What should I do if I get a hard bump to my right jaw?

Management of Hard Bump to Right Jaw

If you sustain a hard bump to your right jaw, immediately assess for airway compromise, severe bleeding, and inability to close your jaw properly—these require emergency medical attention—then examine for dental injuries, jaw displacement, and facial bone fractures, with same-day dental referral needed for tooth displacement, multiple teeth moving together, visible pulp exposure, or jaw dislocation. 1, 2, 3

Immediate Assessment (First Minutes)

Life-Threatening Concerns

• Check airway patency first, as jaw trauma can compromise breathing through soft tissue swelling, bleeding into the airway, or posterior tongue displacement 4, 3
• Control any active bleeding from the mouth or face by applying direct pressure with clean gauze 5
• Assess for cervical spine injury if the mechanism involved significant force (fall from height, motor vehicle accident)—immobilize the neck until cleared 1, 4

Emergency Red Flags Requiring Immediate Medical Attention

• Inability to breathe properly or airway obstruction 4, 3
• Massive bleeding that cannot be controlled with direct pressure 4
• Inability to close your jaw or jaw locked in abnormal position (suggests mandibular dislocation) 2, 3
• Loss of consciousness or signs of head injury 1

Clinical Examination (Within First Hour)

Extraoral Assessment

• Palpate the facial skeleton systematically for step-offs, crepitus, or point tenderness suggesting fractures 1, 5
• Examine jaw movement by asking the patient to open and close their mouth—abnormal movement or deviation suggests fracture or dislocation 3, 5
• Inspect facial symmetry for swelling, asymmetry, or visible deformity 1
• Check occlusion by having the patient bite down—ask them to say "cheese" to visualize whether back teeth meet properly 1

Intraoral Assessment

• Inspect all teeth for fractures, chips, displacement, or abnormal mobility 1, 2
• Look for gingival bleeding at the tooth-gum margin, which indicates luxation injury 1
• Check for multiple teeth moving together as a unit, which indicates alveolar bone fracture requiring immediate splinting 1, 2
• Assess for exposed pulp (visible pink/red tissue in fractured tooth), which requires same-day dental intervention 1, 2

Same-Day Dental Referral Indications

Urgent (Same-Day) Referral Required For:

• Tooth displacement interfering with normal bite/occlusion 2, 3
• Multiple teeth moving together as a segment (alveolar fracture) 1, 2
• Crown fracture with visible pulp exposure (pink/red tissue visible in broken tooth) 1, 2
• Avulsed permanent tooth (tooth completely knocked out)—requires replantation within minutes to hours 2
• Severe extrusive luxation (tooth partially out of socket) or severe intrusion (tooth pushed into gums and not visible) 2
• Jaw dislocation or inability to close jaw properly 2, 3

Referral Within Few Days For:

• Tooth sensitivity with exposed dentin from enamel-dentin fractures 1, 2
• Tooth mobility without displacement (subluxation) 1, 2
• Minor enamel-only fractures with sharp edges 1

Initial Management Before Dental Referral

For Tooth Injuries

• Do NOT replant a primary (baby) tooth if avulsed—this risks damaging the permanent tooth underneath 2
• DO replant a permanent tooth immediately if avulsed: handle by crown only, rinse gently with saline if dirty, and reinsert into socket 1, 2
• For displaced teeth, gentle digital pressure can reposition if displacement is minor 1

Pain and Swelling Management

• Apply ice packs to the affected area for 20 minutes on, 20 minutes off 5
• Administer appropriate analgesia (acetaminophen or ibuprofen) 1
• Soft diet for at least 10 days after any dental trauma 1

Oral Hygiene

• Cleanse the area with water or saline to facilitate accurate examination 1
• Maintain gentle oral hygiene with soft toothbrush, avoiding the injured area initially 1

Critical Pitfalls to Avoid

• Never replant a primary tooth—unlike permanent teeth, replanting baby teeth risks damage to developing permanent teeth 2
• Do not delay replantation of permanent teeth—prognosis worsens significantly after the first hour 2
• Do not assume lack of pain means no serious injury—children often don't report pain from necrotic teeth 1, 2
• Consider non-accidental injury in children under 5 years with oral trauma, especially if mechanism is inconsistent with injury pattern 2, 3
• Do not miss alveolar fractures—check specifically for multiple teeth moving together as a unit 1, 2

Follow-Up Monitoring

Watch for Delayed Complications (Days to Weeks)

• Gray tooth discoloration indicates pulpal hemorrhage and potential necrosis—requires dental evaluation within days 2
• Gingival swelling with increased mobility suggests pulpal necrosis and possible abscess 1, 2
• Parulis (gum boil/pimple on gums) indicates infection requiring extraction evaluation 2

Long-Term Surveillance

• All traumatized teeth require monitoring for pulpal necrosis, root resorption, and ankylosis even if initially stable 1
• Permanent teeth are immature until 3 years after eruption and require special monitoring for continued root development 1