FACIAL TRAUMA

Oral & maxillofacial surgeons are trained and uniquely qualified to provide surgical correction of facial injuries including:

  • Lacerations on the face and inside the mouth
  • Loose or knocked out teeth from injuries
  • Fractured jaws (upper and lower jaws including mandible fractures and Le Fort fractures)
  • Fractured bones in the face (eye socket, cheek)

There are numerous possible causes of facial trauma. Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work related injuries account for many. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. These types of injuries may require the immediate assistance of an oral & maxillofacial surgeon, or simply a facial surgeon, such as Dr. Cohen.

Mandible fractures can result from any direct physical trauma or blunt trauma to the face. Many patients who sustain a mandible fracture will present with pain in the lower jaw, and a complaint that their teeth are not coming together. Patients with a mandible fracture may also have numbness of their lower face or lower lip. Treatment of mandible fractures may require that the teeth be wired together during the procedure so that titanium plates and screws can be applied to realign the broken bones.

Le Fort fractures are facial fractures involving the maxillary bone and surrounding structures. Amongst the many signs and symptoms, patients with Le Fort fractures may present with swelling of the upper lip, inability to put their teeth together, facial swelling and bruising, and numbness in the mid face region. Just like with mandible fractures, Le Fort fractures sometimes require that the teeth be wired together during the procedure to realign the broken bones with titanium plates and screws, and then the teeth are usually unwired at the end of the procedure.

Cheek fractures may cause visible deformity, and since the cheek bone also forms part of the eye socket, these fractures may also involve fractures of the eye socket. Just like the treatment of other facial fractures, the surgical correction of cheek fractures may require using titanium plates and screws to hold the bones together.

Nasal fractures, or broken noses, are very common. They can occur from relatively minor trauma, such as falling against a door, or being bit with an elbow during a sports game. Patients with a nose fracture will often notice that their nose is swollen and that it is pushed over to one side. When treated shortly after the injury, broken noses may be treated by a “closed reduction”, which means that the nose is manipulated and molded back to the midline. Sometimes, however, a closed reduction may not completely correct the fracture, and additional procedures may be required several months later.

We are cognizant of the emotional, functional and cosmetic impact that patients often experience from facial trauma. Dr. Cohen is on staff at most major hospitals in the New York City area and provides emergency room coverage for facial injuries. He received extensive training at Charity Hospital in New Orleans , Louisiana, and at Allegheny General Hospital, in Pittsburgh, Pennsylvania,  both being Level One Trauma Centers, where he has provided treatment for many types of facial trauma.

Injuries to the Teeth and Surrounding Dental Structures

Oral & maxillofacial surgeons treat fractures of the bone that surrounds your teeth and also replant teeth which 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”, immediately place it 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 call and see us as soon as possible. Never attempt to “wipe the tooth off”, since remnants of the ligament which hold the tooth in the jaw may still be on the tooth and are vital to the success of replanting the tooth.

Other dental specialists, such as endodontists and restorative dentists, may be called to perform root canal therapy and to repair fractured teeth. In the event that injured teeth cannot be saved or repaired, a dental bone grafting procedure may need to be performed to preserve enough bone structure for a future procedure for dental implants, to replace these missing teeth.

If you have recently been a victim of a facial trauma and suspect a facial fracture or injury, immediately report to your nearest hospital emergency room, or contact Dr. Cohen at (212) 988-6725 who will evaluate you and determine if you require emergency treatment.