Upper and Lower Jaw Fracture in Dogs

Jaw fractures are painful and require immediate veterinary attention. Given that the most common causes of these fractures are traumatic injury, they are often seen with significant trauma to other parts of the body which may need to be addressed before the fracture itself. In maxillary (upper jaw) fractures, life-threatening airway obstructions are possible due to displaced bones, swelling, or blood.

Any dog with known injury exhibiting labored breathing, swelling or malformation of the face, a visibly fractured bone, excessive salivation, and pain requires immediate veterinary care. It is important to note that many vehicle trauma cases result in serious damage to the internal organs, which may not be initially evident.

Prognosis ranges based on the underlying cause of the fracture, the overall health of the dog, and response to treatment.

Symptoms can be subtle, like not wanting to play or chew on toys or food, or they can be more obvious, like being unable to close the mouth, dripping bloody saliva from the mouth, or not being able to eat at all. Severe jaw fractures may be very obvious, with teeth and bone visible where they should not be.

Jaw fractures range in severity from greenstick fractures (incomplete crack), to open (bone protrudes from the skin), and comminuted (bone breaks into 3 or more pieces).

Traumatic Injury:

• Hit by car
• Fall/jump from height
• Animal bite
• Hit by an object

In some cases, fractures are a result of injury during dental surgery.

Symptoms of jaw fractures include

• Inability to close the mouth
• Pain when the dog attempts to eat
• Reluctance to eat
• Malalignment of the jaw
• Excessive salivation that may be blood-tinged
• Facial distortion
• Oral bleeding
• Nasal bleeding
• Fractured teeth
• Oral bruising
• Facial swelling
• Subcutaneous emphysema (air trapped under the skin)
• Lip/cheek laceration
• Pawing at the face

A case of possible upper or lower jaw fracture with a traumatic cause is first stabilized, followed by x-rays to check for injury elsewhere in the body. Stabilization may involve IV fluids and pain medications. Diagnosis of both traumatic and atraumatic jaw fractures involves a physical examination and advanced imaging (x-rays and/or CT scan).

Mandibular fractures can be repaired in a variety of ways, depending on the type of fracture, location, and age of the animal. In a young animal with minimal bone or tooth displacement, the fracture may be managed with a “tape muzzle.” Other mandibular fractures may be treated via different surgical methods, such as wires placed around the teeth or in the bone, bone plates and screws, and external fixators. These techniques can be used alone or in combination. If the upper and lower jaws need to be wired together, an esophageal feeding tube may be placed so as to eliminate the need for chewing and swallowing.

Many maxillary fractures are stable enough to not require surgical intervention, and can be treated conservatively or with splinting.

All dogs with upper or lower jaw fractures require restricted activity and a soft diet during bone healing.

The type, severity, and location of the injury, the quantity and quality of bone at the injured site, the presence or absence of teeth along the fracture lines, the standard of home care, and the method of treatment chosen all affect the prognosis. In general, if adequate stabilization is achieved, it is good to excellent; if bone segments have moved, it is fair to poor. Healing typically takes 4 to 12 weeks.

Since car accidents are the leading cause of jaw fractures, keeping dogs leashed or confined to a secure area may be preventive. Regular veterinary dental cleaning and at-home oral care can help prevent/manage significant dental disease, which can lead to pathological fractures. Dental x-rays assist in identifying dental disease with the potential to cause a jaw fracture, and help decrease the risk of iatrogenic fracture when extractions are done with dental X-ray guidance.

Jaw fractures are common in dogs.

Stabilize patient if unstable:

• IV fluids, pain medications
• Treatment for life-threatening trauma
• Tape muzzle to immobilize bone pieces

Conservative treatment:

• Fracture left to heal on its own
• Liquid diet during healing

Non-Surgical Treatment:

• Muzzle if applicable and tolerated by dog

Surgical Treatment:

• External fixation with pins and bars
• Internal fixation with wires, plates, screws
• Acrylic splinting

Anti-inflammatories, pain management

Antibiotics where indicated