Oral and Maxillofacial TraUllla
0ne of the most rewarding and demanding aspects of dental and surgical
practice .i~the management of the patient who has suffered facial trauma. The ‘abruptness of the injury can cause intense emotional distress, even when only minor injuries are present. The perception of the injury by the patient or family and their reaction to the trauma may seem out of proportion to the degree of injury. The patient and family may be anxious
and fearful; and they depend heavily on the clinician to make an accurate
diagnosis, communicate that diagnosis to them, offer hope for a successful
outcome, and perform the treatment necessary to repair the injury.
Therefore the clinician must effectively deal with both the patient’s physical. injuries and the patient’s emotional state. Few conditions in clinical practice demand such compassion, competence, and attention to detail.
Whenever a maxillofacial injury is sustained, the patient goes’ abruptly
from a normal state to one. of tissue disruption. Patients usually expect that the treatment of the injury will make them appear as they did before the trau- . ma. Unfortunately. this is rarely achieved. The injuries cannot be repaired or healed; the most the clinician can do is provide the .individual with the most favorable physical circumstances for optimal heali.ig. The clinician accomplishes this by cleaning, debriding, and rcplaclnr tissues into their former positions. The result ing appearance therefore dep: nds on the site, type, and degree of injury; the ability of the clinician to perform tissue repositioning; and the ability of the patient’s tissues to heal the wounds. The dentist’s approach with the patient should be hopeful y l realistic.
The next two chapters discuss the diagnosis and management of injuries
to the maxillofacial region. in Chapter 23 the injuries that dentists see with
some frequency are discussed in detail. These include’ injuries to the teeth,
alveolar process, and surrounding soft tissues. Chapter 2J presents an
overview of the management of more severe maxillofacial injuries .