injuries and poisoning
Fractures of the Jaw and Midface
Treatment of Jaw and Midface Fractures
Treatment of specific fractures, which may include surgery If people suspect their jaw is fractured, they should go to the emergency department immediately. If swelling or bleeding begins to close the breathing passages, doctors may need to insert a tube (endotracheal tube) to help the person breathe. Treatment of mandible fractures involves resting the jaw so that the bone can heal. Mild fractures may require only that the person not chew, so doctors prescribe a liquid or soft-food diet. More severe fractures (such as those with breaks in more than one place or those in which the ends of the bone are separated, called a displaced fracture) require that the jaw be repaired. Doctors may screw metal plates into the bone on each side of the fracture, or they may wire the person's upper and lower jaws together for several weeks. If the jaw is wired shut, the person is only able to drink liquids through a straw. Because only part of the tooth surface can be brushed while the jaw is wired shut, doctors prescribe a mouth rinse to be used twice daily. After several weeks of being wired shut, the jaw usually needs to be strengthened with exercises. In children, some mandible fractures near the ear are not immobilized. Instead, mild restriction of jaw motion with a device for 5 to 10 days is enough. People whose jaws are wired shut should always carry wire cutters. If they vomit, they should cut the wires holding the jaw shut because inhaling vomit should be avoided. Maxillary fractures are treated with surgery if they cause problems such as vision symptoms, a change in the way the teeth fit together, limitation of jaw opening, a sunken eyeball, facial numbness, or an unacceptable change in appearance. Doctors often wait a few days after the injury (when swelling subsides) to decide whether surgery is needed. Surgery typically involves fixation with screws and plates. After surgery, the jaws may need to be immobilized but often for only a few days, after which people should eat only soft foods for several weeks. Any fracture of a tooth socket is treated with antibiotics. 