Procedures
Facial Trauma: The Complete Guide
Key takeaways
- Facial trauma is any injury to the bones, teeth, or soft tissue of the face and jaws, from a knocked-out tooth to a fractured jaw or eye socket.
- Displaced facial fractures are usually repaired within one to two weeks, because facial bones begin to knit quickly after injury.
- Three-dimensional cone beam imaging shows fragment position and nerve location, which changes how a fracture is repaired.
- Numbness in the lip or chin after a jaw fracture is common and usually improves over weeks to months, though recovery is not always complete.
- Facial injury care is often billed under medical insurance rather than dental insurance, and accident or auto policies may also apply.
Facial trauma is any injury to the bones, teeth, or soft tissue of the face and jaws — a broken jaw, a fractured cheekbone or eye socket, a knocked-out tooth, or a deep cut to the lip or chin. In the simplest terms: if something struck your face hard enough to move bone, loosen teeth, or open the skin, that is facial trauma, and it is treated by an oral and maxillofacial surgeon.
These injuries matter for more than appearance. The facial skeleton protects the eyes and airway, holds the teeth in alignment, and lets you chew, speak, and breathe. When it is disrupted, the goal of care is to restore both how the face works and how it looks, in the right order and within the window when bone still moves freely.
What facial trauma actually includes
Facial trauma is a category, not a single diagnosis. It covers a wide range of injuries that often occur together.
- Dental injuries — teeth that are chipped, cracked, loosened, pushed out of position, or fully knocked out (avulsed).
- Alveolar fractures — breaks in the tooth-bearing part of the upper or lower jaw.
- Mandible fractures — breaks in the lower jaw, often in more than one place at once.
- Midface fractures — injuries to the cheekbone, eye socket (orbit), nose, or upper jaw.
- Soft tissue injuries — cuts and tears of the lips, cheeks, tongue, eyelids, or gums, including injuries near the salivary ducts or facial nerve.
- Combined injuries — a fractured jaw with missing teeth and a torn lip is common after a single high-energy impact.
Closely related is the idea of dental emergencies — urgent problems involving the teeth and surrounding tissue, such as an avulsed tooth, a dental abscess, uncontrolled bleeding after an extraction, or a tooth fragment left in the lip. Some dental emergencies are trauma; some are infection or complication. Both are time-sensitive, and both are handled surgically when the situation calls for it.
Who facial trauma care is for
People arrive at our office after all kinds of events. The most common are falls, sports collisions, bicycle and vehicle accidents, workplace injuries, and assaults. Older adults often come in after a ground-level fall; teenagers and young adults more often after sport or a crash.
Surgical evaluation is appropriate when any of the following is true:
- Your bite feels different — teeth no longer meet the way they did.
- You cannot open or close your mouth fully, or the jaw deviates to one side.
- A tooth is loose, displaced, or missing after the injury.
- There is numbness in the lip, chin, cheek, or gums.
- The face looks asymmetric, flattened, or swollen in a way that is not settling.
- A cut crosses the lip border, the eyelid, or the nostril rim.
Who this is not for
Not every facial injury needs a surgeon. A superficial scrape, a small bruise, a minor lip cut that stops bleeding and closes on its own, or a chipped enamel edge with no looseness is usually handled by your general dentist or a primary care visit. A simple broken nose with no breathing obstruction is often managed by an ENT physician. And jaw joint soreness that appears without any injury is typically a TMJ problem, not trauma.
We would also rather see you before you commit to surgery you may not need. Some minimally displaced fractures heal well with a soft diet, observation, and follow-up imaging. Part of our job is telling you when doing less is the better plan.
How treatment works, stage by stage
Stage 1: Stabilization and first contact
If you went to an emergency room, the first priority was your airway, bleeding, and any head or neck injury. Once that is settled, the ER typically refers you for facial repair, often within a few days. If the injury is less severe, you may call our office directly. Either way, tell us what happened, when it happened, and what feels different now.
Stage 2: Imaging and diagnosis
An accurate picture of the bone comes before any plan. Digital X-rays are electronic dental radiographs — sensors replace film, images appear on screen in seconds, and the radiation dose is lower than traditional film. For fractures, we often add cone beam CT (CBCT), a three-dimensional scan that shows the position of every fragment, the roots of teeth, and the nerve canals.
That three-dimensional view changes decisions. It tells us whether a fracture is displaced, whether a tooth root is involved, and where a nerve sits relative to a planned plate or screw.
Stage 3: The treatment plan and sedation discussion
We review findings with you and lay out the options, the sequence, and the timeline. Timing matters: facial bones begin to knit within one to two weeks, so displaced fractures are usually repaired within that window. We also discuss comfort. Depending on the procedure and your health history, options may include local anesthesia, nitrous oxide, oral conscious sedation, or IV sedation. We will walk you through each one so you can choose with clear information.
Stage 4: Repair
Soft tissue injuries are cleaned, explored for debris or tooth fragments, and closed in layers so the surface heals evenly. Loose or displaced teeth are repositioned and splinted to neighboring teeth. Fractures are reduced — the pieces are placed back in correct position — and then held there. Simple fractures may be stabilized by wiring or elastics that hold the bite in place. More displaced fractures are fixed internally with small titanium plates and screws placed through hidden incisions, often inside the mouth.
Stage 5: Healing and follow-up
Expect a soft or liquid diet for roughly two to six weeks, depending on the injury. Swelling peaks around day two or three and eases after that. We see you at intervals to check the bite, confirm bone healing on repeat imaging, and remove any splints or elastics. Most people return to desk work within one to two weeks; contact sports wait considerably longer.
