Facial Trauma

Facial trauma can result from motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries. 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 can be classified as 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 several 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 the ability to breathe, speak, chew and swallow. Treatment frequently requires hospitalization but less serious injuries can be treated in one of our clinics. 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. 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
Bleeding from the mouth or nose

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). Treatment is determined by the patient’s age, health, and the complexity of the fracture. Simple fractures are treated by “closed reduction”, which means simple manipulation of the fracture segments without major surgery. This will often include wiring the jaws together for approximately six weeks. However, other types of fractures of the jaw are best treated by the surgical placement of small “bone plates and screws” at the involved site. This technique of treatment can often reduce the time that the jaws are wired together. 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 in skin creases.

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 injuries to structures such as facial nerves, salivary glands and salivary ducts. Your doctor is a well-trained Oral and Maxillofacial surgeon and is proficient at diagnosing and treating facial lacerations.