Lower jaw
Postoperative problems affecting the lower jaw (mandible) include
- Immediate: bleeding. The mandible has an excellent blood supply from the inferior alveolar vessels which run with a major nerve bundle (inferior alveolar nerve) through the ramus and body of the mandible (the back bit) from an entry hole on the inside (marked by a bony prominence called the lingula) to an exit hole on the lateral (outside) aspect of the body of the mandible (nearer the front). A smaller bundle of nerves and vessels continue through the bone to connect with the opposite side. A further blood supply comes from the enveloping periosteum. Any operation on the bottom jaw, from tooth removal to resection, can bleed despite taking many precautions during the operation.
- Pain is likely if there is inflammation of the bone, infection of the bone or mobility of the bone.
- Malocclusion: if the bone holding the teeth is in the wrong place, for example after a repair of a fracture, then the teeth will not meet in the way they did before the injury or operation.
- Swelling: any operation on a bone will produce swelling but because of the proximity of the airway this is of more significance with some bones than with some other bones.
- Altered sensation: for the reasons given above in bleeding. The main nerve to the lower lip runs from side to side in the mandible. Injury to the bone, surgery to repair that injury, or surgery that removes or divides the mandible can result in various forms of nerve damage.