Stage 6: Rebuilding what was lost
If teeth could not be saved, replacement is planned after the bone has healed. Dental implants are titanium posts placed into the jawbone that fuse with it over several months and then support a crown, bridge, or denture. Implant-supported dentures use a small number of implants to anchor a full arch so it stays firmly in place instead of resting on the gums. When several teeth are lost in one area, these are frequently the most stable long-term answer.
What it costs
The cost of facial trauma care depends on how many bones are involved, whether repair is done in an office setting or a hospital operating room, the sedation used, and whether tooth replacement follows. A single soft tissue repair and a multi-site jaw fracture repair are very different undertakings, so no single figure describes them both.
Injury care is frequently billed under medical insurance rather than dental insurance, and accident coverage or auto policies may apply. Before treatment we provide a written estimate and verify your benefits so you know your expected share in advance. Federal surprise billing protections also apply to many emergency situations.
For payment structures and financing options, see our financing page for this service.
Risks and tradeoffs
Facial trauma surgery is well established, but it is still surgery, and honest expectations matter more here than anywhere else.
- Nerve changes. Numbness or tingling in the lip, chin, or cheek is common after jaw fractures. It usually improves over weeks to months, but it is not always complete.
- Scarring. External cuts leave scars. We place incisions inside the mouth or along natural creases where possible, but visible injuries can leave visible marks.
- Imperfect symmetry. Repair aims to restore function and close alignment. Very small differences in facial contour can persist after significant fractures.
- Bite changes. Occasionally the bite does not settle exactly as before and needs orthodontic or further surgical adjustment.
- Hardware. Titanium plates usually stay in place permanently and are well tolerated, but a small number need removal later for irritation or infection.
- Teeth that cannot be saved. Some injured teeth look intact at first and lose vitality months later, requiring root canal treatment or extraction.
- Diet and downtime. Weeks of soft food and limited activity are a real cost to daily life, not a footnote.
Alternatives
Observation and closed management. For minimally displaced fractures, a soft diet, careful monitoring, and repeat imaging may be enough. It avoids surgery but requires strict discipline and offers less control over final position.
Closed reduction with elastics or wires instead of plates. Less invasive and leaves no hardware, but the jaw is held shut or restricted for longer, and precision is lower.
Removable partial or full dentures instead of implants after tooth loss. Faster and less involved up front, though they rest on gum tissue and do not preserve jawbone the way implants do. A side-by-side look is worth reading before you decide.
Fixed bridge instead of a single implant. It uses neighboring teeth for support, which means reshaping healthy teeth that were not injured.
How to get started
Call our Los Gatos office and describe the injury. If you have been to an emergency room or urgent care, ask them to send records and images, or bring copies on a disc or drive.
Bring with you:
- Any X-rays or CT scans already taken, plus the ER or urgent care report.
- A list of your medications, allergies, and medical conditions.
- Both medical and dental insurance cards, and any accident claim number.
- Any tooth or fragment that came out — store a knocked-out tooth in milk or saline, not water, and get seen the same day.
- A written list of what feels different: bite, numbness, opening, vision.
Good questions to ask: Is this fracture displaced enough to need fixation? What happens if we wait? Which sedation option fits my health history? How long will I be on a soft diet? Will any of my teeth need replacement later, and when would that start?
The first appointment establishes four things — an accurate diagnosis from imaging, a treatment sequence with dates, a comfort and sedation plan, and a written cost estimate with your insurance verified.
Schedule a facial trauma evaluation at Los Gatos Oral & Facial Surgery
Frequently asked questions
What is facial trauma?
Facial trauma is injury to the bones, teeth, or soft tissue of the face and jaws. It includes broken jaws, fractured cheekbones and eye sockets, displaced or knocked-out teeth, and deep cuts to the lips or face. Oral and maxillofacial surgeons treat these injuries to restore both function and appearance.
What counts as a dental emergency?
A dental emergency is an urgent problem involving the teeth or surrounding tissue, such as a knocked-out or displaced tooth, a swelling abscess, bleeding that will not stop, or a broken tooth after an accident. These situations are time-sensitive because delay can cost you the tooth. A knocked-out adult tooth should be kept moist in milk or saline and seen the same day.
Should I go to the emergency room or call an oral surgeon?
Go to the emergency room or call 911 for trouble breathing, heavy bleeding, vision changes, or any loss of consciousness. For a stable injury with a changed bite, a loose tooth, numbness, or a facial cut, call an oral surgeon directly. If you have already been treated in an ER, bring the report and images to your surgical visit.
What are digital X-rays and why are they used after a facial injury?
Digital X-rays are dental radiographs captured on an electronic sensor instead of film, so images appear immediately and use a lower radiation dose. After a facial injury they show fractures, root damage, and tooth position. For fractures we often add a cone beam CT scan, which gives a three-dimensional view of the bone.
What are dental implants, and when are they used after trauma?
Dental implants are titanium posts placed into the jawbone that fuse with it and then support a crown, bridge, or denture. After facial trauma, they are considered once bone has healed and any lost teeth need permanent replacement. Timing depends on how much bone remains and whether grafting is needed first.
What are implant-supported dentures?
Implant-supported dentures are full-arch replacement teeth anchored by a small number of dental implants rather than resting on the gums. They stay firmly in place while chewing and speaking, and they help preserve jawbone over time. They are often considered when several teeth in an arch are lost to injury.