110 Where There Is No Dentist 2012
Bleeding inside the mouth, from between the broken parts of the
bone, is more difficult to stop. You must pull the two sides together
and hold them in that position. To do this, you need wire that is thin,
strong, and bends easily. ‘Ligature wire’ (0.20 gauge) is best.
Place a piece of wire around 2 teeth, one
on each side of the break. Choose the
strongest tooth on each side—the ones
with the longest or the most roots.
Tighten the wire around the two strong
teeth with pliers or a hemostat.
Ask the person to close his teeth. Lift up the broken part of the jaw and
hold it so the lower teeth meet the upper teeth properly. This is the
normal way the jawbone holds the teeth.
Now join the wires. Twist and tighten them
together. This may be painful.
You can inject local anesthetic—see
Chapter 9. You must twist the wire tight
enough to hold the broken parts together.
Bend the end of the twisted wire toward the teeth. Now it cannot poke
the person’s lips or cheek.
3. Put on a head bandage.
Gently close the person’s jaw so that his teeth come together. Support it
in this position with a head-and-chin bandage.
Tie the bandage to support the jaw, not to pull it. Do
not make it too tight. It is all right if his mouth stays
partly open with the teeth slightly apart.
Be sure not to let the bandage choke the person.
4. Give penicillin by injection (page 210) for 5 days to stop infection inside
the bone.
5. Give something for pain. Aspirin (page 94) may be enough. Give 600 mg
by mouth, 4 times a day. For children, see doses on page 95. If there is
a lot of pain and the person cannot sleep, give codeine. The dose for an
adult is 30 mg, 4 to 6 times a day as needed.