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FRACTURED TEETH - CONTINUED
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Dental Volume 1 - Dentist training manual for military dentists
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FRACTURES OF THE MANDIBLE AND MAXILLA - CONTINUED

Signs Upon examination of a type IV fracture, the dental officer may direct you to take a radiograph of the tooth to determine if there is a fracture of the root. You may observe: A fractured root (as seen in the patient’s X-ray), which may be further complicated by a fracture of the crown Tooth  mobility Other  facial  trauma  associated  with  the accident Treatment Perform  emergency  treatment  guidelines. Because of the severity, almost all cases of type IV fractures will be treated by the dental officer. Only in very  rare  cases,  will  the  Dental  Technician  provide treatment. In such rare cases, the dental officer might authorize the DT to place a splint in the same way as for the type III fracture. TRAUMATICALLY  EXTRACTED TEETH If a tooth has been traumatically extracted from the socket, notify the dentist as soon as possible. The dental officer may instruct you to replace the tooth back in the socket after rinsing it with sterile saline. Time is of the essence for the replantation to be a success. Perform emergency treatment guidelines and control hemorrhaging until the dentist arrives. FRACTURES OF THE MANDIBLE AND MAXILLA The dentist will treat this type of injury. Your responsibility is to prevent further injury and to lessen the pain while waiting for the dentist. A person who has a fractured jaw may suffer serious interference with breathing. One of the most important phases of emergency  care  is  to  clear  the  upper  respiratory passage of any obstruction. Fractures are usually the result  of  a  high-velocity  accident  (e.g.,  the  face  striking the dashboard of a car). Of all the facial bones, the nasal bones, followed by the mandible, are the most frequently injured. Less common is a fracture of the maxilla. It can be distinguished from a mandibular fracture because the fractured  maxilla  will  cause  severe  malocclusion consisting of an open bite. The face will also look elongated. Both the mandible and maxilla fractures are treated in the same manner until a dentist arrives. Symptoms Symptoms  for  fractures  of  the  mandible  and maxilla may include some of the following: Difficulty  in  breathing,  talking,  eating,  or swallowing Pain when the mandible or maxilla is moved Figure 6-8.—Bandaging to immobilize both mandible and maxilla. 6-10

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