This webpage has been designed to improve understanding of Fractured Lower Jaws and contains answers to the most commonly asked questions about this treatment. If you have any other questions that the website does not answer or would like further explanation please ask a member of our medical staff.

The problem
The lower jaw has been broken. The doctor who examined the fractured jaw has already established the number of fractures, where they have occurred and whether they need treatment to help them heal. The treatment that is about to take place involves a general anaesthetic, ie: the patient is going to be put to sleep completely.

What does the operation involve?
Once the patient is asleep the fracture sites will be opened up. This involves making a cut on the inside of the mouth through the gum. The broken bones are then put back together and held in place with small metal plates and screws. The gum is stitched back into place with dissolvable stitches that can take a fortnight or even longer to fall out.

During the same operation it is often necessary to place wires or metal braces around the teeth so that elastic bands can be attached to them and guide the bite into the correct position after surgery. Screws inserted into the jawbone above the teeth are occasionally used instead of these wires or metal braces. Any elastic bands are not usually attached until the day after the operation, ie: the patient's jaws will be able to move freely when they wake up from surgery.

Will any further treatment be performed when the patient is asleep?
Occasionally it is necessary to remove damaged or decayed teeth at the site of the fracture. In very difficult fractures it is sometimes necessary to make a cut on the outside of the mouth through the skin. If this is going to take place, the site and size of the cut will be discussed with the patient before they sign any consent form for the operation.

What can be expected after the operation?
It is likely to be sore and regular painkillers will be arranged. The discomfort is usually worse for the first few days although it may take a couple of weeks to completely disappear. It is also necessary to make sure that the fractures heal without any infection and so patients will also be given antibiotics through a vein in their arm whilst they are in hospital. Patients will be sent home with painkillers and a course of antibiotics.

Patients usually stay in hospital for one night following the surgery. The following day the position of the fractures will be checked with X-rays before the patient is allowed home.

Although the plates and screws hold the fractures in place it still takes around six weeks for the lower jaw to heal completely. During this time patients need to eat a relatively soft diet, the nature of which will be discussed by the doctors, nurses and dietitians. It is also important that the patient keeps their mouth as clean as possible for the first few weeks after surgery to prevent infection. It may be difficult to clean their teeth around stitches because it is sore. It is best to keep the area free from food debris by gently rinsing the mouth with a mouthwash or warm salt water (dissolve a flat teaspoon of kitchen salt in a cup of warm water) commencing on the day after surgery.

If any wires, metal braces or screws are used to help guide the bite into the correct position they will be removed in the outpatient department when the doctors are happy that the fracture has healed.

Does this procedure require any time off work?
This varies enormously from person to person and depends on what kind of work they do. We recommend that most people have around a week off work if they are having just a genioplasty carried out. It is important to remember that patients will not be able to drive or operate machinery for 48 hours after general anaesthetic.

What are the possible problems?

		Infection is uncommon because of the antibiotics that are used.
		Bleeding from the cuts inside the mouth is unlikely to be a problem but should the area bleed when the patient gets home this can usually be stopped by applying pressure over the site for at least 10 minutes with a rolled up handkerchief or swab.
		There is a nerve that runs through the centre of the lower jaw that supplies feeling to the lower lip, chin and bottom teeth. This nerve may have been bruised at the time of the fracture and as a result the patient might already feel some tingling or numbness in their lip and / or chin. This tingling may also be caused or made worse by surgery. In the majority of people the numbness gets better on its own although it can take several months to do so.
		Occasionally, screws that are used may damage teeth adjacent to the fracture site.
		If it has been necessary to put any plates or screws in the jaw to hold it in position these are not normally removed unless they get infected because they tend not to cause problems. The metal that is used is titanium, which does not set off metal detectors in airports etc.

Will further appointments be required?
A review appointment will be arranged before the patient leaves hospital. It is usual to keep a close eye on the patient for several months following treatment to make sure that the jaw heals uneventfully.

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