Facial Trauma

As an oral and maxillofacial surgeon, Drs. Mynsberge and Ruggles are highly qualified with the knowledge and expertise to evaluate, diagnose, and treat traumatic injuries to the face, mouth, and teeth. The science and art of treating these injuries requires special training, extensive experience, and a thorough understanding of how the treatment provided will influence the patient’s long term function and appearance.

Drs. Mynsberge and Ruggles are privileged at Marin General Hospital to deliver excellent care in both the emergency room and operating room setting for facial, dental, and oral injuries, including:

• Fractured jaws (upper and lower jaw)
• Fractured facial bones (cheek, nose, eye socket, forehead)
• Facial lacerations
• Oral lacerations
• Loosened or avulsed (knocked out) teeth

The Nature of Maxillofacial Trauma

There are a number of possible 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 simple to extremely complex. Typically, facial injuries are classified as soft tissue injuries (lacerations of the facial skin or mouth), bone injuries (fractures), or dental injuries (loosened or avulsed (knocked out) teeth).

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 for and treat injuries to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Dr. Mynsberge is a well-trained oral and maxillofacial surgeon and is proficient at diagnosing and treating all types of facial lacerations.

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, 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 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 obviates the necessity of 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. When incisions are required, they are placed in such a way that the resultant scar is hidden in either the mouth or the cosmetic creases of the face and neck.  

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 saliva or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. 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. Other dental specialists may be called upon such as endodontists (root canal specialists), who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.