Understanding and Treating Jaw Fractures and Dislocations

A broken jaw, medically known as a mandibular fracture, is a frequent facial injury, second only to nasal and cheekbone fractures. The mandible, or jawbone, is a U-shaped structure comprising the "body" (from chin to jaw angle) and two upward branches called rami. This bone connects to the skull via the temporomandibular joints (TMJs) located in front of the ears. Ligaments stabilize the jawbone, and muscles facilitate its movement. A dislocated jaw occurs when the jawbone moves out of its normal position within one or both TMJs. Causes of Jaw Injuries: Jaw fractures are the tenth most common bone fracture in the human body, typically resulting from direct force or trauma. Common causes include: Motor vehicle accidents Assaults Sports-related injuries Falls Workplace accidents Men, particularly those aged 20 to 29, are approximately three times more likely to experience a broken jaw than women. While trauma can also cause jaw dislocations, they often result from opening the mouth too wide, such as during a large bite, a yawn, or a dental procedure. Symptoms of a Broken Jaw: If your jaw is broken after trauma, you may experience: Jaw pain Misalignment of teeth (malocclusion) Difficulty opening the jaw fully or speaking Swelling or bruising of the jaw Numbness in the chin or lower lip due to nerve damage Bleeding inside the mouth Loose or missing teeth Bruising under the tongue or a cut in the ear canal from backward movement of the jawbone. Symptoms of a Dislocated Jaw: A dislocated jaw presents with: Jaw pain Inability to close the mouth or limited opening Jaw twisted to one side Misaligned bite Difficulty speaking or swallowing When to Seek Medical Care: Any suspected jaw injury requires immediate medical attention, preferably at an emergency department. Do not drive yourself. If teeth are broken or lost, transport them in cold milk, salt water, or saliva. Seek emergency help (call 911) if there are signs of breathing problems (due to tongue support loss), uncontrolled bleeding, shock, or a possible head or spine injury. Diagnosis of a Broken Jaw: Diagnosis involves a physical examination and imaging. A doctor will inspect your face for deformities, bruising, or swelling, and check the TMJ, nerves, and blood vessels. They will then palpate the jawbone, assess its movement, and examine the inside of your mouth, including tooth alignment when you bite down. The "tongue blade test" may be used to evaluate jaw stability. A panoramic X-ray is the preferred screening tool, though other views may be used if unavailable. A CT scan might be ordered for inconclusive X-ray results. Treatment for a Broken Jaw: Consultation with a doctor or an oral surgeon is essential. Self-care (on the way to medical help): Apply ice to control swelling, avoid jaw movement, and use a bandage to immobilize the jaw if needed. A cup may be useful for drool or blood. Medical Treatment: Many jaw pain cases are not fractures and are treated with pain medication, a soft diet, and follow-up. For confirmed fractures, especially "open fractures" with gum or tissue damage, antibiotics are prescribed, and a tetanus shot may be given. Pain management is crucial. Stable fractures often only require wiring the upper and lower teeth together, usually performed by an oral and maxillofacial surgeon. Unstable fractures often necessitate surgery, potentially involving plates across the fracture site to allow early jaw motion and eating. Treatment for a Dislocated Jaw: Manual Repositioning: A doctor or dentist will manually manipulate the jaw back into place by pressing down and backward on the back lower teeth while holding the jaw's base. Pain medication or sedation may be used. Barton Bandage: A bandage wrapped under the jaw and around the back of the head helps immobilize the jaw during healing. Surgery: If dislocations are recurrent, surgery to tighten supporting ligaments may be considered. Recovery and Prevention: Jaw fracture recovery typically takes one to two months, often requiring follow-up with a surgeon. Adhere to antibiotic prescriptions and diet recommendations. For dislocated jaws, avoid opening the mouth wide for several weeks during healing. Prevention of jaw fractures primarily involves safe driving, avoiding violent situations, and wearing protective gear during sports. Outlook: The outlook after a broken jaw depends on the fracture's nature and location. Some fractures heal with diet changes and pain control without surgery, while others require surgical intervention. Hospital admission may be necessary based on the injury's severity.