Managing an Oral Surgery Emergency
By Drs. Stone, Trowbridge, Diamantis and Field
August 15, 2016
Category: Oral Health
Tags: Untagged

It’s a sunny Saturday afternoon, one you plan to spend outdoors gardening before starting up the grill for a family barbeque. Unexpectedly, your garden shovel gets caught on a rock, and when you try to free it, the handle smacks into the side of your jaw. It hurts, but the pain will go away. Nothing to worry about. But later, as you’re preparing to grill burgers, the pain feels worse and you notice it’s hard to close your jaw so your teeth meet. Plus, it feels a bit swollen inside your cheek.  It occurs to you that you should call someone, but maybe it can wait until Monday morning – or can it?

Facial injuries like this happen all the time, and not just to kids. Some injuries can wait, and others can’t, so how do you know when to drop everything and get help? If you have severe pain, bleeding, swelling or other signs of infection, broken teeth or trouble moving your jaw, don’t wait to get help. Contact your dentist immediately, or if the office is closed, head straight to the emergency room. Some injuries need immediate attention to avoid further damage, and there's no way for you to know for sure if your injury falls into that category.

Here’s a summary of how to handle some common injuries:

CHIPPED OR DAMAGED TOOTH – Rinse your mouth with warm water right away. Use gauze to stop any bleeding and then apply ice to your face to reduce swelling. Contact your dentist or oral surgeon as soon as possible, and if you have the pieces of broken tooth, bring them with you to your appointment.

DISLODGED TOOTH – If you have the lost tooth, hold it by the crown (not the root), rinse it in salt water and if possible fit it carefully back in its place in the mouth. If that proves difficult, put the tooth in a cup of milk or salt water to preserve it and contact your dentist immediately. Teeth restored within one hour have the greatest chance of survival, and soaking the tooth, or placing it back in its proper position in the mouth, will help to sustain it.

INFECTIONS – Signs of an infection include redness, tenderness or swelling around the site of the tooth. Infections are most often found around the root of the tooth or in the spaces between teeth and gums. Infections are serious conditions, and if left untreated tissue and surrounding teeth can be damaged. If you suspect an infection, rinse your mouth with salt water and see your dentist as soon as possible.

INJURIES TO TONGUE, CHEEKS, GUMS OR LIPS – Injuries to these soft tissue areas of the mouth are often accompanied by excessive bleeding. To control bleeding, rinse your mouth with a salt-water solution, and apply gauze or a dampened tea bag to the site of the injury. Be sure to contact your dentist or oral surgeon. However, if you can’t reach your doctor, and the bleeding doesn’t stop, continue to apply pressure and go to the hospital emergency room.

FRACTURES – Falls, fights, car collisions and other accidents can sometimes lead to broken bones. The nose and cheekbones are especially vulnerable to fractures. Another common area for facial fractures is the mandible or jawbone, which runs from your chin to just below your ear.

These fractures need immediate attention. Contact an oral surgeon, or your dentist, if you have any of the symptoms listed here – or if you suspect a fracture.

  • Bruising, swelling and tenderness along the jaw or below the ear
  • Misalignment in the bite, meaning your teeth don’t fit together properly
  • Difficulty opening or closing your mouth
  • Trouble chewing and swallowing
  • Numbness in your lower lip or chin
  • Jaw pain that doesn’t go away
  • Double vision or numbness in the face or jaw area
  • ​Swollen eyelids or sunken eyes

TMJ – The join that connects the upper and lower jaw is particularly vulnerable to injury, and treatment for this sensitive joint is critical. If you suspect an injury in this area of the jaw, be especially vigilant about seeking immediate help. There’s no reason to panic, but have it looked at right away to ensure you don’t cause further damage and complicate your treatment.

INJURIES TO THE JAW, CHEEKS, MOUTH OR FACE - An oral surgeon is specially trained to manage these sensitive areas. There is no one easy answer to how these injuries will be treated, but be sure to see your dentist or oral surgeon immediately if you have symptoms of an injury. If necessary, go directly to the emergency room, as some fractures can have life-threatening complications if not treated right away.

What do you do for a facial fracture?

If you suspect a fracture or serious injury to the face, apply ice to decrease pain and swelling and minimize tissue damage. Use the ice for 15-20 minutes out of every hour, and keep your head elevated. Try not to sneeze through the nose or blow your nose, and don’t put any pressure on the sensitive area.  Concussions are another possible complication, so be alert to headaches, nausea, sensitivity to light or noise, problems concentrating or general feelings of confusion.

The symptoms listed here are just a guideline. If you have any reason to suspect a bump, fall or accident caused any harm to your mouth, face or teeth, do not hesitate to seek out help from your dentist, oral surgeon or the emergency room. You may be fortunate, and not have a serious issue or fracture. However, if you do need treatment, you’ll be glad you sought out help right away.