Jaw - broken or dislocated

Answer 1

Definition

A broken jaw is a break in the jaw bone. A dislocated jaw means the lower part of the jaw has moved out of its normal position at one or both joints where the jaw bone connects to the skull (temporomandibular joints).

Alternative Names

Dislocated jaw; Fractured jaw; Broken jaw

Considerations

A broken or dislocated jaw usually heals completely after treatment. However, the jaw may become dislocated again in the future.

Complications may include:

• Airway blockage
• Bleeding
• Breathing blood or food into the lungs
• Difficulty eating (temporary)
• Difficulty talking (temporary)
• Infection of the jaw or face
• Jaw joint (TMJ) pain and other problems
• Problems aligning the teeth

Causes

The most common cause of a broken or dislocated jaw is injury to the face. This may be due to:

• Assault
• Industrial accident
• Motor vehicle accident
• Recreational or sports injury

Symptoms

Symptoms of a dislocated jaw include:

• Bite that feels "off" or crooked
• Difficulty speaking
• Droolingbecause of inability to close the mouth
• Inability to close the mouth
• Jaw that may protrude forward
• Pain in the face or jaw, located in front of the ear on the affected side, and gets worse with movement
• Teeth that aren't normally aligned

Symptoms of a fractured (broken) jaw include:

• Bleeding from the mouth
• Difficulty opening the mouth widely
• Facial bruising
• Facial swelling
• Jaw stiffness
• Jaw tenderness or pain, worse with biting or chewing
• Loose or damaged teeth
• Lump or abnormal appearance of the cheek or jaw
• Numbness of the face (particularly the lower lip)
• Very limited movement of the jaw (with severe fracture)

First Aid

A broken or dislocated jaw requires immediate medical attention because of the risk of breathing problems or significant bleeding. Call your local emergency number (such as 911) or local hospital for further advice.

Hold the jaw gently in place with your hands while traveling to the emergency room. A bandage may also be wrapped over the top of the head and under the jaw. However, such a bandage should be easily removable in case you need to vomit.

If breathing problems or heavy bleeding occurs, or if there is severe facial swelling, a tube may be placed into your airways to help you breathe.

DISLOCATED JAW

If the jaw is dislocated, the health care provider may be able to place it back into the correct position using the thumbs. Numbing medications (anesthetics) and muscle relaxants may be needed to relax the strong jaw muscles.

The jaw may need to be stabilized. This usually involves bandaging the jaw to keep the mouth from opening widely. In some cases, surgery may be needed to do this, particularly if repeated jaw dislocations occur.

After dislocating your jaw, you should not open your mouth widely for at least 6 weeks. Support your jaw with one or both hands when yawning and sneezing.

FRACTURED JAW

Temporarily bandaging the jaw (around the top of the head) to prevent it from moving may help reduce pain.

The specific treatment for a fractured jaw depends on how badly the bone is broken. If you have a minor fracture, you may only need pain medicines and to follow a soft or liquid diet for a while.

Surgery is often needed for moderate to severe fractures. The jaw may be wired to the teeth of the opposite jaw to improve stability. Jaw wires are usually left in place for 6 - 8 weeks. Small rubber bands (elastics) are used to hold the teeth together. After a few weeks, some of the elastics are removed to allow motion and reduce joint stiffness.

If the jaw is wired, you can only drink liquids or eat very soft foods. Have blunt scissors readily available to cut the elastics in the event of vomiting or choking. If the wires must be cut, consult a health care provider promptly so they can be replaced.

Do Not

Do NOT attempt to correct the position of the jaw.

Call immediately for emergency medical assistance if

A broken or dislocated jaw requires immediate medical attention. Emergency symptoms include difficulty breathing or heavy bleeding.

Prevention

Safe practices in work, sports, and recreation, such as wearing a proper helmet when playing football, may prevent some accidental injuries to the face or jaw.

Answer 2

Definition

A broken jaw is a break in the jaw bone. A dislocated jaw means the lower part of the jaw has moved out of its normal position at one or both joints where the jaw bone connects to the skull (temporomandibular joints).

