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 special training involving a "hands on" experience and an understanding of how the treatment provided will influence the patient's long term function and appearance. Dr. Ford is on staff at The Aroostook Medical Center and delivers emergency room coverage for facial injuries, which includes the following conditions:
- Facial lacerations
- Intra-oral lacerations
- Avulsed (knocked out) teeth
- Fractured facial bones (forehead, cheekbone, nose or eye socket)
- Fractured jaws (upper and lower jaw)
The Nature of Maxillofacial Trauma
There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, and work related injuries. Types of facial injuries can range from injuries to the teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves, or the muscles).
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 the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect and treat injuries to structures such as facial nerves, salivary glands and salivary ducts (or outflow channels). Dr. Ford is well-trained and proficient at diagnosing and treating all types of facial lacerations. We also have a compliment of lasers that may be used during the healing period to promote a more esthetic result.
Bone Injuries of the Maxillofacial Region
Fractures of the bones of the face are treated in a manner similar to the 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, 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 option 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 treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and prevents having the jaws wired together. This technique is called "rigid fixation" of a fracture. The relatively recent development and 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. More importantly, the patient's facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary are designed to be small and whenever possible and are placed so that the resultant scar is relatively cosmetic.
Injuries to the Teeth and 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. If the teeth can not be salvaged, special attention is placed on the surrounding bone so that a dental implant can be used to replace the tooth or teeth in the future.
Therefore, 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. We work closely with other dental specialists such as endodontists, periodontists, orthodontists, and restorative dentists to ensure complete care for our patients. As previously stated,in the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.
The proper treatment of facial injuries is within the realm of a specialist who is well-versed in emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.