The MVOMS team of oral and maxillofacial surgeons are uniquely qualified to manage and treat facial trauma. They deliver emergency care, acute treatment, and long-term reconstruction and rehabilitation – providing both physical and emotional support. They also understand how the treatment will influence the patient’s long-term function and appearance.
On staff at San Diego hospitals, the MVOMS team delivers emergency- room coverage for facial injuries including the following conditions:
- Facial and intraoral lacerations
- Teeth that have been knocked out
- Fractured facial bones (cheek, nose, or eye socket)
- Fractured jaws (upper and lower jaw)
The nature of maxillofacial trauma
Motor-vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries all can cause facial trauma. Injuries can range from chipped teeth to extremely severe injuries of the skin and gums (so-called soft tissue), facial bones, and special regions (such as the eyes, facial nerves, or salivary glands).
When soft-tissue injuries such as lacerations occur on the face, they are repaired by suturing. In addition to the obvious concern of obtaining 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 (or outflow channels). MVOMS surgical team members are proficient at diagnosing and treating all types of facial lacerations.
Bone injuries of the maxillofacial region
A variety of factors shape the specific form of treatment, including the location and severity of the fracture and the patient’s age and general health. When an arm or leg is fractured, a cast is often applied to stabilize the bone and obtain proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.
One involves wiring the jaws together. Other types of fractures of the jaw are best stabilized by surgically placing small plates and screws at the fracture site. The development of this technique, called “rigid fixation”, has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.
The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. When incisions are necessary, they are designed to be small and, whenever possible, placed so that the resultant scar is hidden.
Injuries to the teeth and surrounding dental structures
Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out. 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 the chance it will survive. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw can be vital to successfully 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. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for the missing teeth.