Maxillo-facial trauma cases are very common now-a-days. Immediately after trauma these maxillo-facial injuries appear quite formidable. However, comforting the patient or parents is very important. Sometimes stitching of facial or oral wounds (inside mouth) is required. Immediately after the injury facial swelling comes up. Of course, various radiographs (x-rays) are done to find out fractures of jaws or other facial bones.
In some cases the definitive treatment of fractures is deferred till the facial swelling has subsided to some extent or more importantly patient’s general condition has improved. Whatever decision is taken it is done keeping in view a number of factors.
With that background, i want to share a big fact with readers. In maxillo-facial trauma cases, whenever the patient is bit comfortable, we ask him to clench his upper and lower teeth. If he is able to clench his teeth, it is a very good sign. If he comes to us after 2-3 days and is able to clench properly and even is able to chew his meals properly,it can be an indication that the facial bones –particularly upper and lower jaw are intact. However, if he experiences pain while clenching or he clenches properly but is unable to eat his food, it is a negative sign. Of course, thorough check-up backed by x-rays of facial bones helps in arriving at a definitive diagnosis but this clenching of teeth –normal or otherwise – is a big hint!
Now, look at the facial photographs of this gentleman who in the foggy weather was travelling on his bicycle and acccidentally hit into a brick wall. He had come to me 2-3 days after the injury. When i noticed that he is able to clench his teeth properly and even is taking meals normally, it was a big relief. I just gave him some routine pain-killers, anti-swelling tablets, serratiopeptidase tablets and an antibiotic just for prophylaxis for 3-4days. He was advised to use hot fomentation over the affected area of face.
After 3-4 days, he came to me and most of his swelling and pain had vanished except one area which was still swollen as you can see in this photograph. This photograph has been taken one week after the injury.
Since it was somewhat unusual to find such swelling even after a week of injury, he was advised to consult an oral surgeon. Oral surgeon found that this swelling that you are viewing in this photograph is because of haematoma (collection of blood, in layman’s language)– she evacuated the blood from the swelled part and inserted a drain for drainage of the area. Dressing of the area would be required for a couple of days. It is pertinent to mention that procedure was done by the oral surgeon under local anesthesia i.e by making the area numb by giving a local anesthetic injection.
I hope you learnt a bit about the hint provided by clenching of teeth — at least the readers who would be sent by Google uncle searching for this content would feel a bit relaxed!