The broken jaw
introduction
A broken jaw describes an injury to the upper or lower jaw bone with destruction of the bone structure. Therefore, these jaw fractures count as fractures and make up about half of all fractures in the head area. However, the lower jaw is affected far more often than the upper jaw. Modern conservative methods and surgical techniques allow the fracture to regenerate with little risk, so that normal load on the jaw can be restored relatively quickly.
Causes of a broken jaw
Probably the most common cause of a broken jaw is an excessive external mechanical force that the jaw cannot withstand and gives way. Injury to the lower jaw is more likely to result from falling on the head or force from a blow, while upper jaw fractures result from blunt mechanical force.
Due to its anatomy, the upper jaw is much more fragile and porous than the lower jaw and is more prone to breakage. Upper jaw fractures often occur in car accidents and severe violence. Another cause of a jaw fracture can be a sports injury, an occupational accident, or a riding accident. Gunshot wounds can also cause a broken jaw.
Furthermore, the removal of displaced wisdom teeth can cause so much bone loss that a wrong bite of solid food will cause a fracture at this point.
A jaw cyst, if left untreated, can also lead to a broken jaw. You can get to the main article here: Jaw cyst
Jaw fracture due to removal of wisdom teeth
During a wisdom tooth operation, the displaced teeth often have to be milled out of the bone. In this case there is always a certain amount of bone loss, also because the tooth takes up a relatively large amount of space within the bone and the bone is formed around it. If this is removed, there is primarily a hole in the area in which blood collects and slowly restructures into bone cells.
If you stress the area too early by chewing hard food, the jaw can break at this point, as the bone layer is much thinner here and the bone is weakened by the pulling. This phenomenon can also occur when the canine teeth are removed, as the long roots also take up a lot of bone thickness.
Diagnosis of the broken jaw
The diagnosis of a jaw fracture is confirmed by clinical and radiological signs. One of the clinical signs is an occlusal disorder, which means that the teeth no longer fit together optimally. Furthermore, there may be tooth gaps or steps that were not present before the break. An abnormal mobility of the upper jaw also suggests a break.
The dentist can definitely diagnose the resulting fragments as fracture pieces by rubbing them against each other, as they produce a typical noise. This grinding together is called Crepitation designated. In addition, bruises, swelling and numbness can occur, which are, however, not certain clinical signs of a broken jaw.
With the additional imaging procedures such as X-rays or DVT, a fracture can definitely be diagnosed with certainty. In these images, interruptions in the bone structure become visible, which indicate a break.
What are the symptoms of a broken jaw?
Accompanying symptoms of a broken jaw vary depending on the cause. In the event of accidents and strong external forces, bruises and severe swelling are likely. The bruises can appear on the eyes, temples and cheek region and limit the function of this tissue. The swelling can cause numbness on the side, which usually disappears after the swelling. A nerve can be blocked by the swollen tissue structures so that the patient no longer feels anything or less than before in the treated areas.
However, swelling and bruises can also cause severe pain. Furthermore, a jaw opening disorder or a jaw closing disorder can occur. In many cases, there is no longer a proper bite, so that any function of the upper or lower jaw is hindered. The temporomandibular joints and their appendages can also deviate and cause the mouth to tilt.
Pain in the broken jaw
Typical pain characteristics with fractures in the jaw area are compression pain and pressure pain. In the case of fractures of the temporomandibular joint head or the ascending part of the lower jaw, the broken part compresses the joint and causes discomfort, since both sides of the jaw are now stressed differently.
If the broken pieces of bone are displaced, the sharp ends of the fracture can press on soft tissue in the surrounding areas, which causes severe tenderness. Pinching nerves and blood vessels can also trigger symptoms that are almost unbearable. However, after fixation and therapy, the symptoms are usually completely alleviated.
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Therapy of the fracture of the jaw
The treatment of fractures of the jaw is divided into a conservative, closed and an operative, open approach. In the past, the upper and lower jaws were therapeutically tied together with wires until the break had healed. However, since this severely limits the quality of life, as the patient is prevented from speaking and eating, new therapy methods were quickly developed.
