Oral and maxillofacial surgeons are trained, skilled, and uniquely qualified to manage and treat facial and dental trauma. Facial injuries impart a high degree of emotional stress to the patient. The reconstruction and rehabilitation of these injuries often require a protracted treatment, ranging from several months to several years. The science and art of treating these injuries requires specialized training to understand how the care provided will influence the patient’s long term function and appearance.
- Facial lacerations
- Intra oral lacerations
- Avulsed (knocked out) teeth
- Fractured facial bones (cheek, forehead, nose or eye socket)
- Fractured jaw bones (upper and lower jaw)
The Nature of Maxillofacial Trauma
There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Facial injuries can range from fractured teeth to more severe injuries involving the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), hard tissue injuries (bone fracture), or injuries to specialized structures (eyes, facial nerves or the salivary glands).
Soft Tissue Injuries of the Maxillofacial Region
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 that yields the best possible cosmetic result, care is taken to inspect and treat injuries to structures below the skin surface. These structures include facial nerves, salivary glands, and salivary ducts (outflow channels). Oral and maxillofacial surgeons are trained to diagnosing and treat all types of facial lacerations.
Bone Injuries of the Maxillofacial Region
Facial bone fractures 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 (displacement) 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 to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.
Wiring the jaws and teeth together is the most common form of stabilization used while fractures of the upper and/or lower jaw bone are healing. In addition to wiring the jaws together, some jaw fractures are so displaced they require the surgical placement of small plates and screws to stabilize the fractures while healing takes place. This technique is called “rigid fixation” of a fracture. The relatively recent development of rigid fixation has profoundly improved the recovery period for many patients, reducing and sometimes eliminating the need for the jaws to be wired together. This provides the patient with a more comfortable recovery and may allow a quicker return of function.
The treatment of facial fractures requires a systematic approach to achieve a predictable functional and aesthetic result. To attain the best cosmetic outcome, most facial bone fractures can be accessed and repaired through minimal skin incisions. Whenever possible, the skin incisions that are necessary are small and are placed so that the resultant scar is hidden by a natural crease in the skin.
Injuries to the Teeth & Surrounding Dental Structures
Isolated dental injuries are quite common and require the expertise of multiple dental specialists. Oral surgeons are trained to treat fractures of the bone surrounding teeth and replanting teeth that have been displaced or knocked out (avulsed). A displaced tooth is treated by splinting it to the surrounding healthy teeth with wire or a tooth bonding agent. If a tooth is knocked out, the tooth should NOT be scrubbed. Simply rinse the tooth off with water and either replant the tooth in the socket or place it into salt water or milk immediately. If the tooth is to survive, it must be reinserted into the dental socket within 90 minutes of being knocked out of the mouth. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to clean the tooth, since remnants of the ligament that hold the tooth in the jaw are attached to the root surface and are vital to the success of replanting the tooth. A root canal will be required if the tooth has been knocked out of the mouth. If the tooth has been fractured a restorative dentists will be needed to repair or rebuild the tooth. In the event that injured tooth cannot be repaired or replanted, a dental implant can be utilized as a replacement.
If you have questions or would like to schedule an appointment please call our office at Boulder Office Phone Number 303-444-2255