Treating and Preventing Facial Trauma


playing-baseballFacial injuries, also referred to as facial trauma, encompass any injury to the mouth, face and jaw and associated facial structures. Most facial injuries are caused by a sports mishap, motor vehicle accident, on-the-job accident, act of violence or an accident in the home.

Oral and maxillofacial surgeons, the surgical specialists of the dental profession, are specifically trained, skilled and uniquely qualified to repair and manage injuries to the teeth, mouth, jaws, and associated facial structures.

Treating Facial Injury (Trauma)

Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures to the upper or lower jaw and/or palate), or injuries to special regions (cheekbones and eye sockets).

Soft Tissue Injuries

When soft tissue injuries such as lacerations occur on the face, they are repaired by “suturing” or sewing up the laceration.  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).  Our surgeons are proficient at diagnosing and treating all types of facial lacerations.

Bone Injuries

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 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 jaws.  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.”

Injuries to the Teeth and Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists.  Oral 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 or 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.  Therefore, the patient should see a dentist or oral 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.

Don’t Treat Any Facial Injury Lightly

While not all facial injuries are extensive, they are all complex since they affect an area of the body that is critical to breathing, eating, speaking and seeing.  Even in the case of a moderately cut lip, the expertise of the oral and maxillofacial surgeon is indispensable.  So a good rule of thumb is not to take any facial injury lightly.