“If you or a loved one suffer a facial or mouth injury that requires a trip to the emergency room, be sure to ask that an oral and maxillofacial surgeon (OMS) is called for consultation. With their background and training, OMSs are the specialists most qualified to deal with these types of injuries. In some cases, they may even detect a “hidden” injury that might otherwise go unnoticed.
Oral and maxillofacial surgeons are experts in treating and repairing facial trauma, including fractures of the upper and lower jaws, the orbits surrounding the eyes, and facial lacerations. Their knowledge of how jaws come together (dental occlusion) is critical when repairing complex facial fractures.
In fact, the American College of Surgeons states that a multi-disciplinary approach, in which the surgical team is composed of specialists in oral and maxillofacial surgery, otorhinolaryngology, plastic surgery, and ophthalmology, is beneficial for the treatment of complex cranial facial injuries. Moreover, many of the techniques that are standard in today’s hospital emergency rooms were developed by OMSs in combat hospitals during World War II, Korea, Vietnam and today’s international conflicts.
Treating Facial Injury
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 sockets and combinations of these bones. These injuries can affect sight and the ability to breathe, speak and swallow. Treatment often requires hospitalization.
The principles for treating facial fractures are the same as for a broken arm or leg. The parts of the bone must be lined up (reduced) and held in position long enough to permit them time to heal. This may require six or more weeks depending on the patient’s age and the fracture’s complexity.
When maxillofacial fractures are complex or extensive, multiple incisions to expose the bones and a combination of wiring or plating techniques may be needed. The repositioning technique used by the OMS depends upon the location and severity of the fracture. In the case of a break in the upper or lower jaw,
for example, metal braces may be fastened to the teeth and rubber bands or wires used to hold the jaws together. Patients with few or no teeth may need dentures or specially constructed splints to align and secure the fracture. Often, patients who sustain facial fractures have other medical problems as well. An OMS is trained to coordinate his or her treatment with that of other doctors.
During the healing period when jaws are wired shut, the oral and maxillofacial surgeon prescribes a nutritional liquid or pureed diet, which will help the healing process by keeping the patient in good health. After discharge from the hospital, the doctor gives the patient instructions on continued facial and oral care.
Don’t Treat Any Facial Injury Lightly
If a person is unconscious, disoriented, nauseated, dizzy or otherwise incapacitated, call 911 immediately. Do not attempt to move the individual yourself. If these symptoms are not present but the injury is severe or you are uncertain about its severity, take the person to the nearest hospital emergency room as quickly as possible.
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 OMS is indispensable. If sutures are needed, placement must be precise to bring about the desired cosmetic result.”