Jaw fracture occurs in more than half of all fractures that affect the skull. For this reason, jaw fracture is considered one of the most common fractures of the head.
What is a jaw fracture?
The jaw fracture can present itself in two different extents and can be localized on both the upper and lower jaw. If a jaw fracture exists, the bone has been destroyed, so the jaw fracture belongs to the fractures. Depending on where the jaw fracture is located, we are talking about an upper or lower jaw fracture. Both diagnoses require appropriate treatment to restore normal function to the jaw with the teeth embedded in it. In individual cases, however, the jaw fracture is so extensive and complex that it takes an enormously long time for its physiology to be completely restored and for the jaw to be able to bear weight.
Causes
The causes of a jaw fracture are usually based on the sudden action of mechanical forces that result in fracture of the bones. In the case of a fracture of the upper jaw, it is usually so-called blunt force impacts. These usually hit the rather thin bones with a high energetic potential. A jaw fracture of the upper jaw is a consequence of traffic accidents as well as after intense physical assaults. In addition, a jaw fracture can also occur on the lower jaw due to the penetration of bullets or as a result of explosive projectiles, as well as after falls on the head. Accidents during sports activities, as well as impact of force by animals (hooves in the case of kicking out horses) also quite often cause a jaw fracture.
Symptoms, complaints and signs
A jaw fracture is initially manifested by jaw pain. The pain occurs mainly when chewing and speaking and is often described by the affected person as stabbing or pressing. This is associated with limited mobility of the jaw. As a result of jaw malocclusion, teeth may become misaligned and no longer fit together properly. Often the teeth are loose or even fall out. A persistent numbness may occur in the area of the lower lip. In addition, bleeding into the floor of the mouth is possible. In severe injuries, bleeding also occurs in addition to the jaw fracture. The lips, chin and nose are usually affected. Injuries to the tongue and cheek pouches are also conceivable. The visible malposition of the jaw is the most obvious external feature. In addition, a jaw fracture can be detected by any deformities and bleeding. A misalignment of the teeth indicates a past jaw fracture. The symptoms of a jaw fracture subside after a few days to weeks. If surgical treatment is performed at an early stage, any misalignment of the jaw can also be corrected without any late effects. The pain subsides after only a few hours with appropriate treatment.
Diagnosis and course
When making a diagnosis with the aim of identifying a jaw fracture both in its extent and its localization, specialists use various methods. The patient’s statement serves as the primary guide. However, if the patient is unresponsive, the first step is a visual examination of the jaw. In the case of a jaw fracture, it is difficult to make a definitive diagnosis. The final results confirming a jaw fracture are mainly based on the involvement of technical equipment, which includes X-ray devices. In addition to testing the mobility in the case of jaw fracture and triggering a pain, medical professionals can perform a computed tomography scan if the findings are unclear. Depending on where the jaw fracture is located, either abnormal movement occurs or noticeable swelling can be seen on the face. When diagnosed and progressing, a jaw fracture is always a complex of multiple abnormalities that also require inspection of the orbits.
Complications
A jaw fracture is a medical condition that should be treated by a doctor. Otherwise, there is a risk of serious consequential damage from which affected individuals may not fully recover. Accordingly, such a jaw fracture is also associated with various complications, which should always be taken care of by an appropriate doctor. If a jaw fracture remains without any treatment, this fracture will not grow together on its own.Of course, there is also extremely severe pain, which can also only be eliminated by surgery. Anyone who forgoes surgery at this point must of course reckon with considerable complications. The fracture may even have an abscess, so that there is a risk of blood poisoning. Of course, this complication must also be treated by a doctor, otherwise there is an acute danger to life. Existing bacteria and viruses can also spread throughout the body through such an abscess, resulting in an infection. Who leaves such an infection without treatment, of course, also runs a great risk. Headaches, fever and sore throat can occur, so that treatment by a doctor is also necessary at this point.
When should you go to the doctor?
If severe pain in the mouth area occurs after a fall, accident or exposure to force, a visit to the doctor is necessary. If the jaw can no longer be moved as usual or if irregularities in the chewing process occur, a doctor is needed. Visual changes in the shape of the face, discoloration of the skin around the chin, or deformities of the upper neck indicate irregularities that need to be examined and treated. Restriction of phonation, difficulty swallowing, and problems opening the mouth are signs of a health problem. A visit to the doctor is necessary so that medical care can be initiated immediately. If the intake of food and drink is refused, the affected person needs a doctor. If the symptoms persist for several hours or if there is an increase in symptoms, a doctor should be consulted. Anxiety, sweating, tremors, and discomfort with an existing denture are conditions that should be controlled. If blood loss or vomiting of blood occurs, a physician should be consulted. If there is a circulatory collapse, an ambulance should be alerted. At the same time, first aid measures must be taken by persons present. If children show sudden changes in behavior by crying and screaming unabated for a prolonged period of time, they should be presented to a physician as soon as possible.
