Fracture of the lower jaw. The most popular questions and answers

You can contact Dr. Granov's clinic for treatment of jaw injuries. This is one of the areas of treatment that we do.

The jaw is the bony structure that holds the teeth in place. The upper jaw does not move, only the lower jaw moves. Its movements are necessary for eating food and for producing speech. Both jaws connect at a point called the temporomandibular joint (TMJ).

Jaw injuries include cracks, dislocations and fractures. With a fracture or crack, the bone breaks; with a dislocation, the bone changes location and flies out of the joint. Such injuries occur after physical activity (bruise, blow, fall). After appropriate treatment, they heal safely, but the dislocation may appear again.

Jaw injuries are dangerous because they can lead to various complications. Among them:

breathing disorder,
bleeding,
blood entering the lungs
problems with chewing food,
problems with diction,
infection of the jaw or facial structures,
joint pain,
numbness of the jaw or face,
tooth displacement,
edema.

Symptoms of a jaw fracture:

pain in the cheek next to the ear, which increases with jaw movement;
swelling of the face, blood in the mouth;
immobility of the jaw, inability to open or close the mouth;
when opening the mouth, only one side of the jaw moves;
jaw pain that gets worse when chewing;
dental injuries;
swelling of the face or changes in the contours of the jaw;
numbness of the face in the lower lip area.

Symptoms of a dislocated jaw:

pain in the cheek next to the ear, which increases with jaw movement;
feeling that the jaw is not positioned correctly in the joint;
violation of diction;
inability to close your mouth;
drooling due to open mouth;
spasm of the masticatory muscles or protrusion of the jaw forward;
dental injuries.

First aid for jaw injuries

Jaw injuries require immediate medical attention. Call an ambulance or go to the nearest hospital. Before doctors arrive, you can put a bandage on your jaw to keep it immobilized. The bandage should be easy to remove.

Do not try to set a dislocation yourself or wait for the fracture to heal on its own. Be sure to contact a traumatologist.

Why does the lower jaw break?

Experts note that in the vast majority of clinical cases, pathology occurs due to injuries received in everyday life. These are falls, blows. You can get injured by slipping, doing physical activity and traumatic sports, or in active games (for children). The number of fights, domestic conflicts under the influence of alcohol and drugs, and road traffic accidents, due to which people suffer a broken jaw, as in the photo, are growing. Some people encounter problems with poor industrial safety on the shop floor, when working with heavy equipment and at heights.

This is what a mandibular fracture looks like

For many, it comes as a surprise that a fracture of the lower jaw can be caused by a number of dental and chronic diseases. As a rule, such trauma is caused by advanced pathologies, for example, a follicular cyst that has grown on the root of a tooth, or osteomyelitis. Oncological tumors, metabolic disorders and osteoporosis can also gradually destroy bone tissue, as a result of which the patient develops symptoms of a fracture.

According to statistics, young men (under 40 years of age) receive such injuries more often than women. The male sex tends to engage in dangerous sports, works in heavy industries, more often takes part in fights, and has a tendency to take risks and aggression.

Some researchers also argue that in rare cases, damage can occur during dental procedures, for example, during tooth extraction in case of extremely low qualifications of the doctor.

Causes of damage

Many people think how hard it takes to break a jaw. In fact, even if you bite food incorrectly or close your jaws, you can injure them and, if the bone tissue is weakened, its integrity can be disrupted.

Main reasons:

blows;
injuries in athletes;
falls;
car crashes.

In some sports, only the teeth are protected from impacts. But the jaw, the bone tissue itself, is almost always defenseless. Even an unsuccessful fall can injure this bone.

Can the upper jaw break?

Maybe, but doctors admit that this is a very rare situation. Due to anatomical features and lack of mobility, even in the most complex accidents, the upper jaw often remains intact. However, experts also emphasize that when the upper jaw is damaged, the symptoms and consequences are much stronger, they more often lead to death.

A fracture of the upper jaw is much more serious and dangerous than the lower jaw

The mandibular bone is massive and mobile, protrudes forward, therefore, with any external influence on it, it “suffers” first of all. According to statistics, it is damaged in 80% of cases of the total number of injuries to the bones of the facial skeleton.

Are fractures the same for everyone or are they always different?

Jaw fractures can be completely different, and it is impossible to independently determine which one you have. It all depends on the nature of the injury, the direction of the force, and the position of the person at the time of exposure to the traumatic factor. The diagnosis can only be made based on x-rays. Here are the main types and classifications of fractures:

direct and indirect: in the first case, the area that was affected is directly injured. With an indirect injury, it is not the area of impact that is damaged, but the tissues located next to it,
oblique, transverse, longitudinal: it all depends on the direction in which the fracture of the jaw bone will go,
single and multiple: there can be only one fault, but most often there are many of them,
large and small: if the bone is split into several fragments, then we are talking about a major fracture. If there are a lot of fragments and they are small, then doctors diagnose a minor fracture,
one-sided and two-sided,
open and closed: the first type involves damage not only to bone tissue, but to the mucous membrane, periodontal tissue, and teeth. The second type is much less common and only damages bone tissue.

