Mandibular Fracture (Broken Jaw)

First aid for a suspected broken jaw

1. Protect the airway: if the person is bleeding into the mouth, have them sit up and lean forward so blood drains out. Call 911 if breathing is difficult.
2. Support the jaw gently with a hand or a bandage wrapped under the chin and over the top of the head. Remove it immediately if the person feels sick or needs to vomit.
3. Apply a cold pack wrapped in a cloth to reduce swelling.
4. Keep knocked-out teeth in milk or the person's saliva and bring them to the ER.
5. Do not eat or drink until assessed, in case surgery is needed.
6. Go to the ER. A blow strong enough to break the jaw can also cause head and neck injuries, including concussion.

Where the jaw breaks

The mandible is a U-shaped bone. Fractures commonly occur at:

• the condyle (the joint area in front of the ear), often from a blow to the chin
• the angle (near the back of the jaw), common in assaults and around wisdom teeth
• the body (the side of the jaw holding the teeth)
• the symphysis/parasymphysis (the chin area)

Because the jaw is a ring of bone, a blow often breaks it in two places, for example the chin on one side and the condyle on the other.

Symptoms

• jaw pain and tenderness, worse when moving it, talking or chewing
• swelling and bruising of the face, under the chin or inside the mouth
• a bite that feels wrong (malocclusion): teeth no longer fit together
• difficulty opening the mouth widely, or the jaw shifting to one side when opening
• numbness of the lower lip, chin or teeth from injury to the inferior alveolar nerve
• loose, broken or missing teeth (dental trauma)
• bleeding from the gums or mouth
• drooling and difficulty swallowing
• a step or gap felt along the gum line

Diagnosis

A clinician examines the face, teeth, bite and nerve sensation and checks for other injuries, including other facial fractures. Imaging includes:

• panoramic X-ray (orthopantomogram): shows the whole lower jaw
• CT scan: especially for condyle fractures, multiple facial fractures and surgical planning

Head and neck injuries are assessed at the same time.

Treatment

Treatment is usually by an oral and maxillofacial surgeon.

Non-surgical treatment

Stable, minimally displaced fractures with a normal bite may be treated with:

• a soft or liquid diet for several weeks
• pain relief and antibiotics if the fracture communicates with the mouth
• close follow-up with repeat imaging

Surgery

• Open reduction and internal fixation (ORIF): the bones are realigned and held with small titanium plates and screws, usually through incisions inside the mouth. This allows the jaw to move soon after surgery.
• Maxillomandibular fixation (jaw wiring): wires or elastic bands hold the upper and lower teeth together for several weeks so the bone heals in the correct position. Wire cutters must be carried at all times in case of vomiting.
• Removal of damaged teeth in the fracture line if needed.

Many condyle fractures, especially in children, are treated with a short period of wiring or elastics followed by exercises.

Recovery

• bone healing takes about 6 weeks
• soft or liquid diet for several weeks, then gradually return to normal food
• careful oral hygiene: salt water or antiseptic rinses and gentle brushing
• jaw exercises after immobilization to restore opening
• avoid contact sports for at least 6 to 8 weeks, or as advised
• stop smoking, which slows healing and increases infection risk

Complications

• infection of the fracture or plates
• poor bite (malocclusion) or misaligned healing
• non-union of the bone
• numbness of the lip or chin, which often improves over months
• jaw joint problems (TMJ disorder) and limited opening
• tooth damage

Frequently asked questions

How do I know if my jaw is broken?

Signs include jaw pain and swelling after an injury, a bite that feels misaligned, difficulty opening or closing the mouth, numbness of the lower lip or chin, bleeding gums and loose teeth. An X-ray or CT scan confirms it.

How long does a broken jaw take to heal?

The bone typically heals in about 6 weeks. Full return of jaw movement and normal diet may take a few more weeks, especially if the jaw was wired shut.

Will my jaw be wired shut?

Not always. Many fractures are fixed with small plates and screws, allowing you to open your mouth soon after surgery. Wiring is still used in some cases, particularly for some condyle fractures or when plates are not suitable.

What can I eat with a broken jaw?

You will usually need a liquid or soft diet such as smoothies, soups, yogurt, mashed foods and nutritional drinks for several weeks. Your surgeon will advise when you can gradually return to chewing.