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Oral Surgery/Fractured jaw after molar extraction

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QUESTION: My friend had an upper molar extracted by her dentist (not an oral surgeon) a week ago today. She still had a lot of pain, saw him today and he told her that her jaw was fractured during removal of the tooth. He said this is "very common" (I don't agree). An X-ray was taken prior to extraction. He has told other patients in our town whose jaws were fractured with tooth extraction that this is common. How common is it for one to have a fractured jaw after tooth extraction?

ANSWER: Missy - Fractures of the bone around the tooth while being extracted is often common when general dentists attempt extractions.  Often these doctors are not skilled in applied the appropriate amount of force to expand the bone slowly and skillfully to prevent cracking of the bone.  A quick attempt with excess force is the most common cause for fracture of the bone.  

By the way, the a fracture of the jaw does not usually occur on the upper jaw, but only a local area of fracture by not completely like what occurs in the lower jaw.  So a good doctor who is patient and does not try to rush the extraction is one who is skilled.

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QUESTION: Thank you for your quick response! My friend was told by her dentist that it was a "hairline fracture" and it was common. She also said that he had such a hard time removing the tooth that his instrument actually slipped and "clanked" against her lower teeth. Should we assume that "time" will heal the fracture?

Answer
Missy - What the doctor describes as a fracture might just be an expansion crack due to the extraction.  If that is what occurred, a knowledgeable dentist would simply squeeze the socket from the lip and palate side at the same time.  This squeezing is done with not too much force but just a simple gradually increased pressure.  If the dentist did this, the area will heal quickly with minimal discomfort and a normal appearance.  If the doctor did not do this, the bone may have sharp areas and can become a chronic area of irritation.  

For now your friend should just leave the area alone and do warm salt water rinses for about 30 seconds 4-5 times a day.  The warm salt water does more than keep the area clean.  It will promote a quicker healing.  If after healed there are sharp areas, her dentist should send her to an oral and maxillofacial surgeon to smooth the bone so the bone does not perforate the overlying gum tissue.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

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

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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