An oral and maxillofacial surgeon can best perform the proper treatment of facial fractures due to an understanding of the stabilizing relationship of the teeth to the rest of the facial skeleton. Oral and maxillofacial surgeons are trained, skilled and uniquely qualified to manage and treat facial trauma injuries including:
- Facial lacerations
- Avulsed (knocked out) teeth
- Fractured facial bones (cheek, nose or eye socket)
- Fractured jaws (upper and lower jaw)
Soft Tissue Injuries
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 cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands, and ducts.
Fractures of the bones of the face are treated in a manner similar to 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, 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 together for a certain period of time is the most common treatment of fractures of the upper and/or lower jaw. Certain 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 rigid fixation technique can speed healing and lessen the time of jaw wiring.
Injuries to 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 re-implanting teeth that have been displaced or knocked out. These types of injuries are treated by splinting and stabilizing teeth by wiring or bonding.
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 chance it will survive. The patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe off the tooth, since preserving the remnants of the ligament that hold the tooth to the jaw is vital to the successful healing of the re-implanted tooth. Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and 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 utilized as replacements for missing teeth.