Jaw Fracture
A fractured jaw causes pain and usually changes the way the teeth fit together. Often, the mouth cannot be opened wide, or it shifts to one side when opening or closing. Most jaw fractures occur in the lower jaw (mandible).
Fractures of the upper jaw (maxilla) may cause double vision (because the muscles of the eye attach nearby), numbness in the skin below the eye (because of injuries to nerves), or an irregularity in the cheekbone that can be felt when running a finger along it. Any injury forceful enough to fracture the jaw may also injure the spine in the neck. A blow powerful enough to fracture the jaw may also cause a concussion or bleeding within the skull.
If a person suspects a jaw fracture, the jaw should be held in place with the teeth together and immobile. The jaw may be held with a hand or preferably with a bandage wrapped under the jaw and over the top of the head several times (Barton's bandage). The person wrapping the bandage must be careful not to cut off breathing. Medical help should be sought as soon as possible because fractures can cause internal bleeding and airway obstruction.
 See the figure Barton's Bandage.
At the hospital, before the jaw fracture is treated, neck x-rays are often taken to rule out spinal damage. The upper and lower jaws may be wired together; they remain wired for 6 weeks to allow the bone to heal. During this time, the person is able only to drink liquids through a straw. Many jaw fractures can be repaired surgically with a plate (a piece of metal that is screwed into the bone on each side of the fracture); the jaws are immobilized for only a few days, after which soft foods can be eaten for several weeks. In children, some jaw fractures are not immobilized. Instead, initial treatment allows restricted motion, and normal activity resumes in a few weeks. Antibiotics are usually given to a person with a compound fracture--one that extends through a tooth or its socket and opens to a contaminated area, such as the mouth.
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