Jaw, broken or dislocated

• airway obstruction
• bleeding
• aspiration of foreign material (such as blood or food) into the lungs
• infection of the jaw or face
• recurrent dislocated jaw
• chronic temporomandibular joint problems ( TMJ )
• difficulty talking (temporary)
• difficulty eating (temporary)
• imperfect closure (malocclusion) of the teeth

Causes:

• A broken or dislocated jaw is a common facial injury. The jaw (mandible) is the only mobile bone of the face (it holds the lower teeth). The term "upper jaw" sometimes also refers to the bone that extends from the upper teeth to the eyes (maxilla). The mandible is connected to the temporal bone of the skull by a hinged joint located in front of the ears (temporomandibular joint). Strong muscles extend from the mandible to the skull.
• A dislocated jaw occurs when the mandible is displaced from one or both of the temporomandibular ( TMJ ) joints. Fractures (breaks in the bone) of the mandible may occur at the site of injury and on the opposite side of the jaw. If the upper jaw bone (maxilla) is also fractured, the trauma may have been severe enough to involve multiple areas of the face, neck, and back.
• The most common cause of broken or dislocated jaw is accident or trauma involving a blow to the face. This may be the result of a motor vehicle accident, industrial accident, recreational/sports injury, or other accident. It may also result from assault.

Symptoms:
For dislocated jaw

• pain in the face or jaw, located in front of the ear on the affected side(s), worse with movement
• inability to close the mouth
• drooling because of inability to close the mouth
• difficulty speaking
• jaw may protrude forward
• teeth may not align normally
• bite feels "off" or crooked

For fractured (broken) jaw

• jaw tenderness or pain
• worse with biting or chewing
• jaw stiffness
• difficulty opening the mouth widely
• severe fracture may limit any movement of the jaw
• lump or abnormal appearance of the cheek or jaw
• numbness of the face (particularly the lower lip)
• facial swelling
• facial bruising
• loose or damaged teeth

Do not:

• DO NOT attempt to relocate the jaw
• DO NOT move a person with a dislocated jaw unless they are in danger

Call Your Healthcare Provider if:

• a broken or dislocated jaw may be present. Emergency symptoms include difficulty breathing or profuse bleeding after a facial injury.

First Aid:
Note: A broken or dislocated jaw is an acute condition that requires prompt examination by the health care provider because of the risk of breathing difficulty or profuse bleeding . A tube may need to be inserted into the airway (endotracheal tube) if breathing difficulty or profuse bleeding is present, or if swelling of the face is severe and breathing difficulty is likely to develop. The jaw should be supported during transportation to the emergency room. This is most easily accomplished by holding the jaw gently in the hands.

Dislocated jaw:
The goal of treatment is proper positioning of the jaw hinged ball (condyle) within the temporomandibular joint ( TMJ ).

Manual manipulation by the health care provider may replace the condyle into the TMJ. The thumbs are placed behind the back teeth on both sides of the mouth and the mandible is pressed downward firmly.

Anesthetics (local or general) may be required to allow the strong jaw muscles to relax enough for manipulation of the jaw.

Stabilization of the joint may be required. This usually involves bandaging the jaw to keep the mouth from opening widely.

Surgical stabilization of the joint may be required, particularly if repeated jaw dislocations occur.

The mouth should not be opened widely for at least 6 weeks after dislocation . The jaw should be supported by one or both hand(s) during motions such as yawning and sneezing to prevent excessive strain on the temporomandibular joint.

Fractured jaw:
The goal of treatment is proper alignment of the jaw bone.

Temporary immobilization of the bone by bandaging the jaw or immobilizing the jaw with the hands may reduce pain.

If the fracture is minor, no treatment may be required other than analgesics for discomfort.

Soft food may minimize pain when chewing.

Surgery is often required for moderate to severe fractures , to align and immobilize the bone so that it can heal.

The jaw may be wired to the teeth of the opposite jaw to improve stability. Jaw wires are usually left in place for 6 to 8 weeks.

If the jaw is wired, only liquid or very soft foods can be eaten. A wire cutter should be available so that if the person vomits or chokes, the jaw can be opened to prevent aspiration into the lungs. If the wires must be cut, consult the health care provider promptly so that the wires can be replaced.

Prevention:
Safe practices in work, sports and recreation may prevent some accidental injuries to the face or jaw.