Fractures of the upper and lower jaw, oral injuries

What it involves

Oral injuries are most often the result of being hit by a car, a cat falling from a height, a bite from a larger dog or — in miniature dogs — a fracture of a mandible weakened by periodontal disease. They include fractures of the mandible and maxilla, separation of the mandibular symphysis (very typical in cats after a fall), tears of the palate, knocked-out teeth and tongue wounds.

The aim of treatment is to restore a normal bite and allow the animal to eat while the injury heals. In the mouth, plates and screws as used in the limbs are rarely applied — more often we use splinting of the teeth with composite and wire, interdental sutures, or temporarily holding the mouth closed in the correct alignment. The choice of method depends on the site of the fracture, the animal's age and the condition of its teeth.

Important: a patient after an accident is first a trauma patient, and only then a dental one. Before we deal with the fracture, we check the chest, abdomen and nervous system — a head injury is rarely the only one.

When it is used

Any head injury with bleeding from the mouth, a mouth that will not close, an asymmetric jaw or an inability to eat needs a same-day visit. During opening hours, call before you set off so that we can get ready for you; you do not need a referral.

A pathological fracture in a small dog can happen without any obvious injury — for example while playing with a chew or yawning. If the lower jaw suddenly “hangs” or your dog cannot close its mouth, come as soon as possible.

Indications: symptoms that should prompt a visit

• After an accident or a fall, your dog or cat has its mouth open and cannot close it, and is drooling heavily, with blood in the saliva.
• The lower jaw is clearly crooked, and the lower and upper teeth no longer meet as they did before.
• After a fall from a balcony, a cat has a split at the front of the lower jaw — the two halves move independently.
• The animal tries to eat but cannot grasp or chew its food, and flinches away in pain.
• You can see a tear in the palate, and food appears in the nose or blood runs from it.
• After being bitten by a larger dog, a small dog has a swollen, painful head and bleeds from the mouth.
• In a Yorkshire terrier or a Chihuahua with periodontal disease, the lower jaw has suddenly “dropped” without any obvious injury.

Conditions for which we use it in particular

Diagnostics beforehand

After admission we stabilise the patient: assessment of breathing and circulation, oxygen, fluid therapy and pain management according to STD-04. We take a chest X-ray and an abdominal ultrasound (FAST examination) to rule out pneumothorax, internal bleeding or a ruptured bladder — in cats after a fall these are common accompanying injuries. We take blood for a full blood count and biochemistry.

Once the patient is stable, we take X-rays of the skull in several projections, and dental X-rays under anaesthesia — only these show the exact course of the fracture line and the condition of the tooth roots along it.

How it proceeds

Aftercare

For 4–8 weeks, soft food only (a mash, or feeding through the tube), no chews, toys or play with other animals, and a collar as advised. Rinse the mouth with a chlorhexidine solution as directed on the discharge sheet, because the splint collects food debris. Give the painkillers and antibiotic to the end of the course.

Check-ups every 1–2 weeks: we check the splint, the bite and the healing of the wounds. We confirm union with an X-ray after 4–8 weeks and then, under brief anaesthesia, remove the splint or wire. Call immediately if the splint loosens, or swelling, fever or discharge from the nose appears, or the animal stops eating.

Frequently asked questions