Oral and Facial Surgery
An oral and maxillofacial specialist is thoroughly qualified to repair facial injuries. These professionals are well versed in emergency care, acute treatment, and long-term reconstruction and rehabilitation – not just for physical reasons but emotional as well. 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 special training involving “hands on” experience and an understanding of how treatment will influence the patient’s long term function and appearance.
Dr. Cayo and Dr. Boisen meet and exceed these modern standards. They are trained, skilled, and uniquely qualified to manage and treat facial trauma. They are on staff at local hospitals and deliver emergency room coverage for facial injuries, which include the following conditions:
- Facial lacerations
- Intraoral lacerations
- Avulsed (knocked out) teeth
- Fractured facial bones (cheek, nose, or eye socket)
- Fractured jaws (upper and lower)
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 trauma 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 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. Cayo and Dr. Boisen are 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, including the location of the fracture, the severity of the fracture, and the 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. Other types of jaw fractures are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique, known as rigid fixation, obviates the necessity of having the jaws wired together. 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. Any necessary incisions are designed to be small and, whenever possible, are placed so that the resultant scar is hidden.
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 splinting (stabilization 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. 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. An endodontist may be asked to perform root canal therapy, and/or restorative dentists may be needed to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often utilized as replacements for missing teeth.
The proper treatment of facial injuries is the realm of specialists who are well versed in emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.