Facial Trauma

An oral and maxillofacial surgeon is thoroughly qualified to repair facial injuries. These specialists are well versed in emergency care, acute treatment, and long-term reconstruction and rehabilitation – for both physical and emotional reasons. Injuries to the face, by their very nature, impart a high degree of emotional and physical trauma to patients. The science and art of treating these injuries requires special training involving “hands on” experience and an understanding of how the treatment provided will influence the patient’s long-term function and appearance.

Dr. Nelson is trained, skilled, and uniquely qualified to manage and treat facial trauma. 

  • Facial lacerations
  • Intraoral lacerations
  • Avulsed (knocked out) teeth

The Nature of Maxillofacial Trauma

Possible causes of facial trauma include motor vehicle accidents, falls, sports-related injuries, interpersonal violence, and work-related injuries.  Facial injuries can range in from teeth to skin and bones.  Typically, facial injuries are classified as 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

Soft tissue injuries, such as lacerations, to the face are often repaired by suturing.  Care is taken to provide the best cosmetic result possible.  In addition, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Dr. Bode and Dr. Nelson are well-trained oral and maxillofacial surgeons proficient in diagnosing and treating all types of facial lacerations.

Bone Injuries of the Maxillofacial Region

Facial bone fractures are treated in a similar manner to fractures in other parts of the body. The specific form of treatment is determined by location and 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 bone fractures.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw.  Other types of fractures are best treated by the surgical placement of small plates and screws at the involved site. This technique, called “rigid fixation” may allow for healing and eliminate the necessity of having the jaws wired together.  The relatively recent development and use of 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 thorough, predictable, and with minimal effect on the facial appearance of the patient. 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 resultant scar is hidden.

Injuries to the Teeth & Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons are usually involved in treating fractures in the supporting bone, or in replanting teeth that have been displaced or knocked out. These types of injuries may be treated by various 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. In the event that injured teeth cannot be saved or repaired, dental implants are often used to replace missing teeth.

The proper treatment of facial injuries is now the realm of specialists who are well versed in emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.