Mandible (Lower Jaw) Fractures

Illustration of a mandible fracture

Mandibular fractures are second most common facial fractures with nasal fractures holding #1 place. Whether you have been in a car accident, altercation or sport injury causing you to sustain a mandibular (jaw) fracture, rest assure that Dr. Bolourian frequently encounters and helps hundreds of patients with jaw fractures.

Where do I go if I think I have  mandibular (jaw) fracture?

Typically patients report to a hospital emergency room to be evaluated for facial injuries. That is the right thing to do. There are certain times where an isolated jaw fracture may not be obvious to a patient and therefore he/she may not report to a hospital.

The person may feel:

  • Pain in the face or jaw, located in front of the ear or on the affected side, that gets worse with movement.
  • Bruising and swelling of the face, bleeding from the mouth.
  • Difficulty chewing.
  • Jaw stiffness, difficulty opening the mouth widely, or problem closing the mouth.

In above situations, the patient should seek an Oral and Maxillofacial Surgeon immediately. The sooner a mandibular fracture is diagnosed, the better outcome the patient will have. Patients should make sure to seek an oral and maxillofacial surgeon that covers hospital trauma surgery and performs jaw fracture surgeries on a regular basis. Many oral and maxillofacial surgeon are office based clinicians and may not be able to perform the type of surgeries to correct a broken jaw.

What happens if I have a mandibular (Jaw) fracture?

Your Oral and Maxillofacial Surgeon will perform a full history and physical examination prior to treatment recommendations. Once diagnosis of a mandibular (jaw) fracture is conformed, the surgeon will review the surgical options with you. In our practice, Dr. Bolourian admit patients at the local hospital and attends to your needs as quickly as possible. We realize and emphasize the importance of early intervention for superior outcome.

What type of surgery would I require to fix my broken jaw?

The type of surgery needed to fix a broken jaw depends primarily on the type of fracture a patient sustains. A closed or non-displaced fracture is repaired by intermaxillary fixation (IMF). That is wiring the mouth shut for a period of time. That is similar to a cast on a broken arm. Some fractures may be displaced also known as open fractures. They may require open reduction and internal fixation (ORIF). This approach requires accessing the fracture site and using stabilizing plates and screws to fixate the jaw.

Some patients may not be candidate for a cast on the jaw, meaning they may not be able to tolerate wiring their jaw due to certain medical conditions. Dr. Bolourian discusses all options for achieving the best outcome.

X-ray of the lower mandible facing rightX-ray of the lower mandible facing right with hardware
X-ray of the lower mandible facing leftX-ray of the lower mandible facing left with hardware

What post-surgical care do I require?

Post-surgical care after repair of a jaw fracture can be extensive. Since Dr. Bolourian performs jaw fracture surgery routinely, we have strict protocol in place, where you can be sure you will receive optimum care after your surgery. If you are wired, we see you at our private office on weekly basis to insure your proper healing. We also monitor the progress of the bone healing by CT scans done right in our office. Rest assured that we will do everything we can to insure your recovery goes smooth and pain free.

In cases where the jaw is not wired, our patients will see us two to three times post surgery to ensure adequate healing. After that, they can go about their normal life, hopefully accident free.

It is also important to note that after the jaw is wired, it is difficult to clean your teeth. We have partnered up with our Periodontist Dr. Jin Eslami to take care of our patient’s oral hygiene during the process and after the wires are removed.

What type of food can I eat while my jaw is wired shut?

If your jaw is wired shut, you will be on a full liquid diet. That means, drinking liquids through a straw! At first, this may be very difficult, but our experience has shown that we as humans are resilient and adapt to many challenging situations. We recommend that you allow us to walk you through a healthy and high protein liquid diet for the time where your jaw is wired. You will find that it is not as bad as you imagined it to be.

Is there any long term rehabilitation required after repair of a jaw fracture?

After the jaw is released and wires are removed, our experience has shown that our patient recover rapidly and smoothly. At times, it may be difficult for patients to open their mouth wide after the wires are removed. A series of prescribed jaw exercises by Dr. Bolourian eliminates problems with opening the mouth and patients quickly return to normal function.

What type of surgeon is qualified to perform this type of surgery?

Oral and Maxillofacial surgeons that are on active trauma call for hospitals are best suited to perform jaw fracture surgery. These surgeons are trained in medicine and surgery and understand not only the surgical aspects of jaw fracture, but also the dental link as it relates to jaw fractures.

Reza Bolourian, M.D., D.D.S., F.A.C.S. is a dual board certified surgeon. He is on active trauma staff at Memorial Care Medical Center and performs jaw fracture surgery on routine basis.

What if I have fractured teeth needing extractions and replacements or restorations?

Injuries to teeth are common sequala of jaw fractures. Dr. Bolourian, a trained dentist and physician will address not only a fractured jaw, he will also address the dental structures as necessary. If restorations via dental implants are needed, we will discuss those options with you as well.