Fractures can be different

Is it possible to do without splinting?

For a more progressive rehabilitation process, specialists in some cases resort to splinting and bypass procedures. When splinting a jaw fracture, the jaw is fixed in the desired position using a special plastic device. The structure is applied directly to the fracture area, but if the patient is diagnosed with a complicated fracture, then special pins, rings and hooks are added to it. In addition to the device, a fixing bandage is applied to the patient’s jaw, thus creating complete immobilization of the joints and bone tissue. The treatment process will take place over two months.

Bypass surgery involves fixing bone fragments using a splint. The tire consists of catchy loops and rubber ties.

The latter procedure is used to relieve pressure on the jaw and other bones and joints.

How can you tell if a person has a broken jaw?

A person who has suffered such a serious injury experiences severe pain that radiates throughout the head. Due to the painful shock, you can lose consciousness or experience severe dizziness. Nausea and vomiting are possible. It becomes impossible to open or, conversely, close your mouth; accordingly, in this state you cannot chew, swallow, speak, and sometimes even breathe. Saliva and blood may involuntarily flow from the mouth.

It is visually noticeable that the lower jaw has shifted relative to the upper jaw, and facial asymmetry has appeared. The lower row of teeth has also shifted relative to the upper one. With open fractures of the jaw, some teeth are often twisted, knocked out, broken, they can stagger, tilt and fall out.

With such an injury, the dentition shifts

A little later, a person with a similar injury may feel numbness in the chin area, which indicates that the trigeminal nerve has been damaged in the process. Another striking symptom indicating a problem is bleeding not only from the mouth, but also from the nose and ears. Naturally, in a person with a similar problem it is difficult not to notice bruises, hematomas, bruises, and wounds of different nature.

A jaw fracture is often accompanied by other injuries, damage to the head and body, and concussion.

Types of fractures and healing features

The task of a dental surgeon in the event of a patient’s jaw fracture is to restore the integrity of the broken bone along with the dentition.

Up to 70% of damage occurs in the lower jaw due to:

accidents, accidents;
blows during a fight;
sports injuries;
complications of serious diseases.

The collective concept of trauma combines a wide range of injuries.

Healing will be faster and more effective if symptoms are correctly recognized and time is not wasted in providing medical care.

The healing time of the jaws will differ significantly in the case of:

direct or indirect fractures, i.e., distant from the point of impact;
closed or open injuries, i.e. with rupture of soft tissues;
with displacement of bone fragments or without displacement, while maintaining the anatomical location;
a complete fracture with the advancement of a fragment with an angle, or a comminuted one (one of the most dangerous) with dispersed fragments in disarray.

An accurate assessment of the damage can be made based on the x-ray and clinical picture.

Healing times largely depend on the type of fracture and the provision of timely assistance. Soft tissue injuries, bone displacement, concussion, contusions and associated injuries increase the period of inpatient observation.

Features of jaw treatment may be associated with general diseases of the patient.

Is it possible to help a person with such an injury on your own?

If your friend or loved one has suffered a broken jaw, then the only right decision in this case is to call an ambulance. If the person is conscious and able to swallow and breathe on their own, give syrup or a pre-crushed painkiller tablet to relieve pain. You can quickly take him to the hospital by personal vehicle, but before that you must try to immobilize the damaged area with the help of a bandage that secures the lower jaw to the upper.

Often people who receive such injuries lose consciousness. Many people stop breathing because their tongue becomes stuck and their airways become clogged with blood clots and vomit. In this case, delay and prolonged absence of professional medical care is dangerous, because without pulmonary resuscitation and other measures, respiratory failure and death can develop.

How will the treatment be carried out?

How is pathology treated and what do doctors do for it? First, specialists restore vital body functions: breathing, heartbeat. Immediately after the patient is admitted to maxillofacial surgery, it is necessary to stop the bleeding and relieve acute pain. Then a thorough diagnosis of the condition is carried out using x-rays and the type and nature of the injury is determined, because this will determine how to treat a fracture of the lower jaw.

There are different methods of repositioning (comparing) and immobilizing (fixing) fragments. There are conservative (splinting) and operative (direct and indirect osteosynthesis). All of them allow you to assemble a broken jaw into a single whole.

Conservative treatment uses splinting

If, according to indications, the patient requires surgical intervention, then doctors act in the following sequence: antiseptic treatment is carried out, fragments are removed and the fractures are combined with each other. Various devices help to fasten fragments of bone tissue - intraosseous pins and screws, compression devices, and metal plates on the bone. Then the mucous membranes are sutured and sutured. Another mandatory step is the removal of teeth located in the damaged area. After the operation, doctors install a fixation splint.

