Oral and maxillofacial trauma may result in the following:

• Fractures of the teeth and alveolar bone

• Fractures of the maxilla, mandible orbit and nose

• Contusions, lacerations and cuts of soft tissues in general, the trauma varies in severity and may be associated with a variety of complications

• Severe haemorrhage

• Airway obstruction

• Trauma to the eye

• Injury to intracranial structures

• Injuries to the cervical spine

• Contamination and/or infection of tissues

• Varying degrees of deformity and interference with the function(s) of the injured structure/organ.

Investigations

• X-ray:

Management

• Maintain patent airway

• Control bleeding without damaging tissue, by suturing or gauze packs

• Give injectable penicillin then orally when able to swallow

• Give tetanus toxoid

• Give analgesics e.g paracetamol 1 gm TDS

• When in severe pain give pethidine 50-100 mg IM STAT.

• Always suture the face with fine nylon 4/o or 5/o

• Ensure proper apposition of skin edges

• Remove stitches on the 5th day.

Admit If

• In severe pain

• Blood loss is severe

• Injuries are extensive.

Refer

• When a tooth is completely removed and it is not fractured - put the tooth in normal saline and clean gently. Re-implant under local anaesthesia and give gauze pack for biting on while a dental surgeon is contacted for fixation

• All suspected fractures to a dental surgeon/maxillofacial surgeon.