Illustration of Skull with Mandible
If your child is experiencing pain in the jaw as a result of an automobile accident, sports related injury or a fall, you need to determine the appropriate course of action. Obviously the amount of pain, combined with your child's symptoms will determine if you proceed immediately to the emergency room or wait to further evaluate the situation. To determine if a jaw is broken or dislocated, a CT scan or panoramic X-ray of the jaw needs to be taken along with a physical exam. A broken jaw, also known as a mandibular fracture, is a common facial injury. It is almost as common as a broken nose in terms of facial fractures.
Symptoms of a Broken Jaw
- Pain in the jaw
- Bruised, swelling or bleeding on the chin, jaw or gums
- Deformed or crooked jaw
- Missing teeth
- Abnormal bite
- Numbness or tingling on chin
- Pain below the ear on jawbone
- Trouble eating, swallowing or opening mouth wide
Symptoms of a Dislocated Jaw
Dislocation of the jaw occurs when the lower jawbone gets dislodged or displaced from one of the temporomandibular joints, or joints connecting the jawbone to the base of the skull.
- Abnormal bite
- Pain when talking or moving jaw
- Deformed or crooked jaw
- Unbearable pain
- An immediate loud crunching noise hear the eardrum
Causes of a Broken Jaw
In children, the most common cause of a fractured jaw is from falling. It can also occur from an automobile accident or sports injuries. In adults, a fractured jaw occurs more often in males. One of the leading causes is altercations or fights. In women, it can be as a result of domestic abuse.
Diagnosis and Treatment for Injured Jaw
If you suspect a broken jaw, apply ice and seek medical attention. The doctor will first do a physical exam of the jawbone and inside of mouth. This can be very painful as he will open and close the mouth and feel the joints to determine if the jaw is out of joint. He will have the child open and shut his mouth to inspect the bite. The doctor will look for any bleeding or cuts, missing teeth, bruising and swelling. To rule out a possible fracture, he may order a panoramic x-ray or CT scan.
If the doctor determines a fracture, the good news is the younger the child, the faster a fracture will heal. The doctor may need to apply wires, bands or splints to support the jaw. If there is an open wound, he will clean the dirt out. He will prescribe pain medicine if needed and give a tetanus shot of one has not been given in the last five years. If it is a severe fracture, surgery may be needed.
My Daughter's Soccer Injury
Just last week, my nine year old daughter got smacked in the chin with a hard hit soccer ball at close range during her soccer game. I saw the incident and heard the crowd exclaim "ooohhh." In spite of my daughter's painful expression, she did not exit the game, so I initially thought it wasn't a bad injury. That night, chewing was nearly impossible and she had significant pain in her jaw. I applied ice and gave her ibuprofen for swelling. The next morning she was a bit swollen and complained of pain in her jaw radiating up to her ear. She also told me her bite felt weird and she couldn't open her mouth wide. Time to get medical attention.
The first question was where do I take her? I called the pediatrician's office who said that I could bring her in but she would need a panoramic x-ray and they did not have that capability on site. Next I called our sports medicine doctor, he referred me to a specialist in ENT (ear, nose and throat) surgery. The specialist was overbooked and could not see her, thus referring her to the pediatric emergency room for diagnosis. Before I headed out the door, I called our pediatric dentist for advice. He referred me to an oral surgeon. The oral surgeon told me that if my daughter had a broken jaw, the ER would be referring me to an oral surgeon. So, I decided to skip the ER and go straight to the oral surgeon's office.
The specialist took panoramic x-rays and did a physical exam to rule out a fracture. He immediately knew her jaw was not dislocated by the way he could maneuver it. Thank goodness, even though she had many symptoms of a broken jaw, we had a false alarm. Her diagnosis was a bad bruise. It's hard to tell what to do for kids sometimes. I think I should have let pain be my guide. Though my daughter had pain, it likely wasn't severe enough pain for her jaw to have been broken. I was worried when she complained that her bite didn't feel right. The doctor said that could be attributed to the soreness and swelling.
Sources of Information
John Hopkins Medicine: http://hopkins.portfolio.crushlovely.com/reference/article/jaw-dislocation-or-fracture
Prevention of a Broken Jaw When Playing Sports
Because the jawbone is not covered by most protective devices when playing sports, it is more susceptible to sports injuries. In sports it is most often caused by a blow to the lower jaw by a bat or a hockey stick, but it can occur in other sports as well. For example, if a child riding a bike stops suddenly and flies over the handlebars, he can fracture a jaw depending on the severity and the angle of his fall.
The best prevention is to wear headgear with jaw protection. Of course, in some sports, like soccer, this is not part of the equipment. With all sports, parents need to be aware of the signs and risks associated with concussions.
What Doctor Should You See?
|Symptom||Call 911||ER||Urgent Care||Pediatrician||Oral Surgeon||Dentist|
Any weak vital signs, trouble breathing, severe emergency
Accident after hours/weekends
Obvious broken jaw
Symptoms as indicated above
Swelling after 48 hours
Emergency Room or Urgent Care?
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.
aykianink on October 27, 2012:
Very good stuff here. Awesome chart.
Penelope Hart from Rome, Italy on October 24, 2012:
Helpful advice to parents here. Knowing where to go straight away for the right medical attention is always so confusing, but looks as though you got it right pretty quickly! Hope your daughter is on the mend now. Best wishes to you both. Voting!