Treatment and therapy
As part of the possible therapy for a jaw fracture, there is usually an initial treatment of the fracture. Later, more advanced treatments follow after intensive differential diagnosis. In the case of a jaw fracture, these are based on surgical intervention, reduction and fixation. During the initial treatment, which is usually a trauma treatment, improved breathing is made possible. In some cases, intubation may be required due to airway obstruction in mandibular fracture. Temporary splinting of the upper or lower jaw and emergency pain management follow for a broken jaw. Surgical intervention for a jaw fracture involves aesthetic restoration. In this context, in case of a jaw fracture, it may be necessary to connect individual splintered bone parts and fix them to the skull bone. During intubation, ventilation is mainly performed through the nose. If the jaw fracture is extremely extensive, ventilation can be performed by means of a tube through the opened floor of the mouth. In order to obtain an exact reconstruction of the healthy jaw in the case of jaw fracture, the bone parts are placed in their natural anatomical locations as part of a reduction. Treatment for jaw fracture is accompanied by prolonged immobilization and possible compression on the fracture site. Pain medication and anti-inflammatory drugs are used to promote better healing. In addition, the pain medications help to relieve the permanent severe headaches.
Outlook and prognosis
Normally, a jaw fracture is easily curable if medical care is sought immediately after the triggering event. Otherwise, the affected person is at risk of permanent damage as well as a severe impairment of quality of life. Without medical help, the fracture will not grow together on its own. There is severe pain and the risk of complications is significantly increased. Chewing is significantly impaired and speaking is much more difficult. Viruses and bacteria can settle and spread in the mouth and throat area. In severe cases, the affected person is at risk of respiratory distress or blood poisoning.Sepsis means an immediate threat to life. If the respiratory tract is disturbed, the course of the disease can also be fatal. With treatment, extensive control of the damage sustained takes place. In difficult cases, surgical intervention is performed immediately to save the life of the affected person. The jaw is immobilized so that the best possible healing success can take place. Under optimal conditions, the patient receives a splint after a few weeks or months, which ensures the stability of the jaw in the further course of the recovery process. In some people, additional surgical procedures take place for aesthetic reasons. Split bone parts must be joined together and permanently fixed to the skull bone.
Prevention
To prevent a jaw fracture, it is particularly important to prevent mechanical force on this area. In addition, it is unavoidable to wear a chin guard during accident prevention to cushion or insulate any impacting shocks or blows.
Aftercare
One of the goals of follow-up care is to prevent recurrence of disease through scheduled follow-up examinations. However, this objective cannot be implemented for a mandibular fracture. This is because the typical complaints are caused by external forces such as falls or blows. They occur purely randomly and selectively. A doctor cannot detect a future fall or blow to the jaw at an early stage, as is the case with a tumor. As a result, follow-up care after recovery is of no importance. Medical care ensures that no complications arise in the healing process. However, it cannot prevent a new jaw fracture. If a new jaw fracture occurs, the doctor tries to support his patient in his everyday life as in the previous treatment. For six weeks the patient has to take it easy. Food intake is possible only in liquid form. Since oral hygiene cannot be performed in everyday life, the patient must avoid foods containing sugar. The progress of the healing process is monitored in regular examinations. Imaging procedures such as an X-ray or CT scan are suitable for this purpose. The jaw can then be fully loaded again. There is no need for further medical examinations.
What you can do yourself
If a jaw fracture is suspected, the first thing to do is to cool down and take it easy. Until the emergency doctor arrives, the jaw must be treated with a cold pack and immobilized. If it is an open fracture, it must be covered immediately with germ-free dressings. In the event of shock, the victim must be placed in the recovery position – then sedated and repeatedly checked for consciousness and breathing. The emergency physician must be informed immediately about the circumstances of the jaw fracture. After the initial treatment, bed rest is recommended. The jaw must be rested for several weeks. In order to lose as little weight as possible during this time, a change in diet is necessary. At the beginning, only liquid food can be consumed – soups and teas, pureed meals and drinkable food from the pharmacy sufficiently cover the calorie requirement. Accompanying this, oral hygiene must also be adjusted. Special hygiene rinses from the drugstore are just as suitable as natural home remedies (e.g. tea tree oil or aloe vera) and curved toothbrushes. Finally, the jaw muscles should be strengthened through regular exercise. Especially in the case of major fractures, it is important to practice chewing daily to avoid discomfort after recovery.
