Section: Overview
Fractures of the maxilla (upper jaw) are usually the result of major trauma, but can be caused by disease of the bone itself or dental disease.
Fractures of the maxilla are often segmental involving a short region of the upper dental arcade. The fractures can be impacted (pushed inward) resulting in disruption of the adjacent nasal cavity. Maxillary fractures infrequently result in instability. These fractures are usually "open" (bone exposed) and "comminuted" (multiple bone fragments). Depending on the nature of the fracture and the age of the animal, different methods of management may be indicated for each situation. Maxillary fractures can have serious complications if repair is indicated but not performed or if the repair fails.
What to Watch For
Drooling
Bloody fluid coming from the nostril
Difficulty breathing through the nose
Inability to close the mouth
Pain when attempting to eat
Diagnosis
Thorough physical examination including examination of the oral cavity is initially performed. No laboratory tests are required to make the diagnosis, but several additional tests may be needed, including:
Chest X-rays
Complete orthopedic examination
Complete neurological examination
Radiographs or computed tomography (CT scan) of the skull
Treatment
Emergency care for concurrent problems caused by the trauma is initially performed prior to specific treatment for the maxillary fracture. After stabilization, additional treatment may include:
Some fractures of the maxilla can be managed without surgery simply by resting the dog and preventing further injury to the mouth by feeding soft foods and not allowing the animal to chew on toys or other objects.
Some maxillary fractures require anesthesia and surgical stabilization of the bone fragments for the best results.
If dental disease is suspected as the cause for the fracture, a full dental cleaning with extractions of some teeth may be required.
Injectable analgesics (pain medications) are given to the animal while being treated in the hospital and may be continued orally once discharged from the hospital.
Antibiotics are commonly given to minimize the chance for systemic infection from bacteria in the mouth.
Home Care and Prevention
With conservative management or after surgical repair of the fracture, the dog will be kept restricted from activity for several weeks and will be fed only a soft gruel that does not require chewing.
Recheck appointment with the veterinarian will occur in several weeks to evaluate how the bone is healing (possibly with new radiographs), to monitor the animal's progress, and to make sure it is safe to return the animal to his regular diet.
Many traumatic events are true accidents and thus unavoidable. Dental hygiene and routine cleaning by the veterinarian may prevent severe dental disease that could lead to maxillary fractures.
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