After Fractured Jaw Surgery

• BLEEDING: Prolonged bleeding, such as nosebleeds or bleeding from the incision sites following discharge from the clinic or hospital is not normal and you should contact Dr. Sowden should this occur.
  
• SWELLING: For the first 48 hours apply an ice pack to the outside of the jaw to help minimize the swelling. Following this period you will need to use heat (hot, wet facecloth, hot water bottle, heating pad etc) to help reduce the remaining bruising and swelling. As it takes about 2 weeks for the majority of the swelling to disappear, continue to use heat for 30 – 45 minutes, 4-5 times per day for at least 1 – 2 weeks after your surgery.
  

• For the first couple of days following surgery you may experience a sore throat and some nasal congestion. This is normal after general anaesthesia and should go away within a couple of days. Drinking plenty of liquids usually helps with throat tenderness.

• You will be unable to keep your lips moist when your jaws are held together with elastics. It is recommended that you use Vaseline or a lip balm regularly to prevent chapped lips and cracking at the corners of the mouth.

• Brush teeth and arch bars well three times a day – use a smaller toothbrush if access is a problem.
  
• Arch bars and wires should be reflective and bright, dullness indicates plaque build up.
  
• Use the Chlorhexidine (Peridex) mouth rinse as prescribed by the Doctor. This medication will, however, stain the teeth so a professional cleaning may be needed once the arch bars are removed.

• Since your jaws are held together with wires initially and elastics later in your healing phase, you will require what is called a balanced fluid diet (blenderized). It is essential that your body receive adequate fluids and nourishment in order to promote healing. Attempt to consume 5000 calories daily.
  
• Weigh yourself the first week (and make a note of it) and every week following. A weight loss is expected, however anything over 20 lbs is a concern.
  
• You can use the syringe for feeding initially and when comfortable use a straw or drink from a glass.

Caloric Considerations:

• Proteins 
  • Protein shakes
  • Weight gainer formula (Health food stores have this)
• Complex Carbohydrates 
  • Avoid simple sugars
  • Fluid nutrition drinks obtain a majority of their caloric value from carbohydrates and fat. Attempt to limit the amount of simple carbohydrates (sugars) as these sugars are the energy source for cavity producing bacteria. Limitation of glucose and fructose is helpful.
• Essential Fatty Acids 
  • Your body requires fat to heal. During jaw wiring this may be difficult to obtain. Good sources of essential fatty acids (fats) include Ensure and Boost drink supplements
• Alcohol and smoking can delay wound healing and promote infection.
• Alcohol and smoking should be avoided until your surgical sites are completely healed.

• Upon release of jaw wiring you will experience a period of limitation in jaw opening and increase in discomfort. This is expected. Your arch bars may remain in place for a period following release of the jaw wiring and you will be given elastics with instructions on use. Specifics regarding elastic use and home physiotherapy will be covered during your follow-up visits.
  
• Continue on a liquid diet until directed otherwise. Continue to maintain meticulous oral hygiene.

• Once it is determined that your jaws are healed and your occlusion or bite is satisfactory you will have your arch bars removed. This will be done usually under sedation in the office. A panorex x-ray will be taken following removal to ensure no wire fragments are retained. The sedation, removal of arch bars and panorex, are all billed for at the time of service.
  
• Of utmost importance both during this procedure and in the ensuing months following is the small but significant risk for the loss of teeth surrounding your fracture(s). While every attempt is made to minimize the risk for loss of your teeth, this is a risk associated with a jaw fracture. Moreover, many times teeth which appear firm while your arch bars are in place are, in fact, grossly mobile upon arch bar removal and require extraction. This will be discussed in detail during your pre-operative counseling session.
  

• Physical activity should be kept to a minimum for the first 6 – 8 weeks after surgery.
  
• Excessive activity (running, exercising, swimming, heavy lifting, contact sports etc) can cause bleeding and/or dizziness.
  
• If you had an upper jaw fracture you should avoid bending over for this time period as it may cause dizziness.
  
• Excessive fatigue can also slow the healing process as well as increase the chance of infection by reducing your resistance. A gradual increase back to normal activity is the most sensible approach.
  
• Contact sports should be avoided for 2 – 3 months to minimize the risk of another fracture. If you have any specific activities you wish to perform following your surgery, please discuss this with your doctor.
  

• A follow up appointment may be made with your surgeon prior to your discharge. If an appointment was not made, please call the office during regular business hours to make an appointment.