Dr Benley George
Vice Principal, Pushpagiri College of Dental Sciences, Tiruvalla,
Dental fractures are fracture of the upper and lower jaw bones including the teeth. Dental fractures occur commonly in cases of accidents, trauma, domestic violence, sports injury, fall etc. Due to any one of these reasons either a fracture of the upper jaw alone, lower jaw alone or a combination of upper and lower jaw can occur. Fracture of the bone can also involve fracture of the tooth or avulsion of the tooth. Fracture of the jaw bone is the 10th most common type of fracture which occurs in a human body.
Signs and symptoms
Movement of the whole segment of the jaw
Restricted mouth opening
Swelling over the fractured jaw bone
Laceration over the skin
Paresthesia
Derranged occlusion
Pain
Diagnosis
The fracture of the jaw bone can be identified by a dentist through a thorough clinical examination. In addition the dentist would require x rays like OPG, PNS, OMV, PA mandible for identification of the extent of the fracture in the jaw bone. Advanced CT scans would be required in cases of multiple fractures of the jaw bones to get a better picture of the fracture. Now there are 3D CT scans which gives a three dimensional view or image of the face. This provides a perfect image of the jaw bones and the fractures which is very helpful for the oral surgeon in planning out the surgery.
Treatment
Fractures of the jaw bone are fixed by the oral surgeons based on the extent and type of fracture. Oral surgeons treat the fracture of the jaw bone through open reduction or closed reduction method. Fractures of the jaw are fixed by open reduction method by using metal plates and screws like titanium or stainless steel plates and screws under general anesthesia. These plates hold the fractured segment firmly and thereby promote healing of the fractured site. The healing period would be around 4-6 weeks. Usually these plates need not be removed after the reunion of the fracture, but if it gets infected the plates will have to be removed. In fracture fixation by closed reduction method the upper and lower teeth would be wired for a period of 4 weeks to stabilize the occlusion. After the period is over the wiring over the teeth would be removed. During this period the patient will be on soft diet and extra care must be given to maintain good oral hygiene. After the complete healing of the jaw bone, treatment for the injured teeth should be done. A complete scaling of the teeth should be undergone by a dentist to remove the hard deposits formed around the teeth and gums.
Complications after surgery
Swelling
Post op numbness
Limitation of mouth opening
Infection
The complications after surgery are transient and will resolve gradually. Swelling over the surgical site will increase during the first 24 hours post-surgery and gradually subsides over a period of 3-4 weeks. Mouth opening will improve through mouth opening exercises in 2-3 weeks. Infections if present after surgery would be treated by the surgeon through antibiotics. Numbness of the face or lips occurs due to an injury of the underlying nerve. This injury is transient and will resolve over a period of 6-12 months.
Dental fractures can be prevented to some extent. Individuals involving in contact sports can protect their face with helmets and mouth guards. Individual riding motor bikes should wear helmet to protect them from head and facial injuries which can be fatal. Individuals driving cars should wear seat belts to avoid injury to their body and face. Treatment for dental fractures by an oral surgeon will help in restoring the condition of the face to normal as possible.
