The commonly held view is that the bone of the bottom jaw is designed to be strong to protect the spinal column from trauma and that of the upper jaw is made weak to crumble and absorb the forces thus protect the mid-face. The exceptions are the buttresses of the cheek and the bone of the eye socket.
Trauma is more likely to cause a fracture in the more mature individual than in children or younger adults given the denser, stiffer bone in the former group.
Common causes in our community are sports related, falls particularly in the extremes of age, motorcar accidents, and interpersonal violence.
Usually fractures are diagnosed and referred by the emergency departments of various hospitals to our Rooms but the GP or the dentist could be the first point of contact.
Facial Bone Fractures
From the skull to the bone of the mandible (lower jaw) there are multiple possibilities for single or concurrent injuries.
The nose is most prominent and can often be involved.
The frontal bone above the eye brows is strong but can rarely fracture and causes a significant deformity.
Cheekbone fractures commonly have a relatively pain free depressed appearance.
The eye-socket can have a depressed lower rim and particularly when associated with a fracture of the floor of the eye-socket can have facial numbness or double vision associated with it. It is crucial in these injuries to avoid sneezing violently or blowing the nose for the fear of forcing air into the tissues through the damaged bones.
Injuries to the upper jaw bones can occur at any level from above the roots of the teeth to the upper border of the eye sockets and consequently have varying degrees of importance. Suspicion of any such injury should be professionally evaluated.
Injuries to the lower jaw may involve the joint, neck of the lower jaw, angle, or body. The occlusion (bite) usually feels different and numbness may be associated in the lip. Again any suspicion of such injuries should be professionally evaluated.
Failure to treat broken facial bones generally results in pain, infection, cosmetic and functional shortfalls such as an inability to chew
There is almost an obsession in the popular press about jaw fractures perhaps given that the sportsmen and women are prone to these injuries and are in the public’s eyes. In contrast to common public perceptions wiring of the jaws shut is seldom needed in the modern setting.
Dr Younessi has a special interest in this area of his particular surgical craft and has a passion for excellence in trauma management. He can treat soft tissue injuries to the skin, the specialised cosmetically sensitive structures of the face such as the lips or the eye lids as well as the specialised tissues like nerves and salivary glands.