The conservative method involves installing a therapeutic splint. As a rule, this is an intraoral intermaxillary structure that is attached to the teeth using a ligature wire.

Factors complicating the prognosis of recovery

Different treatment methods are used for different types of fractures. The basis for successful recovery is proper fixation of bone fragments, which will ensure proper blood circulation in the affected area and rehabilitate the functions of the jaw. Tissues take longer to recover if the injury damaged vessels that provide access to oxygen and all useful substances that promote regeneration when soft tissues are damaged.

After all, if specialists had to fuse the fragments during the operation, and then apply splints, plaster or other fixing structures, then the injury requires much more time for complete healing. Therefore, when doctors have to assemble the bone piece by piece and stitch up the resulting gaps, there is no guarantee of a quick recovery. In addition, in such cases, after the operation it is necessary to immobilize the affected area for a while. For this reason, experts refuse to make predictions, because if there is a risk of complications that will affect the recovery time.

How long will it take for the injury to heal?

When asked how long it takes for a jaw fracture to heal, doctors answer that on average rehabilitation lasts up to 3 months. The trauma is significant, and only after the first month of treatment do patients begin to feel relief. Much of the relief is due to the fact that 21 days after the operation the fragments heal and doctors remove the splint, but sometimes this happens later, only on days 30–40.

On average, rehabilitation lasts up to 3 months

If you do not follow the doctor’s recommendations, in case of chronic diseases that disrupt tissue trophism (for example, diabetes), the healing process may take 2–4 weeks longer.

“I suffered a broken jaw in an accident. How many tears I shed while being treated!!! This whole thing heals quite slowly, you have to wear a splint, and it’s generally difficult to eat normally. If you want to lose weight and get rid of extra pounds, break your jaw. Black humor! This splint also constantly rubbed the mucous membrane on the cheeks and lips. All this time there was pain. After the splint was removed, there were sores and inflammation in my mouth. Then she replaced the teeth, since some were knocked out during the accident. In total, it took six months to recover. Now, thank God, the pain is gone, but it pulls and aches for any reason, for example, if the weather changes...”

Mi, fragment of review from otzovik.com

Let's find out the forecast

Every patient is immediately concerned about one question: when will he be able to fully recover? As has already been mentioned several times, this depends on a number of factors. If there are no complications, the patient is young, and the jaw fracture is not complicated, then within a month the injury can be forgotten like a bad dream.

But there are factors that cannot be ignored. And even with a simple fracture of the jaw, its recovery is delayed.

Factors:

genetic characteristics;
inflammatory processes in acute or chronic form;
pathologies and ailments of the immune system, bone tissue;
calcium and vitamin D deficiency.

In addition to radical treatment methods, patients with such diagnoses always need to adjust their diet. It should be enriched with foods that contain calcium, vitamin D, as well as other vitamins, micro- and macroelements. If this is not enough, a specialized doctor may additionally prescribe vitamin and mineral complexes.

What needs to be done during the rehabilitation period?

After the operation, it is allowed to eat exclusively liquid food and broths: it is recommended to eat food through a straw. Later, when the splint is removed (after about 21 days), you are allowed to eat food that has been blended and has a pureed consistency, as well as ground meat. A gentle diet must be followed for at least another month from the moment the tires are removed,
you cannot open your mouth and strain your jaw: you will have to say “no” to meeting friends, communicating with colleagues, talking and laughing,
it is necessary to follow the recommendations of doctors and take prescribed medications and drugs,
It is important to undergo a course of physiotherapy procedures that promote accelerated tissue restoration: they can be carried out no earlier than 3–5 days after surgery. This could be magnetic therapy, electrophoresis,
physical therapy: it is done after removing the fixing splints,
undergoing routine examinations: they are carried out at least once a week until complete recovery.

Do not open your mouth or load your jaw

How to take care of your mouth and brush your teeth while wearing a splint?

Often patients are given a splint that tightens the upper and lower rows of teeth. Therefore, difficulties arise with daily care of teeth and gums. However, it is necessary to maintain hygiene, because a number of studies1 show that after wearing splints, many patients experience periodontal inflammation, as well as caries if hygiene was lacking.

Hygiene can be carried out using antiseptics and rinses that are used to rinse the mouth. To clean teeth and dental structures, you need to buy a brush with soft bristles and a brush. It is also recommended to purchase an irrigator that will help thoroughly rinse the mouth from food debris. True, you can use it no earlier than 10 days after the operation, and only on the most gentle regimen. It is necessary to rinse and irrigate up to 8–10 times a day.

