Dislocated Or Fractured Jaw

Displacement of the temporomandibular joint results in a dislocated jaw. A break in one or both of the two maxillae (upper jawbones) or the mandible (lower jawbone) constitutes a fractured jaw. Treatment usually restores jaw alignment and function.

Causes

Simple dislocations or fractures are usually caused by a manual blow along the jawline as may occur in cases of child, spouse, or elder abuse; more serious compound fractures frequently result from motor vehicle crashes.

Symptoms

Symptoms of a dislocated jaw include:

• Pain in the face or jaw, located in front of the ear on the affected side, worse with movement
• Inability to close the mouth
• Teeth may not align normally
• Bite feels "off" or crooked

Symptoms of a fractured (broken) jaw include:

• Jaw tenderness or pain, worse with biting or chewing
• Jaw stiffness
• Loose or damaged teeth
• Bleeding from the mouth

Diagnostic tests

X-rays confirm the diagnosis; for a more accurate diagnosis, panorex views are usually required. The patient may be required to sit upright for the test unless this is contraindicated by the condition, such as a possible cervical spine fracture.

Treatment

As in all traumatic injuries, treatment involves first checking for a patent airway, adequate breathing, and circulation. After that, treatment focuses on controlling hemorrhage and caring for any other injuries. The patient may need an oropharyngeal airway, nasotracheal intubation, or a tracheotomy to help maintain an adequate airway.

Treatment also includes:

• medications to relieve pain and anxiety and to prevent infection before and after surgery, if indicated
• in dislocated jaw, manual reduction under anesthesia
• in fractured jaw, surgical reduction and fixation by wiring to restore mandibular and maxillary alignmemt (wiring usually is removed after 6 to 8 weeks)
• in maxillary fracture, reconstruction and repair of soft-tissue injuries as necessary
• reimplantation of any lost teeth within 6 hours, if possible, while they're still viable (teeth and bone fragments aren't removed during surgery unless they have to be).

Prevention

Safe practices in work, sports, and recreation -- wearing a proper helmet when playing football -- may prevent some accidental injuries to the face or jaw.

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