Specialist Management of Jaw Fractures
Mandibular fractures involve the lower jaw (mandible), a key structure responsible for chewing, speech, and facial form.
Because the mandible is a load-bearing bone and houses the teeth, fractures affect both skeletal stability and dental occlusion, requiring careful assessment and, in many cases, surgical treatment.
How Mandibular Fractures Present
Symptoms may include:
- Pain and swelling
- Difficulty chewing or speaking
- Change in the bite (malocclusion)
- Limited mouth opening
- Mobility or instability of the jaw
- Numbness of the lower lip or chin (inferior alveolar nerve involvement)
Assessment
Assessment includes:
- Clinical examination of jaw function and occlusion
- Palpation for instability
- Evaluation of nerve function
- CT imaging to define fracture pattern and displacement
Accurate diagnosis is essential in planning treatment.
Surgical Treatment (Open Reduction and Fixation)
Most displaced fractures require surgical management under general anaesthetic.
Surgery typically involves:
- Repositioning the fractured segments
- Restoring the correct bite (occlusion)
- Stabilising the bone using titanium plates and screws
Access is usually through:
- Intraoral incisions (inside the mouth)
- Occasionally small external incisions where required
Role of Occlusion
Restoring the bite is central to treatment.
- Teeth act as a guide for correct jaw alignment
- Precise positioning is essential to restore normal function
In some cases, temporary intermaxillary fixation (elastic or wire support between jaws) may be used.
Condylar Fractures
Fractures involving the condyle (jaw joint) are managed based on:
- Degree of displacement
- Function and range of movement
Many condylar fractures can be managed without open surgery, using:
- Physiotherapy
- Functional rehabilitation
Surgery is reserved for selected cases.
Timing of Treatment
- Treatment is typically undertaken within several days
- Early management helps restore alignment before healing occurs in an incorrect position
Delayed treatment can make correction more complex.
Recovery
Recovery varies with severity.
- Swelling and discomfort settle over a few weeks
- A soft non-chew diet is required during early healing
- Jaw function improves gradually
Follow-up ensures:
- Healing is stable
- Bite and function are restored
Elite Sport and Return to Play
Dr Tom Pepper understands that facial trauma in athletes requires a different approach to standard care. Alongside accurate reconstruction, there is a need to:
- Minimise time away from sport
- Protect the injury during recovery
- Restore functional performance as early as possible
Drawing on his experience treating high-level athletes in the USA, surgical care is structured to minimise downtime while preserving long-term function.
This includes rapid intervention where required, an accelerated return-to-play strategy, and the use of custom-fitted facial protective equipment to enable earlier reintroduction to training while reducing the risk of re-injury.
Risks and Considerations
Potential risks include:
- Persistent change in bite
- Numbness of the lower lip or chin
- Infection or delayed healing (uncommon)
- Requirement for further surgery in complex cases
These are minimised with careful planning and technique.
Specialist Assessment and Treatment
Mandibular fractures require integration of:
- Skeletal reconstruction
- Dental occlusion
- Functional rehabilitation
As a dual-qualified (medical and dental) Consultant Maxillofacial Surgeon, treatment is guided by:
- Detailed understanding of jaw biomechanics and occlusion
- Experience in managing complex jaw fractures
- Ability to restore both structure and function
- Selection of appropriate surgical or conservative pathways
When to Seek Assessment
Urgent assessment is required if you have:
- Facial trauma with jaw pain
- A change in your bite
- Difficulty opening or closing your mouth
- Numbness of the lower lip or chin
These injuries require prompt evaluation and management.
Consultation
Assessment includes examination, imaging, and discussion of the most appropriate treatment plan.
Book a Consultation
For assessment and management of mandibular fractures in London, arrange a consultation to discuss your condition.