Exodontia.Info
Fractures of the Mandible /
Lower Jaw
Fractures of the Mandible / Lower Jaw

This leaflet has been designed to improve your
understanding of your forthcoming treatment and contains
answers to many of the common questions.  If you have any
other questions that the leaflet does not answer or would
like further explanation please ask a member of the medical
or nursing staff.
Will anything else be done while I am asleep?

Occasionally, it is necessary to remove damaged or decayed teeth at the site of
the fracture.  In very difficult fractures, it is sometimes necessary to make a cut on
the outside of the mouth through the skin.  If this is going to take place, the site and
size of the cut will be discussed with you before you sign any consent form for your
operation.


What can I expect after the operation?

  • It is likely to be sore and regular painkillers will be given to you by the hospital
    doctor.  The discomfort is usually worse for the first few days although it may
    take a couple of weeks to completely disappear.

  • You will also be given antibiotics through a vein in your arm whilst you are in
    hospital to fight infection.

  • You will be sent home with painkillers and a course of antibiotics.

  • You usually stay in hospital for one night following the surgery.  The following
    day, the position of your fractures will be checked with X-rays before you are
    allowed home.

  • Although the plates and screws hold the fractures in place it still takes around
    six weeks for your lower jaw to heal completely.  During this time you need to
    eat a relatively soft diet.  This will be discussed with you by the doctors, nurses
    and dieticians.

  • It is also important that you keep your mouth as clean as possible for the first
    few weeks after surgery to prevent infection.  It may be difficult to clean your
    teeth around stitches because it is sore.  It is best to keep the area free from
    food debris by gently rinsing your mouth with a mouthwash or warm salt water
    (dissolve a flat teaspoon of kitchen salt in a cup of warm water) starting on the
    day after surgery.



Do I need to take any time off work?

Depending on the nature of your work you may need to take a fortnight or so off
work.  Avoid strenuous exercise for this time.  It is important to remember that you
should not drive or operate machinery for 48 hours after your
general anaesthetic.


What are the possible problems?

  • Infections are uncommon because of the antibiotics that are used.

  • Bleeding from the cuts inside your mouth is unlikely to be a problem.  However,
    should the area bleed when you get home apply pressure over the site for at
    least 10 minutes with a rolled up handkerchief or swab.

  • Numbness of the Lower Lip & Tongue.  The Inferior Dental Nerve that runs
    through the centre of the lower jaw that supplies feeling to your lower lip, chin
    and the lower teeth.  This nerve may have been bruised at the time of the
    fracture and as a result you might already feel some tingling or numbness in
    your lip and/or chin.

    This tingling may also be caused/made worse by surgery.  In the majority of
    people the numbness gets better on its own although it can take several
    months to do so (this usually lasts about 6 – 12 months, but may be
    permanent).

    The Lingual Nerve is on each side of the inside of the mandible (lower jaw).  
    This nerve passes very close to the tongue side of the fracture.  It gives feeling
    and taste to that side of the tongue.  This nerve may have been damaged in
    the injury.  Due to the closeness of this nerve to the area of surgery, there is a
    small possibility of some damage to the nerve.  Damage to this nerve causes
    that side of the tongue to go numb.  More rarely, it may cause irritating
    sensations as well as loss of taste on that side of the tongue.  Although this
    effect is usually temporary (6 – 12 months) it may be permanent.

  • Damage to Teeth in Fracture Zone.  Occasionally, teeth next to the fracture
    site may be damaged by screws that are used to hold the titanium plates in
    place or to bring the jaws together with wires.  As a consequence, these teeth
    may die and require dental treatment to keep them.

  • Plate Removal.  If it has been necessary to put any plates or screws in your
    jaw to hold it in position, these are not normally removed unless they get
    infected because they tend not to cause problems.  The metal that is used is
    titanium which does not set off metal detectors in airports etc.

  • Delayed Union of the fractured jaw bone occur in approximately 3% of
    fractures.  Delayed union is a temporary condition in which adequate reduction
    of the broken jaw and limitation of movement of the broken jaw eventually
    produces bony union (that is, it heals).

  • Mal-Alignment / Mal-Union.  In a few cases, the fracture may not heal after
    repair and further operations may be needed.  The fracture may not be able to
    be precisely put back together.  This may result in some change in the bite.  
    Not all mal-unions are clinically significant.

  • Non-Union.  Sometimes, the fracture just doesn’t heal.  This can often be due
    to infection or impaired healing due to the patient’s medical condition.  This may
    need further surgery to correct the non-union of the fracture.

  • Facial Weakness.  Sometimes, in order to get good access to repair the
    broken jaw, we have to go through the cheek.  The nerve making the facial
    muscles move (the Facial Nerve) may be traumatized as a result.  This can
    lead to a drooping at the side of the mouth.  This improves with time.  Also,
    there may be some scarring at this site.  This will be small and not particularly
    noticeable.

  • Limitation of Mouth Opening.  This should improve with time.  However, to
    begin with, you may find you have to stick to a soft / liquidized diet.

  • Need for ‘Fine Tuning’ of the Bite.  Even though we will try to restore the way
    you bite together to its original state, there is sometimes the need to ‘fine tune’
    the way you bite together.  This involves grinding spots on the biting surface of
    the teeth.



Will I need further appointments?

A review appointment will be arranged before you leave hospital. We will keep a
close eye on you for several months following treatment to make sure that your jaw
heals uneventfully.
Last Updated 26th December 2014
The problem

Your lower jaw has been broken.

The number of
fractures, where they have occurred and whether they need
treatment to help them heal has already been established by the doctor who
examined you.


What does the operation involve?

The treatment involves a general anaesthetic, which means you are going to be
put to sleep completely.

Once you are asleep, we will make a cut on the inside of your mouth through the
gum.

The broken bones are then put back together and held in place with small metal
plates and screws.

The gum is stitched back into place with dissolvable stitches, which can take a
fortnight or even longer to fall out.

Sometimes, it is necessary to
place wires, metal braces or orthodontic brackets
around / on your teeth so that elastic bands can be attached to them.  Screws
inserted into the jawbone above the teeth are occasionally used instead of these
wires or metal braces.

Any elastic bands are not usually attached until the day after your operation, which
means that your jaws will be able to move freely when you wake up from surgery.  
The bands will guide your bite into the correct position after surgery.