Lower jaw bone fracture also termed as mandibular fracture is the second most common fracture of facial bones, first being the fracture of nose. It is predominantly noted in men than female and highest seen in the age group of 20-30s.
When your lower jaw starts aching after a fall or assault, it is overlooked for presence of any fracture.
It is most painful when the jaw movements are made and further examination will specify whether it’s a broken bone or injury to your muscles and soft tissues only.
Causes Of Jaw Fracture
Various causes of jaw fractures are present. They are:
1. Road traffic accident: this is one of the most grievous injuries that reports with multiple bone fractures and sometimes only with mandibular fracture. A term called dashboard injury is used, as most people tend to hit their chin on the dashboard of cars during a road traffic accident. This leads to a fracture in the chin or the condyle region (near the ears where the jaw movements are felt)
2. Assault / hit by another person: assault by any person leads to fracture of facial bones. The hit by fist to the chin or cheek or using any weapon can lead to the fracture of facial bones.
3. Self fall ; accidental self fall, or by a slip on floor leads to fracture of the bones, often sparing the head injury at times. The mandible is the first bone that comes in contact with the floor during falls.
4. Work-space injury : the industrial injury commonly reports soft tissue injury than fractures. But he incidence of jaw bone fractures is still high. The cutting and trimming machineries used in the industries are the most common source of injury to the face
5. Dental procedures : dental procedures like removal of impacted tooth has reported incidence of lower jaw bone fracture. It is because the impacted tooth generally makes the lower jaw bone weaker and during removing the tooth out, the first applied tend to break the cortical plates of the bone.
How To Know Whether It Is A Fractured Bone?
When in your jaw bone seems to be fractured you can have a small check of it yourself.
- If any teeth are missing. Its always to better to carry the broken teeth with you if by any chance you happen to collect it on the accident site.
- Mobility in the jaws. The lower jaw may start moving into pieces of two or rarely three
- Severe swelling : swelling Is a first reaction that the body shows up when there is any injury. But when there is a fracture, the swelling will higher than the soft tissue injuries.
- Bleeding from the mouth : fractured bone with breach in the soft tissue covering the bone will lead to bleeding from the mouth or nose.
- Unable to swallow or breathe : when the jaw bone is fractured, there will be difficulty in swallowing food and breath sometimes as the support to the jaw is impaired.
- Inability to open the mouth : often jaw bone fracture will restrict the mouth opening due to overriding of fracture segments or spasm of muscles responsible for jaw movements.
- Deranged occlusion : this is the nost common finindg in the fracture. As the jaw bone shifts to new position upon fracyure, the teeth don’t come in contact with each other. There is fine adjustment between the upper and lower teeth that make them always occlude in a certain position. Any changes in this , will make the teeth change its contact and leads to difficulty in chew any food.
Who to Contact In Case Of Fracture?
The specialty that deals with jaw bone fracture are oral and maxillofacial surgeons. They are trained specialists who fix the jaw bone back to their original position along with taking care of occlusion so as to provide optimum functionality of mouth.
As you see your health care provider in initial checkup, make sure you are directed to an oral and maxillofacial surgeon to get it fixed
How Is It Treated?
Jaw bone fracture treatment depends on the site and type of fracture.
Your healthcare provider will examine you for any broken bone movements on the U shaped lower jaw. The bruising under your tongue or in the trough of inner lip are suggestive of bleeding in between the muscles usually occurs due to high intensity blow on the jaws. Joint movements near the ears are examined. The occlusion is checked. Derangement in the bite, is a sign of fracture.
Radiographs like OPG, CT are taken to identify the fracture lines and correlate clinically.
The fractures that are displaced are treated surgically by placing titanium plates and screws to stabilize the segments. The teeth may have to undergo wiring so as to give extra support in case if needed.
The fractures that are non displaced or hair line fractures (greenstick fractures in medical terms) are treated conservatively. An arch bar will be placed around your teeth suspended by elastics to provide extra support during healing process.
Intra venous antibiotics and analgesics are provided to support the healing whereas oral hygiene plays an utmost importance in healing of the jaws fracture.
During discharge from the hospital, the medication will be changed oral tablets.
Home Care For Jaw Fracture
Home care of jaw fractures included mainly maintenance of oral hygiene. Once the jaw boned are stabilized using plates or wires, you can start brushing your teeth gently. Mouth wash and chlorhexidine gels will help in wound healing.
