AboutJoel S. Teig, DMD, FABOMS Expertise I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.
Experience Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.
Organizations American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons
Expert: Joel S. Teig, DMD, FABOMS Date: 6/24/2008 Subject: Lasting pain and discomfort after broken jaw
Question QUESTION: I fell on my chin 4 weeks ago and broke my jaw on the right side. The bone is in the joint and my mouth didn't have to be wired shut. I had intense pain about a week after the break that lasted about 5 days. Since then the jaw does not hurt as much but it feels very uncomfortable. I feel like I have to keep swallowing or drinking liquids for my mouth to feel normal. I have not been doing any chewing since the jaw was broken. I would like to know if this sensation of needing to swallow as if there is something foreign in mouth is to be expected. My oral surgeon is not very sympathetic. When I was in a lot of pain he told me that I would have to live with it or he would wire my jaw shut.
ANSWER: Nancy - First of all, let me know if the fracture of the jaw in the joint is separated at all or if it is just cracked? In the joint area there is attachment of muscles. At least one of the muscles in the area helps in the swallowing function. If the area is inflamed it can definitely affect your swallowing. The sensation you might feel might feel like something is stuck in you throat.
So get back to me and let me know if there is bone separation. Also you say it is in the joint, but is it in the neck of the joint or is it in the ball (the only part of the jaw in the joint)? Get back to me and let me know.
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QUESTION: Hi,
The break is in the neck of the joint. The bone is in alignment so my jaw didn't have to wired shut. The oral surgeon has been following me once a week to make sure the bone stays in alignment. I am still having moderate pain in the area along with the feeling that something is "different" so that I feel like I have to constantly adjust the position of my mouth by swallowing. In addition I am occasionally getting some pain in the ear on the broken side. It is now more than 4 weeks since I broke the jaw. I have not done any chewing.
Thank you for your help,
Nancy
Answer Nancy - I have to tell you that philosophically, when there is a fracture in the neck of the mandible below the actual joint, I like to wire my patients shut for a short 2-3 weeks. Like a cast for a broken arm or leg, it allows healing without the distracting forces of muscles. One of the main reason I think you are having some continuing discomfort, besides inflammation in the area is due to the micro pressure from the jaw muscles pulling of the fractured segments, even though it is not completely severed. I know this is different that your doctor did, but I am a "belt and suspender" doctor and I would rather be aggressive and ensure complete healing.
It sounds like you are having some irregular forces applied to the joint area by the muscles of the jaw. Again, I am a "belt and suspender" doctor might still rest your jaw even now. Maybe not 3 weeks but a week to 10 days would allow everything to quiet and then the muscles can be strengthened after the rest without significant pain.
I think you need to stay away from chewing now anyway. Usually all patients with jaw fractures should not chew for about 6 weeks. I don't know what to tell you to do. Tell the doctor how much discomfort you are in.
