Oral and Facial Injuries

What are the symptoms?
What is the emergency treatment?
Teeth Fractures
Knocked-out Teeth
Treatment options for teeth that are severely fractured or knocked out.
What is the treatment for a displaced tooth?
Lacerations or Cuts
Jaw Fractures
What is the emergency treatment for jaw fractures?
Cheek Bone Fractures

What are the symptoms?
Most injuries have obvious signs such as bleeding, cuts, or displaced or lost teeth. However mild injuries may not be as obvious. You may have suffered a fracture or injury if you are experiencing one of these symptoms:

  • A tooth that feels high when you bite down
  • Pain associated with a certain tooth or part of jaw bone
  • Pain when opening or closing mouth
  • Swelling or bleeding

What is the emergency treatment?

  • Call our office for an immediate evaluation. You’ll be seen right away for an exam and X-rays to assess your injuries and plan necessary treatments
  • Do not eat or drink anything in preparation for possible anesthesia.
  • If you have retrieved lost teeth, put them in milk or in your mouth by your cheek to protect them and come to office within 30 to 45 minutes.
  • If you are bleeding from any cuts in mouth or face, put a clean gauze over it with pressure.
  • Once in our office, Dr. Kazemi will determine the proper treatment.

Teeth Fractures
Also known as dentoalveolar trauma, teeth may break, move and loosen, or come completely out of their socket. Depending on degree of fracture, teeth may be saved but they require immediate attention. The various types of fracture and treatment are:

  • Mild to moderate chipping of tooth crown: If there are no root fractures and supporting bone is intact, a chipped tooth can be saved with tooth colored buildup material. If it is a deep fracture, a root canal treatment must be done first. If it is a superficial fracture, it may be restored, but its health should be re-evaluated by a root canal specialist later.
  • Teeth with deep fractures require immediate extraction. The supporting bone is evaluated carefully at the time and treated accordingly. Immediate implants may be placed if the bone is relatively healthy and intact. A temporary tooth is then made within a day or two. Implants may be restored with permanent teeth after three to six months of healing.
  • Teeth that have moved or were pushed out of position: This is called tooth subluxation. If there are no root fractures and the supporting bone is relatively healthy, moved teeth can be realigned to their original position and held stable by bonding. Root canal treatment is initiated within a week to avoid infection. After four to six weeks, the bonding is removed and any necessary cosmetic work may be initiated.

Knocked-out Teeth
Teeth that are completely out of their sockets are called avulsed teeth. There are two treatment options:

  1. Re-implant the tooth and try to save it. This has only a 25 to 40 percent chance of success in adults but maybe more predictable in children between ages 6 to 8.
  2. Replace the lost teeth with immediate dental implants. The prognosis is 98 percent or above, and is today’s treatment of choice.

If you have found the tooth follow these instructions:

  • Only grab the tooth by its crown (the white part). Do not touch its root.
  • Place the tooth in a small container with milk. If not available, then place the tooth inside your cheek. Saliva is a good protector and will keep the root surface healthy.
  • Come to our office within 30 to 45 minutes for possible re-implantation.
  • If the tooth is contaminated, fractured, or has been out of its socket for longer that 30 minutes, re-implantation is not recommended.

Treatment options for teeth that are severely fractured or knocked out?

  • Immediate implant placement: This is done if the supporting bone is relatively healthy and undamaged from the injury. Dr. Kazemi is also a specialist in dental implants.
  • Bone graft: If bone was significantly damaged or lost during injury, immediate implant may not be possible. In this case, bone grafting material may be placed to build up the supporting bone and prepare it for implants once they are healed in four to six months.
  • No treatment: In more severe injuries, it may not be possible to place an implant or bone graft. They may be irrigated, cleaned and sutured. Implant placement may be initiated in two to three months.
  • Getting a temporary tooth: A transitional or temporary tooth can be made within days of injury to help you return to work or school.

What is the treatment for a displaced tooth?
If a tooth has been displaced, but not fractured and the supported bone is relatively intact, it may be possible to reposition the tooth and stabilize it using bonding materials. The tooth is splinted for about 4 weeks. Root canal treatment by endodontist is often necessary to prevent root resorption or infection. The long term prognosis is very good.

Lacerations or Cuts
Cuts to the mouth and face are common and should be repaired as soon as possible. Dr. Kazemi utilizes contemporary plastic closure techniques to achieve proper healing and minimize scars. We manage any facial cut, including to the eye, nose, cheeks, chin, forehead, scalp, lips, tongue, and gum tissues.

Jaw Fractures
Jaw fractures may occur in both the lower and upper jaws. They may involve partial fracture or segments containing teeth or may be complete. There is often bleeding and the bite may feel off. There might also be areas of numbness over the lip, chin, or other facial regions. Treatment is required to re-align your teeth and bite, to allow proper healing of bone and avoid deformities.

What is the emergency treatment for jaw fractures?
Treatment may take place in the office under IV sedation or in the hospital under general anesthesia. The treatment involves:

  • Examination of teeth around the fracture and extraction if severely damaged
  • Re-aligning of teeth and fractured segments
  • Holding the jaw stable using either wires (closed reduction) or plates (open reduction with internal fixation)
  • Repair of any cuts or lacerations
  • Jaw wiring may be required for four to six weeks, depending on type of injury. Patient will be on liquid diet for the duration of this treatment.

Cheek Bone Fractures
Cheek bone fracture occurs commonly in response to a blow or fall. The signs and symptoms are:

  • Flat or depressed look of the cheek bone
  • Swelling or bruise around the eyes
  • Difficulty opening mouth
  • Numbness of side of face, nose, and under the eye
  • The treatment involves repositioning the fractured segments and stabilization, a procedure that must be performed in the hospital under general anesthesia.