An oral and maxillofacial surgeon is thoroughly trained to repair facial injuries. These professionals are well versed in emergency care, acute treatment, and long-term reconstruction and rehabilitation. Injuries to the face, by their very nature, impart a high degree of emotional as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long-term function and appearance.
Drs. Jay and James Harlan are trained, skilled, and uniquely qualified to manage and treat facial trauma. They are on staff at local hospitals and deliver emergency room coverage for facial injuries, which include the following conditions:
- Facial lacerations
- Intraoral lacerations
- Fractured facial bones (cheek, nose, or eye socket)
- Fractured jaws (upper and lower jaw)
The Nature of Maxillofacial Trauma
There are a number of possible causes of facial trauma, such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries to teeth to extremely severe injuries to the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves, or the salivary glands).
Soft Tissue Injuries of the Maxillofacial Region
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 salivary ducts. Our doctors are well-trained surgeons, proficient at diagnosing and treating all types of facial lacerations.
Bone Injuries of the Maxillofacial Region
Fractures to the bones in the face are treated in a similar manner 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, and the age and general health of the patient. When an arm or 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.
One of these options involves wiring the teeth together for certain fractures of the lower jaw for 3-6 weeks, known as a “closed reduction.” Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site–a technique known as “rigid internal fixation.” This technique allows your jaw to function during healing and eliminates the necessity of having the jaws wired together.
The treatment of facial fractures is often difficult due to the complex pattern of blood vessels and nerves in the face and jaws, and the fact that nobody wants their facial appearance to be permanently altered. 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 resulting scar is hidden. This means that the incisions we use may be made far away from the fracture site.
All of these factors, as well as a patient’s existing teeth and jaw bone structure, mean that not every patient is a good candidate for all available treatment options, and our doctors will evaluate each patient’s specific injury to determine the best treatment.
Injuries to the Teeth & Surrounding Dental Structures
Oral surgeons usually are involved in treating fractures in the supporting bone around the teeth, or placing bone grafts and dental implants into areas of injury. Isolated injuries of the teeth are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). 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. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists may be called upon, such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists, who may need to repair or rebuild fractured teeth.