Our jaws form the foundation of our face and oral cavity. They play a significant role in our daily activities like breathing, eating and speaking. Any trauma or injury to the jaw causes pain and discomfort and results in inhibition of some of the pivotal functions of the mouth.
Such traumatic events can affect the jaw in two ways and they are fracture and dislocation. A fracture of the jaw results as a break in the bone or the joint which often goes unnoticed and is reflected as chronic jaw pain.
Dislocation commonly occurs in the mandible where the bone moves out of the joint capsule and inhibits the closing of the mouth. Whatever the injury may be, immediate medical attention is necessary to reduce the complications and improve healing.
Let us read further to differentiate between the two jaw injuries and look at the available treatment options.
What is a jaw fracture?
The jaws consist of two bony structures. The upper one is called the maxilla and the lower one is called the mandible. Mandibular bone typically extends from the chin to the ears on both sides.
Both of them support the surrounding facial and oral tissues. Jaw bone also supports the teeth and holds it in position.
The mandible is an essential supporting bone that functions in the opening and closing of the mouth and aids in the chewing mechanism.
Fracture of the jaw commonly refers to the fracture of the mandible which may cause pain, discomfort, and inability of the mouth to open fully.
Majority of the fractures occur at two places in the mandible and they are the angle and neck of the jaw. Fractures are typically a result of a traumatic injury such as a fall onto the chin or a hit from the side. (1)
What do you mean by dislocated jaw?
Dislocation of a jaw occurs when the bone detaches from its joint. Often during dislocation, the jaw gets locked in its deviated position and it becomes difficult to open or close it back in position. (2)
The unwanted rotations that happen during a dislocation may cause a severe pain that may extend to the head. The most common activity that may cause dislocation is yawning.
What causes a fracture/dislocation of the jaw?
A facial blow or a trauma is the most common cause of both a fracture and a dislocation of the jaw. There are plenty of factors that may cause both types of jaw injuries.
- A physical blow/punch in the face
- Injuries to the jaw while playing sports
- Road traffic accidents
- An accidental fall onto the chin by falling
- Workplace accidents, especially for people working in an industry
What are the signs and symptoms?
The clinical presentation and symptoms may differ in case of a fracture as compared to a dislocation.
Symptoms of a bone fracture
- Pain during chewing or speaking
- Facial swelling
- Bleeding from the mouth causing breathing difficulties
- The stiffness of the jaw
- Inability to move the jaw
- Numbness and bruising of the face
- Numbness in the gums
- Pain in the tooth
- A missing tooth or loose tooth (3)
Symptoms of a bone dislocation
Pain is a common factor that may be present during dislocation of the jaw. Additionally, the following symptoms may be experienced –
- A reverse overbite, the jaw may be placed forwardly
- Uneven occlusal bite, the teeth don’t line up evenly, and it feels different while biting
- Locking of the jaw, i.e., inability to open or close the mouth. This event also increases drooling from the mouth
- Difficulty in speaking
How is it clinically diagnosed?
Besides the obvious symptoms, the location and extent of the fracture can be diagnosed with the help of radiographic diagnostic tools like dental x-rays, CT scans, and MRI.
The health care professional may inject a contrasting liquid to make the location more visible. This liquid can be easily washed out of the system.
Make sure that you inform the health care provider about any allergies before using the contrast liquid. Also, remove any metal items like jewelry or hair clips before getting an MRI.
How can it be treated?
Treatment of a jaw injury is always considered as an emergency. If in case, the medical help takes time to arrive, you can support your jaw to stabilize it and keep the airway open.
Treatment of a dislocation may differ from that of a fractured jaw.
Treatment of a dislocated jaw
Commonly, a dislocated jaw can be manually manipulated back to its position by a health care professional. The pain can be subsided by using local anesthesia and pain medications.
The muscles of the jaw can be allowed to loosen and soothe by using muscle relaxants. In severe cases of jaw lock, temporomandibular joint surgery may be planned to correct the position and minimize the risk of reoccurrence. (4)
Treatment of a fractured jaw
- In the case of open wound, antibiotics are prescribed to reduce the infection. Pain medications can ease the pain.
- Jaw wiring – It is done to hold the jaw in place, prevent it from moving and allow it to heal. Usually, the wires are to be removed by the healthcare provider, but he may also train you to cut the wires yourself in case of emergency when the airway is to be maintained. (5)
- In severe fractures, surgery may be recommended to repair the fracture site and bring the jaw back in alignment. It may also be done to repair any surrounding structures that may be involved in the fracture, for example, a nerve, blood vessel or tongue.
Recovery is usually slow. A dislocation and a non-surgical fracture healing may take up to 4-8 weeks to heal. A surgical recovery may take up several months to recover completely.
Specific instructions are to be followed strictly to ease out the healing process:
- Application of ice for every 15-20 minutes after treatment helps to decrease the swelling and pain.
- Change in dietary habits – switch to soft food and juices. In case of jaw wiring, the food is ingested through a syringe or a straw. A doctor can provide you a diet chart specifying the food that can be consumed by the patient.
- Clean the mouth using a small head soft-bristled toothbrush that can reach the difficult areas with minimal mouth opening. A water floss can be used to aid in additional cleaning. Chapping of the lips can be [prevented by application of petroleum jelly.
- Do not apply any pressure on the jaw and do not play any sports until the jaw heals completely.
Take away message
Our jaws play a crucial role in our day to day functions. Any injury to the jaw can prove to be fatal for our life. Be aware of the incidents happening around you to prevent traumatic accidents.
If you suffer jaw injury, then it is always better to contact a medical professional immediately for early diagnosis and treatment.
Early intervention by your healthcare provider might decrease the complications and the risk of surgical intervention.
Whatever the type of jaw injury may be, it is always taken as an emergency due to the potential issues of bleeding and difficulty in breathing caused by it.
Follow the post-operative instructions very carefully to let your jaw heal quickly and with ease.