PROCEDURES

Oral & Facial Trauma

ORAL & FACIAL TRAUMA (injuries)

The basis of much of our training as Oral and Maxillofacial Surgeons, is trauma. In fact, many of the reconstructive techniques commonly used today, are of origin and developed out of necessity, to repair traumatic injuries of the facial skeleton. Our natural comfort with caring for the facial trauma patient is therefore apparent. A bulk of current literature with respect to facial trauma is found in the Oral and Maxillofacial Surgery literature.

Facial trauma is frequently treated by overlapping surgical specialties including Plastic Surgery, Otorhinolaryngology (ENT), and Oral and Maxillofacial Surgery. Unfortunately, training and experience do not have commonality between these specialties or for that matter within the specialties. Surgical residency training differs greatly in the volume of experience and scope of care provided. Therefore, one cannot assume surgical expertise merely by evidence of specialty training or title.

Dr. Stephens trained at one of the premiere Oral and Maxillofacial Surgery residencies in the country; The University of Texas, Southwestern Medical School, Parkland Memorial and affiliated Hospitals. Parkland Hospital and Southwestern Medical Center, in Dallas, is internationally known for its’ advances in trauma surgery and the care of trauma patients. It is "the" level 1 trauma center for the entire mid and southwest, and has one of the busiest emergency departments in the country, frequently receiving trauma patients from as far as Oklahoma, Arkansas, and West Texas. The residency experience is therefore vast with respect to not only volume of cases, but diversity of the injuries.

Our doctors continue to care for maxillofacial trauma patients at various area hospitals including Huntington Memorial Hospital, Arcadia Methodist Hospital, and San Gabriel Valley Medical Center. The following types of facial trauma cases are routinely treated:

Mid-facial fractures (LeForte I, II, & III type facial fractures)
Zygomatic arch and Zygomatic Complex (cheek bone) fractures
Naso-orbital-ethmoid (NOE) fractures
Orbital Rim and Orbital Wall fractures (orbital blow out fractures)
Nasal fractures
Mandibular (lower jaw) fractures
Dental and Dentoalveolar injuries (teeth and adjacent structures)
Facial soft tissue injuries (simple and complex facial lacerations)
Missile and penetrating injuries to the facial skeleton (gun shot and stab wounds to the face)

Injuries to the Teeth and Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral and Maxillofacial Surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth which have been displaced or "knocked out". These types of injuries are treated by one of a number of forms of "splinting" (stabilizing by wiring or bonding teeth together).

What Should You Do If You Knock A Tooth Out?

If a tooth is "knocked out", it should be rapidly placed back in the tooth socket if at all possible. Deciduous (baby) teeth are generally not replanted due to their poor success.

Keeping the tooth moist is most critical. Other alternative include placing the tooth in the mouth between the cheek an gum, placing the tooth in dilute salt water (tsp salt in 8 -12 oz glass of water) or milk. The sooner the tooth is re-inserted into the dental socket, the better for the survival of the tooth. Therefore, the patient should see a dentist or oral & maxillofacial surgeon as soon as possible. Never attempt to "wipe the tooth off", since remnants of the ligament which hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. You may gently rinse the tooth of before reinserting into the socket.

Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.

If you have any questions with regards to our scope of trauma services please do not hesitate to contact any of our support staff at The Pacific Coast Center for Oral & Facial Surgery (626) 440-0099.

return to top>