Oral and maxillofacial surgeons are trained, skilled and uniquely qualified to manage and treat facial trauma. Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires experience and an understanding of how the treatment will influence the patients long term function and appearance.
Dr. Lahar is uniquely qualified to manage and treat facial trauma. Dr. Lahar is on staff at Harrisburg Hospital and the Pinnacle Health System and he provides emergency room coverage for facial injuries, which include the following conditions:
- Intra oral lacerations
- Avulsed (knocked out) teeth
- Fractured facial bones (cheek, nose or eye socket)
- Fractured jaws (upper and lower jaw)
The Nature Of Maxillofacial Trauma
There are a number of causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).
Soft Tissue Injuries Of The Maxillofacial Region
When soft tissue injuries such as lacerations occur on the face, they are repaired by suturing. In addition to providing a repair that yields the best cosmetic, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels).
Bone Injuries Of The Maxillofacial Region
Fractures of the bones of the face are treated in a manner similar to fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, as well as the age and general health of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.
One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best stabilized by the surgical placement of small plates and screws at the involved site. This can obviate the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. The use of rigid fixation has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.
The treatment of facial fractures should be accomplished in a thorough and predictable manner. Goals of trauma treatment include restoration of normal facial cosmetics and facial structure. As few incisions as possible are used and placement of these incisions are designed to minimize scars.
Injuries To The Teeth & Surrounding Dental Structures
Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth that 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, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. The patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists will be called upon such as endodontists, who may perform root canal therapy, and/or restorative dentists who may repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are routinely utilized as replacements for missing teeth.