In the case of upper jaw fractures, open surgical treatment is usually always necessary to fix the upper jaw back to the base of the skull. In the case of lower jaw fractures, it depends on whether the fracture is displaced or the fragments are still in their normal position. In the case of displaced fragments, a surgical approach is always the therapy of choice.
Conservative treatment is indicated for non-displaced fractures or only fractured lower jaws. If the lower jaw is only partially broken, protection is the only therapy.In the event of fractures, the practitioner decides whether a splint is to be put through wire or orthodontic appliances such as an activator must be worn. Splinting is conservative as the most popular therapy method.
Operation of the broken jaw
In the case of displaced fragments after a fracture, comminuted fractures and multiple fractures, an open surgical approach is inevitable. Contraindications for the operation are alcohol addiction, pregnancy and convulsions. In operative therapy, a distinction is made between two procedures:
- With plate fixation, the pieces of bone are fixed to one another by plates. The plates prevent the pieces of bone from moving. In addition, the plates prevent rotational mobility in particular. As a rule, the plate fixation leads to good healing of the fracture. The metal material can be removed after at least 12 months. Usually, however, it takes 12 to 18 months to remove them.
- In lag screw osteosynthesis, one piece of bone is drilled open so that a screw can be inserted into this hole. In the other fragment, a smaller hole is drilled into which a thread is cut. By screwing in the screw, tension is exerted on the fragments and the two pieces are fixed together.
Nowadays plate osteosynthesis is the predominant method that lag screw osteosynthesis is increasingly replacing due to the success of the therapy.
Splinting of the jaw at the break
Splinting is the treatment of choice for conservative procedures. This splint is used when the fragments are not displaced and are in their normal position. The rows of teeth are fixed by an arch wire splint so that they cannot be incorrectly loaded and the fracture can regenerate. Since this form of conservative treatment does not adequately fix the fracture for greater mechanical loads, a splint or plaster cast is usually also put on so that the fracture does not reopen.
Time it takes to heal a broken jaw
When a bone can be fully loaded again after an osteosynthesis depends on the type of fracture, the individual healing process and the type of therapy. After jaw fractures, complete bone regeneration usually takes place after six weeks. Then the bone is fully resilient again and the patient no longer has any restrictions.
How can you speed up healing?
There is no scientific proof for accelerating preparations or measures, which is why all therapy measures and rules of conduct prescribed by the doctor must be strictly observed. In homeopathy there is the preparation Symphytum made from comfrey, which is supposed to accelerate osteosynthesis and bone regeneration. Symphytum is used in globule form primarily for bone fractures, but also for sprains. The attending dentist should be discussed in advance about the intake so as not to produce a therapy failure.
The diet after a broken jaw
The diet after a broken jaw is heavy and the surgical therapy is severely limited. During this time, food is consumed exclusively in liquid and pulpy form. Hard foods can cause the fracture to open again or to move. Good oral hygiene is hardly possible during the healing period of six weeks, which is why the patient should avoid foods containing sugar. By doing without, the risk of tooth decay, which is caused by restricted oral hygiene, is not increased any further. In the case of severe debris fractures, it is quite possible that the patient must initially be fed via a gastric tube.
Sick leave with a broken jaw
Depending on the extent of the injury, the patient is unable to work for around two to six weeks, during which he is on sick leave. In the healing phase after the inpatient stay, weekly follow-up checks are prescribed in order to follow the healing process and rule out complications. Irregular follow-up can lead to delays in healing and functional problems. Complications can therefore also prolong sick leave and follow-up care. Rehabilitation measures such as special functional physiotherapy are not necessary for most fractures.
Who receives compensation for pain and suffering after a broken jaw?
A person concerned receives compensation for pain and suffering if he is harmed by grossly negligent or willful action by others, such as B. in a fight. The compensation for pain and suffering stands for a kind of compensation. A broken jaw justifies the payment of pain and suffering, which is not a lump sum. The amount is case-related and can vary greatly, depending on the severity of the damage. Factors such as permanent scars and subsequent psychological symptoms are included and can increase the amount of compensation for pain and suffering.
