Errant Slap Shots, Bike Falls and Bar Fights: Oh My!

With spring (hopefully!) around the corner I’ve decided to dedicate this week’s blog to facial trauma and dental injuries. Warmer weather in Canada means more outdoor activities – street hockey, recreational softball, biking, etc. – that unfortunately can result in facial injuries that require surgery. As an experienced facial surgeon I’ve seen and treated all kinds of facial and dental injuries; ranging from a beer-league hockey player’s broken front teeth to an NHL player’s fractured jaw. Here are some answers to the most-common questions that my patients ask regarding facial trauma:

Is putting a tooth in milk after it’s knocked out a myth?

No. Milk is a readily available medium for the average person, and because time is of the essence, it is the medium of choice to store knocked-out teeth in the absence of biological media such as Hank’s solution or ViaSpan. Tooth cells need to be kept alive after injury in order help to re-establish attachment of a replanted tooth to the surrounding bone. Milk has been shown to prevent tooth cell death for a short period of time; thus maintaining cells that are vital in facilitating tooth re-attachment. More important, though, is the amount of time that elapses between tooth loss and replantation – the faster you can get to your local oral surgeon’s office, the better chance that tooth has to survive!

Should I be evaluated by an oral surgeon and/or get x-rays if I just have a cut on my face?

Absolutely. It’s always a good idea to have an oral and maxillofacial surgeon or emergency room doctor evaluate you after injury to ensure that there was no damage to the jaws, teeth, facial bones, facial nerves, saliva ducts or other areas. For cuts and bruises you might only need stitches to repair the injury; but if the injury also involves broken bones or teeth you will likely require further treatment in order to properly restore function and aesthetics.

Do you still wire people’s jaws shut to treat bone fractures?

Yes. Because we can’t put a cast on your face we sometimes have to wire the jaws together for a short period of time to immobilize and stabilize the facial bones. Other times, we can use small titanium plates and screws to fix the fracture without having to wire the jaws. Both techniques work equally well to treat facial bone fractures – just ask Kanye West who had his jaws wired together for four weeks (and wrote a great song about it)!

What are my options if my teeth were broken or knocked-out and not recovered for replantation?

Losing one or more teeth to an errant slap shot or bike accident can cause significant functional and aesthetic deficits. Thankfully several treatment options exist to replace missing or broken teeth and vary on a case-to-case basis; however dental implants have generally become the gold standard option to replace missing teeth after trauma. Thorough evaluation and diagnosis is key, though – be sure to trust your care to a provider experienced in treating facial trauma and reconstructing oral and facial defects.

Are you qualified to treat dental and facial bone injuries?

Oral and maxillofacial surgeons are the experts in face, mouth and jaw surgery, including the treatment of traumatic dental and facial injuries. As for me personally, let’s just say that my experience includes someone who’s jaw was on the wrong side of a slap shot from an NHL all star!