An oral and maxillofacial specialist is thoroughly qualified to repair facial injuries. These professionals are well versed in emergency care, acute treatment, and long-term reconstruction and rehabilitation – not just for physical reasons, but for emotional ones as well. Injuries to the face, by their very nature, impart a high degree of emotional as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long-term function and appearance.
There are a number of possible causes of facial trauma, such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries to teeth to extremely severe injuries to the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves, or the salivary glands).
Fractures to the bones in the face are treated in a similar manner to fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the 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 fractures.
One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and eliminates the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. 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 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. 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.
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. These types of injuries are treated by one of a number of 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 now utilized as replacements for 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.
Before surgery, you may be asked to get blood tests and take or adjust medications. If you smoke, quitting will help you heal faster and avoid possible complications. You will be given special instructions to follow prior to your surgery.
You will also need to arrange for transportation to and from the surgery and for someone to stay with you the night after the surgery.
According to the American Society of Plastic Surgeons, risks include:
You may have gauze or bandages applied to your incisions following surgery. In addition, a thin tube may be placed under the skin to drain excess fluid or blood. A member of your healthcare team will provide specific directions about how to clean and care for the surgical site.
Recovery time depends on the level of correction needed and whether additional treatments were done at the same time. You may experience bruising and swelling of your face immediately following surgery, which may last a few weeks. Recovery time may be longer for more complex cases.