Results

As can be seen from the material, maxillofacial damage can adversely affect not only the general condition of the patient, but also individual organs. However, there is no need to despair, because medicine does not stand still, and now the patient is offered a number of alternative options that will help speed up the period of healing and rehabilitation after injury. One of these is the method of osteosynthesis, which helps to collect bone fragments and completely rehabilitate the maxillofacial bones, bringing them to their natural anatomical appearance. Therefore, now even the most severe injuries can be treated faster and more effectively with the help of innovative methods that promote rapid healing.

It is important to understand that, despite the length of the recovery process, complete rehabilitation is only possible if you carefully follow all the doctor’s instructions. In this case, positive dynamics may occur faster, which means recovery will occur after a not-so-long period. Therefore, in some cases it is worth remembering that the speed of recovery also depends on the patient.

Can fragments heal incorrectly?

In 85% of clinical cases the outcome is favorable, that is, recovery occurs. But sometimes (in 7% of cases) a broken jaw does not heal as it should. Doctors attribute this to the fact that the patient did not follow all the recommendations and violated the regime. This may also be due to incorrectly chosen tactics and treatment methods, or poor fixation of fragments. But improper bone fusion is not the most dangerous consequence or complication of injury. Sometimes the patient’s suffering continues further because he develops traumatic osteomyelitis.

If not treated promptly or correctly, the fracture may heal incorrectly.

Osteomyelitis is a serious purulent-infectious lesion of the jaw bone tissue. It can occur due to a violation of asepsis at the time of the operation or after it, in the presence of unremoved and broken teeth, roots, caries, pulpitis, and periodontitis in the mouth.

A disease such as osteomyelitis, as well as untimely seeking of specialized help, can lead to the formation of a pseudarthrosis after the jaw has healed. This cosmetic defect greatly spoils the aesthetics of the face and disrupts the bite, so it needs to be corrected through surgical manipulation. But pathology can be completely avoided if the patient receives all the necessary medical care quickly and in a timely manner.

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prevention

Zoirov T.E., Bobamuratova D.T., Elnazarov A.T. The state of hygiene and periodontal disease during treatment using splinting in patients with a jaw fracture // Questions of science and education. – 2022.

Expert “After removing the splints, it is very important to sanitize the oral cavity and remove plaque, as well as restore the functionality and beauty of teeth damaged as a result of injury. Contact a dentist who will perform professional oral hygiene and, depending on the clinical situation, offer composite building, installation of crowns and veneers, prosthetics with removable and fixed structures, and implantation.” Dentist therapist, periodontist Marina Igorevna Tarabanovskaya

Consulting specialist

Tarabanovskaya Marina Igorevna

Specialization: Dentist therapist, periodontist Experience: 10 years

Comments

After installing the splint, is the patient allowed to go home or does he have to stay in the hospital?

Mike (06/26/2020 at 02:41 pm) Reply to comment

Editorial staff of the portal UltraSmile.ru (06/29/2020 at 09:14) Reply to comment

A very unpleasant phenomenon. I wonder what to do with food for forty days. That is, the patient is unable to chew or take solid food at all. Will this have a negative impact on the digestive system if food comes in liquid form for several months?

Sergey Petrovich (07/23/2020 at 08:50) Reply to comment

How long do the consequences of a fracture of the lower jaw last? What I mean is that at the site of any fracture a certain callus appears. And how long does it usually take to make itself felt after an injury?

Vladimir Logvinov (07/23/2020 at 09:06) Reply to comment

Is it true that after a jaw fracture, this place becomes so vulnerable that if you put a little pressure on it, say, cracking a nut, and a second fracture will immediately occur?

Nikolay (07/23/2020 at 09:22) Reply to comment

Surely, after all, there are consequences from a fracture of the lower jaw, even if surgery and rehabilitation are performed, or only in difficult cases do there remain any consequences?

Lera (07/23/2020 at 09:30) Reply to comment

My husband broke his lower jaw when he hit himself at work. Now he is in the hospital, and through a bunch of bandages on his face, it seems to me that he did not have a very successful operation. What are the consequences if the operation is not performed correctly? Can this be fixed immediately before it is too late?

Zhanna (07/23/2020 at 10:24 am) Reply to comment

During a fight, along with a broken jaw, teeth are often damaged. Are there any contraindications to installing metal-ceramic implants after a jaw fracture has been healed?

Evgeniy (07/23/2020 at 14:37) Reply to comment

It’s very interesting whether this has ever happened in medical practice, when there are no obvious symptoms of a jaw fracture, but there is still a fracture? And is it possible to fully recover after a fracture, without any consequences?

Svetlana (07.23.2020 at 14:46) Reply to comment

Good afternoon My brother has had more than 21 days of rehabilitation, but his jaw is not healing well, the doctor reassures him that everything will heal, but we are worried. Tell me, should I worry or should I expect a full recovery?

Victor (07/23/2020 at 15:26) Reply to comment