Try to avoid sleeping in the side of your jaw fractures. It always to sleep straight or in supine position without any pressure on the fracture site.
Do not do forceful rinsing of the mouth as the sutures inside the mouth might get loosened and may needs you to undergo resuturing again. Try avoiding usage of straws for 2 days as the negative pressure that is created inside the mouth upon sucking through the straws will lead to bleeding.
Do not spit forcefully. Apply ice pack on cheek bones or in sites of increased pain and swelling.
Do not apply heat patch on fracture site.
Do not apply rubefacient agents like zandu balm, vicks etc. it will worsen the course of healing and also infects the area. Further draining of pus and medication has to be put in that case.
Follow soft advice until adviced. Perform mouth opening exercises as told by your surgeon.
Diet To Be Followed
Jaw fracture cases are always advised to consume liquid diet for 3 days initially.
After 3rd day, patient can shift to soft diet. The diet can range between malt to smashed rice or idli. The less to non-chewable foods are preferred. Make sure your food is not sticky like caramel. Even cakes and ice creams are advised but shouldn’t contain any jellys or nuts in them.
2 Litres of fluids is a must. This sums up to 10 cups of water or juices if your cup measures 200ml per serve. Hydration plays a major role in healing. Complete diet includes carbohydrates, fats, proteins, minerals and vitamins. 3 months of multivitamin tablets will benefit in wound healing.
Recommended Foods for jaw fracture patient
Soft food that cab be blended or pureed can easy to consume.
Liquid diet is essential for hydration. Soups and juices hydrate the body also providing essential minerals and vitamins.
Nutrient-rich foods: emphasis on protein-rich foods like yogurt, eggs, and pureed meats.
Easy-to-chew foods: Opt for soft, tender foods like cooked pasta, oatmeal, or scrambled eggs, idli, smashed Pongal or khichdi.
Foods to Avoid
Hard and crunchy foods: Avoid nuts, chips, or hard candies, chapati and roti that needs lot of chewing and biting force.
Sticky foods: Avoid foods like caramel, gum, or dried fruits that can stick to teeth or appliances.
Spicy or acidic foods: Avoid foods that irritate or cause burning sensations on the tongue, gums or digestive system.
Hot food: Avoid extremely hot or cold foods that can cause discomfort.
Additional Tips
Eating in small quantities helps in managing discomfort and ensures adequate nutrition. There are no hard rules that your meal timings should be restricted to three times daily.
Avoid usage of straws to drink. This causes suction effect leading to negative pressure inside the mouth. This leads to dislodge of clot in the operated site thereby leading to bleeding. These delays healing process.
Consult a healthcare professional. An oral surgeon can provide you with personalized dietary plans based on your specific needs and treatment plan.
Following these guidelines helps in promoting healing, minimizes discomfort, and ensures adequate nutrition during the recovery.
Complications Of Jaw Fracture
1. Malocclusion: when the jaw bones are fractures, the teeth present in them can get displaced. Thereby not allowing us to bite properly in occlusion. This is termed as malocclusion.
2. Infection: when the fracture site is not properly cared, it can lead to infection. The bacteria enter the fracture site leading to sepsis.
3. Nerve damage: the nerves passing through the bone can get damaged when the bone fractures. There will be sensory and motor disturbances.
4. Malunion or nonunion: when the jaw bones don’t heal properly, it leads to mismatch in the original anatomy of the bone. It leads to increase in pain and restricts the functionality of the jaw bone. The bone can also heal with fibrous tissue in between the edges of fracture without new bone formation. This condition is called a s non-union. This leads to mobility in the fracture site.
5. Temporomandibular joint (TMJ) problems: the fracture can lead to clicking sound in the join. It can even cause restricted movement of the jaw with severe pain on opening and closing the jaws.
6. Aesthetic concerns: the jaw fractures lead to asymmetry of face along with scarring of the cut skin wounds.
7. Difficulty with speech or eating: as the main function of mouth is to speak and chew food. The fracture in the jaws may hinder these activities.
8. Chronic pain: untreated or partially treated fractures can lead to chronic pain at the fracture site.
9. Limited mobility: jaw fracture restricts the jaw movements. You will have severe pain when you try to move jaws. The cut edges of the fracture may override and not allow you to move any bit.
10. Systemic complications: in severe cases the fracture site, might lead to breathing difficulty as the tongue is pushed backward. Also if the fracture site is infected severely it can lead to sepsis. It’s a major complication where the patient has to be in ICU care and monitored vigilantly to get the infection down.
