other
dental specialists may be called upon such as endodontists, who may
be asked to perform root canal therapy, and/or restorative dentists
who may need to repair or rebuild fractured teeth. In the event that
injured teeth cannot be saved or repaired, dental implants are often
now utilized as replacements for missing teeth.
Bone Injuries of the Maxillofacial Region:
Fractures of the bones of the face are treated in a manner similar
to the fractures in other parts of the body. The specific form of
treatment is determined by various factors which include the
location of the fracture, the severity of the fracture, and the age
and general health of the patient. When an arm or a leg is
fractured, a "cast" is often applied to stabilize the bone and allow
for proper healing. Since a cast cannot be placed on the face, other
means have been developed to stabilize facial fractures.
One of these options involves wiring the jaws together for certain
fractures of the upper and/or lower jaw. However, certain other
types of fractures of the jaw are best treated and stabilized by the
surgical placement of small "plates and screws" at the involved
site. This technique of treatment can often allow for healing and
obviates the necessity of having the jaws wired together. This
technique is called "rigid fixation" of a fracture. The relatively
recent development and use of "rigid fixation" has profoundly
improved the recovery period for many patients by allowing them to
return to normal function more quickly.
The treatment of facial fractures should be accomplished in a
thorough and predictable manner. Importantly, the patient's facial
appearance should be minimally affected. An attempt at accessing the
facial bones through the fewest incisions necessary is always made.
At the same time, the incisions that become necessary are designed
to be small and, whenever possible, are placed so that the resultant
scar is "hidden", such as in the hairline, under the jaw or inside
the eyelids.
Soft Tissue Injuries of the Face:
When soft tissue injuries, such as lacerations, occur on the
face, they are repaired by "suturing". In addition to the obvious
concern of providing a repair which yields the best cosmetic result
possible, care is taken to inspect for and treat, injuries to
structures such as facial nerves, salivary glands and salivary ducts
(or outflow channels). Your doctor is a well-trained Oral and
Maxillofacial surgeon and is proficient at diagnosing and treating
all types of facial lacerations.
Oral and Maxillofacial Surgeons are well trained in the emergency
care, acute treatment and long-term reconstruction and
rehabilitation of facial trauma patients.
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