Facial Trauma

As an oral and maxillofacial surgeon, Dr. Gadler is highly trained to repair facial injuries. He is an expert in emergency care, acute treatment, and long-term reconstruction and rehabilitation, addressing both the physical and emotional aspects of recovery. Facial injuries, by their very nature, impart significant physical and emotional trauma to patients. The science and art of treating these injuries requires special training, involving “hands on” experience and an understanding of how the treatment will affect the patient’s long-term function and appearance.

The Nature of Maxillofacial Trauma

Facial trauma can result from various causes, including motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. These injuries can range from damage to teeth to severe injuries affecting the skin and bones of the face. Facial injuries are generally 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 achieving the best cosmetic outcome, special care is taken to inspect for and treat any damage to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Dr. Gadler is a  highly trained oral and maxillofacial surgeon, skilled in diagnosing and treating all types of facial lacerations.

Bone Injuries of the Maxillofacial Region

Fractures of facial bones are treated similarly to fractures in other parts of the body. The specific treatment approach is determined by various factors, including the location and severity of the fracture, as well as the patient’s age and overall health. While a cast is often used to stabilize fractures in the arms or legs, a cast cannot be applied to the face, so alternative methods are used to stabilize facial fractures.

One option for certain fractures of the upper and/or lower jaw involves wiring the jaws together. Other types of jaw fractures are best treated and stabilized by surgically placing small plates and screws at the involved site. This technique, known as “rigid fixation,” stabilizes the fracture and often eliminates the need for jaw wiring. The introduction of rigid fixation has significantly improved recovery times, allowing patients to return to normal function more quickly.

Facial fractures should be treated in a thorough and predictable manner, with minimal impact on the patient’s appearance. The goal is to access the facial bones using the fewest incisions necessary, and required incisions are designed to be as small as possible. Whenever feasible, incisions are placed in locations where scars are less visible.

Injuries to the Teeth & Surrounding Dental Structures

Isolated tooth injuries are common and may require the expertise of various dental specialists. Oral surgeons usually handle fractures of the supporting bone or the replanting of teeth that have been displaced or knocked out. These injuries are often treated with various forms of splinting, such as wiring or bonding the 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 its chances of survival. Therefore, it is important to see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, as remnants of the ligament that hold the tooth in place are crucial for successful replantation. Other dental specialists, such as endodontists, may be needed to perform root canal therapy, and restorative dentists may be needed to repair or rebuild fractured teeth. If the injured teeth cannot be saved or repaired, dental implants are often used as replacements for missing teeth.

The proper treatment of facial injuries is now the responsibility of specialists who are well-versed in emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.