Post-Operative Instructions: Fracture and Jaw Surgery

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It is important that your jaws remain together and movement is avoided to allow normal healing. Avoid trying to move your jaws or play with the wires, rubber bands, etc.—this will cause them to loosen or break. If wires or elastics do become loose or break, notify our office; they need to be replaced or tightened!

There are several important don’ts when your jaws are wired shut:

  • You should not be in water more than waist deep! No swimming.
  • No alcoholic beverages—no medications or drugs that may make you sleepy or drowsy.
  • No contact sports or activities that might cause any type of injury to the face.

Swelling

Ice can be applied to the lower face for the first 1–2 days. After 3–4 days, heat may be beneficial in decreasing swelling. A heating pad, hot water bottle, or cloth with hot water can be used. Be careful not to burn the skin.

Swelling typically takes 10–14 days to resolve. After the first few days, swelling should begin to decrease. If you notice an increase in swelling after this time period, it may indicate an infection or another problem, and you should contact our office.

Pain

Initially, you may have pain. Take prescribed medication as needed. Make sure you get some type of food or a drink in your system before taking your pain medication, as it can cause nausea. Do not attempt to move or open your jaws. This action only increases the pain, may delay healing, and may cause muscle spasms in your jaw muscles. A non-steroidal anti-inflammatory (such as ibuprofen, Advil®, Motrin®, or Aleve®) may be taken along with your prescription medication if needed for pain.

Nausea and Vomiting

Avoid all alcohol and any foods that may cause your stomach to become upset. Stay well hydrated and avoid taking pain medication on any empty stomach. Should you experience nausea, you can use over-the-counter Dramamine® as directed on the bottle. If nausea persists, please contact our office. Anti-nausea medicine can be prescribed if nausea persists.

If you feel that you are going to vomit:

  • Bend forward or roll onto your side.
  • Put your finger inside your cheek alongside the teeth and pull your cheek outward.
  • Remember that everything you are taking in is liquid. If anything comes out, it will be liquid as well—the stomach contents can escape around the teeth and will come out of your nose and mouth. It is not recommended that you try to cut your wires or elastics when you think you are going to vomit.

Medications

You may be prescribed several medications depending on the nature of your surgery. If you have been given a prescription for medication, please have it filled and follow the instructions on the bottle. If antibiotics are prescribed, it is important to take them as prescribed until all gone.

Every effort will be made to give all medicines in the liquid form; however, some medications are not available in the liquid form, so it may be necessary to crush pills (placing pills between two spoons is an easy way to accomplish this) and dissolve your medicine in juice or mix with applesauce.

Activities

Avoid strenuous activity that causes you to clench your jaws or leaves you short of breath. No swimming or contact sports are allowed. You may bathe or shower and wash your hair.

Diet

Since your jaws may be held together with elastics, you will require what is called a balanced fluid diet (pureed in a blender). It is essential that your body receive adequate fluids and nourishment to maintain your nutritional status and promote healing. It is not unusual to lose 5–10 lbs during the first week after surgery—this is mostly water weight. You may lose 5–10% of your normal body weight while jaws are wired shut. You will be limited to a liquid diet until your jaws are no longer tightly held together. It is especially important to drink adequate amounts of fluids, 3–4 liters per day. You can purchase liquid nutritional supplements (such as Ensure® or Boost®) in grocery stores or pharmacies.

Instead of eating the usual 3 meals a day, eat more frequent small meals to increase caloric and nutritional intake. Initially, you will find it easier to use the plastic syringe to squirt liquid inside your cheek to the back of your mouth — when comfortable, you can use a straw or drink from a glass. Extremely hot or cold food can be uncomfortable to eat, especially through a straw. Eat foods served at room temperature. Don’t forget to add variety to your meals. Experiment with different foods and flavors.

You may eat anything that can be thinned into liquid form. Meals may be blended until smooth. If food is still lumpy, use a strainer. Cold whole milk can be used to thin puddings, yogurt, cereal, sandwiches, ice cream, and cakes. Warm whole milk can be used to thin cheese, eggs, toast, hot cereal, muffins, pasta, hot main dishes, and casseroles. Fruit juice can be used to thin fruit, yogurt, and ice cream.

Oral Hygiene

It is very important to keep your mouth clean, especially if you have wounds inside the mouth that are healing. Rinse vigorously with warm tap water after each meal or snack—a syringe with a curved plastic tip helps to squirt water into hard-to-reach areas. Brush thoroughly after meals and before bed with a child-sized soft toothbrush. Use the prescription mouth rinse (Peridex, also known as chlorhexidine) or Listerine® twice a day—swish for 1–2 minutes with 1 tablespoon, then spit. Using a Waterpik® device is great for cleaning but should not be used for at least 2 weeks if you have surgical wounds inside the mouth. You must do this as thoroughly as possible. You will not be able to brush the tongue side of your teeth with a brush. The tongue side of the teeth can be brushed by moving your tongue across them while using a mouth rinse.

Sharp Wires or Sore Spots

Use wax to cover wires or hooks that may be causing discomfort, such as poking your cheeks, lips, or gums. Do this by using a very small piece to cover the wire or hook at the site of discomfort. Remove the wax before brushing teeth and eating or drinking.

Care of Skin Incisions

Depending on the type of surgery, it may have been necessary to make an incision on your skin or to repair lacerations or wounds associated with your injury. Care of these wounds is important to prevent infection and minimize scarring. Keep wounds covered with a dressing. Once the stitches are removed, keep the wound clean by gently washing twice a day and applying a topical antibiotic ointment (Bacitracin, etc.).

For the first 6 months, avoid excessive sun exposure to your scar—apply sunblock and wear a brimmed hat.

Wires and Rubber Bands

Do not cut, remove, bend, or twist wires! If wires or braces begin to irritate cheeks or lips, a small piece of wax can be placed over these sharp areas temporarily. Point out these spots during your next office visit. Vaseline® or other lip lubricants aid in comfort.

Loose wires may compromise or delay healing or result in fracture healing improperly. Call the office if you can open your mouth or move your jaws!

Remember, the wires or rubber bands can be stretched or broken, causing the problems noted above, or teeth can be loosened and damaged. Don’t try to fight them and open or move your jaw. If you need to cough, sneeze, or yawn, use your hand to support below your chin to avoid the tendency to try to open your mouth!

Follow-Up Care

Frequent office visits and periodic post-operative X-rays are necessary to ensure healing. Please keep all of your scheduled appointments.

If any problem arises, such as a shifting of your bite, loose wires, fever, excessive swelling, bleeding, or vomiting, call our office at (520) 214-8749.

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