Alternative Names

Dislocated jaw; Fractured jaw; Broken jaw; TMJ dislocation

Considerations

A broken or dislocated jaw usually heals completely after treatment. However, the jaw may become dislocated again in the future.

Complications may include:

• Airway blockage
• Bleeding
• Breathing blood or food into the lungs
• Difficulty eating (temporary)
• Difficulty talking (temporary)
• Infection of the jaw or face
• Jaw joint (TMJ) pain and other problems
• Problems aligning the teeth

Causes

The most common cause of a broken or dislocated jaw is injury to the face. This may be due to:

• Assault
• Industrial accident
• Motor vehicle accident
• Recreational or sports injury

Symptoms

Symptoms of a dislocated jaw include:

• Bite that feels "off" or crooked
• Difficulty speaking
• Droolingbecause of inability to close the mouth
• Inability to close the mouth
• Jaw that may protrude forward
• Pain in the face or jaw, located in front of the ear on the affected side, and gets worse with movement
• Teeth that do not line up properly

Symptoms of a fractured (broken) jaw include:

• Bleeding from the mouth
• Difficulty opening the mouth widely
• Facial bruising
• Facial swelling
• Jaw stiffness
• Jaw tenderness or pain, worse with biting or chewing
• Loose or damaged teeth
• Lump or abnormal appearance of the cheek or jaw
• Numbness of the face (particularly the lower lip)
• Very limited movement of the jaw (with severe fracture)

First Aid

A broken or dislocated jaw requires immediate medical attention because of the risk of breathing problems or significant bleeding. Call your local emergency number (such as 911) or local hospital for further advice.

Hold the jaw gently in place with your hands while traveling to the emergency room. A bandage may also be wrapped over the top of the head and under the jaw. However, such a bandage should be easily removable in case you need to vomit.

If breathing problems or heavy bleeding occurs, or if there is severe facial swelling, a tube may be placed into your airways to help you breathe.

DISLOCATED JAW

If the jaw is dislocated, the health care provider may be able to place it back into the correct position using the thumbs. Numbing medications (anesthetics) and muscle relaxants may be needed to relax the strong jaw muscles.

The jaw may need to be stabilized. This usually involves bandaging the jaw to keep the mouth from opening widely. In some cases, surgery may be needed to do this, particularly if repeated jaw dislocations occur.

After dislocating your jaw, you should not open your mouth widely for at least 6 weeks. Support your jaw with one or both hands when yawning and sneezing.

FRACTURED JAW

Temporarily bandaging the jaw (around the top of the head) to prevent it from moving may help reduce pain.

The specific treatment for a fractured jaw depends on how badly the bone is broken. If you have a minor fracture, you may only need pain medicines and to follow a soft or liquid diet for a while.

Surgery is often needed for moderate to severe fractures. The jaw may be wired to the teeth of the opposite jaw to improve stability. Jaw wires are usually left in place for 6 - 8 weeks. Small rubber bands (elastics) are used to hold the teeth together. After a few weeks, some of the elastics are removed to allow motion and reduce joint stiffness.

If the jaw is wired, you can only drink liquids or eat very soft foods. Have blunt scissors readily available to cut the elastics in the event of vomiting or choking. If the wires must be cut, consult a health care provider promptly so they can be replaced.

Do Not

Do NOT attempt to correct the position of the jaw.

Call immediately for emergency medical assistance if

A broken or dislocated jaw requires immediate medical attention. Emergency symptoms include difficulty breathing or heavy bleeding.

Prevention

Safe practices in work, sports, and recreation, such as wearing a proper helmet when playing football, may prevent some accidental injuries to the face or jaw.

References

Herrmann HJ. Wilderness dentistry and management of facial injuries. In: Auerbach PS, ed. Wilderness Medicine. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 26.

Kellman RM. Maxillofacial trauma. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2010:chap 23.

Reviewed By

Review Date: 06/04/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.