Facial Trauma | Oral & Facial Surgery in Auburn and Sumner, WA

As an Oral and Maxillofacial surgeon, Dr. Molen has extensive training and experience in the proper treatment of facial injuries. Injuries to the face, by their very nature, impart a high degree of emotional as well as physical trauma to patients. The modern science and art of treating these injuries requires special training involving hands on experience and an understanding of how the treatment provided will influence the patient’s long term function and appearance.

Oral and Maxillofacial surgeons meet and exceed these modern standards. They are trained, skilled and uniquely qualified to manage and treat facial trauma. Dr. Molen is on staff at a local hospital and delivers emergency room coverage for facial injuries, which include the following conditions:

• Fractured upper and lower jaws (maxilla and mandible)
• Fractured facial bones (cheek, nose or eye socket)
• Facial and oral lacerations
• Dental injuries

Fractured Jaws and Facial Bones

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, the age and general health of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Some fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and eliminates the necessity of having the jaws wired together. This technique is called "rigid fixation”. The relatively recent development and use of rigid fixation has profoundly improved the recovery process for many patients, allowing them to quickly return to normal function.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient's facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions on the skin of the face necessary is always made. At the same time, the incisions that are necessary are designed to be small, and whenever possible are placed so that the resultant scar is hidden.

Facial and Oral Lacerations When soft tissue injuries such as lacerations occur on the face or in the mouth, they are repaired by suturing (stitches). In addition to the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands and salivary ducts. Many times, secondary procedures such as resurfacing or scar revision can be undertaken at a later date to improve the appearance of a traumatic scar. Dr. Molen is proficient at diagnosing and treating all types of facial lacerations. Injuries to Teeth and Surrounding Structures Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral and Maxillofacial surgeons are usually involved in treating fractures of the supporting bone or in replanting teeth that have been displaced or knocked out. These types of injuries are usually treated by a form of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out, it should be placed in normal saline solution (many people have this in the form of contact lens solution) or milk. The sooner the tooth is re-inserted into the dental socket, the better the chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth.

Other dental specialists such as endodontists may be called upon, 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.

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