After Jaw Surgery/Repair of Facial Fractures
There will be some swelling. However, the amount varies with each individual. Generally, more swelling occurs with lower jaw surgery than upper jaw surgery. Swelling will continue to increase for approximately forty-eight hours following surgery. Swollen lips can be made more comfortable by utilizing the lubricant available at your bedside. Swelling typically remains unchanged until approximately 4-7 days following surgery, while during the second and third post-operative weeks, it subsides dramatically. Every attempt will be made to minimize swelling. Ice packs and steroids (anti-inflammatory drug used to diminish swelling) will be used to minimize your swelling. You will be encouraged to keep your head elevated for the first week following surgery, since an upright posture and early ambulation minimizes the swelling that may occur.
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Nausea and Vomiting
You may experience some nausea and vomiting. It is important to realize that this is not a life threatening situation. Therefore, if vomiting does occur, remain calm and turn your head to the side so that any fluid produced clears your mouth freely. Although wire cutters are readily available in an extreme emergency, it is very unusual to have to cut the wires that are holding your jaws in position.
Minor Bleeding Following Surgery
It is not uncommon to experience some degree of minor bleeding and increased salivation following surgery. Swallowing the normal saliva that is produced in your mouth should be done.
It will be important that you drink sufficiently. Your fluid intake and output will be monitored during the early post-operative phase. An average adult requires approximately two to three liters of fluid every twenty-four hours. While this may seem like a large quantity, it can be achieved with constant sipping. As soon as possible, you will be encouraged to drink clear fluids and you will also be encouraged to drink directly from a glass or a cup. Do not use a straw for eating for the first seven days as this creates a negative pressure in your mouth and could cause bleeding or wound breakdown.
The ease with which you can communicate and be understood is not predictable. Speech will only improve, however, by repeated attempts on your part to talk and be understood. It is important that you slow your rate of speech, concentrate on each word, and be willing to try repeatedly. Most patients can be understood within twenty-four hours after surgery. It is interesting to note that people may speak to you more loudly, confusing your speaking difficulties with a hearing loss.
Discomfort may be anticipated. In most instances, it is mild and is treated easily with medications. Often, elastics will be applied to the braces to help keep the jaws together loosely and stabilize the bite. It is not unusual for patients to complain of earache or discomfort associated with the jaw joints. This may be partly due to muscle spasm or changes in the position of the joint that have occurred at the time of surgery. If you have trouble sleeping because of facial pain, headaches, earaches or difficulty equalizing pressure, a medication can be given to you.
You will be encouraged to brush your teeth following each meal. A soft toothbrush can be utilized for this purpose, paying particular attention to keeping the brush in direct contact with the teeth and not the gum tissue. In addition to brushing, a mouth rinse is recommended. A prescription antiseptic mouth rinse called Chlorhexadine will be used one or two times a day in the hospital and will be prescribed to you for home use. This antiseptic significantly lowers the bacteria count in your mouth. It may stain your teeth to some degree, but this is superficial and can easily be removed by your dentist. A Water Pic, along with a toothbrush, will provide an excellent means of maintaining oral hygiene.
Weight loss of 5 to 10 pounds may be anticipated during the post-operative period. This is a reflection, in most incidences, of a loss of appetite. It may also reflect the character of your diet which has changed considerable from what you are used to. By one week following surgery, your appetite should be sufficiently improved to maintain and possibly increase your weight. Hunger is a common complaint by many patients, while others are delighted to shed an extra few pounds.
Day of Discharge
Medications with instructions will be sent home with you. If you have any questions or concerns, or if any complications should arise, please call us immediately. You are encouraged to resume your normal activities as soon as it is possible.
Jaws that are Wired Together
If your jaws are wired together following surgery, there will be a set of wire cutters or scissors at your bedside. As previously noted, jaw wiring is rare due to the use of rigid fixation. When surgery is on the lower jaw or both jaws, you may be wired together for four days to four weeks depending on the complexity of your surgery. We ask that you carry a set of wire cutters or scissors with you at all times. We will show you where these wires are located and how to remove them in the event of an emergency.
If you smoke, try not to during the post-operative period. Heavy staining will occur to the teeth, braces and splint, as well as retardation of wound healing. This may be a golden opportunity to quit smoking if you so desire.
Do’s and Don’ts
Sleep with your head elevated.
Be prepared for nose bleeds or runny noses.
If you suffer from nausea and if you have to vomit, it is important not to panic and simply turn your head to the side and let it drain out of your mouth.
Avoid contact sports for at least eight weeks.
Don’t exert yourself or do any exercises that may cause heavy breathing.
If your jaws are wired, carry wire cutters with you at all times.
Avoid any foods, liquids, or alcohol that may upset your stomach.