Post-Operative Instructions – Orthognathic/Jaw Surgery
Patients are usually released from the hospital the next day with post-operative instructions. Patients typically may be off work/school for two to four weeks to one month after surgery. Return to normal chewing function may take up to 2 months. Unnecessary pain, bleeding, swelling and other complications can be minimized if these instructions are reviewed and followed carefully.
- Soft puree diet for 2 weeks
- Analgesics for pain and Antibiotics for infection to be taken as directed
- Ice over face x 48 hours, then heat x 72 hours or until swelling is down (15 min on/15 min off)
- Oral Rinses – Peridex and saltwater 4x/day
- Oral hygiene is reviewed – use small soft tooth brush with salt & water rinses or Peridex
- Intermaxillary Elastics must be replaced if they brake
Call office in case of emergency and leave message with answering service 506-859-7200.
Medication and Antibiotic Mouth Rinse
Be sure to take prescribed medication or mouth rinses (such as Peridex, Perichlor) as directed to help reduce the chance of infection. Take the recommended or prescribed pain medication as directed to relieve symptoms. Analgesics (pain medication) can be stopped when no longer needed.
However the prescribed antibiotic must be completely finished. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and contact the office immediately at 506-859-7200.
After surgery most patients experience swelling around the mouth, cheeks, eyes and sides of the face. The swelling usually does not become apparent until the day following surgery and will peak at 48-72 hours post-operatively. You can minimize swelling by applying ice to the facial area for the first 48 hours (15 minutes on then 15 minutes off for every awakened hour) then switch to applying moist heat in order to reduce the size of the swelling (15 minutes on then 15 minutes off for every awakened hour). Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve with time.
Bruising is a common post-operative complication of jaw surgery and could extend to the cheek, under the eyes or in the lower jaw and neck area. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. Bruising is not dangerous, and will usually resolve a few weeks following surgery. Moist heat applied to the area may speed up the disappearance of bruising.
Elastics will be placed the day of surgery. If the intermaxillary elastics break you must call our clinic to have them replaced.
Good oral hygiene is essential to good healing. In addition to the prescribed Oral Rinses begin using warm salt water rinse (1/2 tsp of salt in a cup of warm water) 24 hours following surgery. You should do this every 4-6 hours, especially after meals, for several days until the tenderness is gone. It is important to brush your teeth during the post-operative period, but avoid any trauma to the surgical site(s) and stitches as this may cause bleeding.
It is a good idea to plan for your diet in advance of your surgery. More complicated cases may require more specific instructions. A soft puree (blender) diet is followed for the first two weeks. Begin with clear fluids (juice, broth, jello) and in approximately 10 days progress slowly to a soft diet such as pasta/fish/eggs/mashed potatoes by chewing away from the surgical sites. Remember it is important to hydrate and maintain adequate nutrition for optimal healing to occur.
Stitches will begin to dissolve and fall out on their own as early as 1 week after surgery. You may experience a few drops of blood in your saliva or minor discomfort when this occurs. If they come out earlier it is not usually a concern unless persistent bleeding occurs. They are harmless if swallowed.
The surgeon will advise you if there are non-resorbable stitches which must be removed.
Studies have proven smoking may lead to many complications, such as infection and causes prolonged pain and healing time. Avoid smoking until the site has healed over (this could take 2-3 weeks).
It is important to maintain your follow-up appointments with your surgeon and all treatment team members (orthodontist, prosthodontist and/or family dentist).
Occasionally, an infection may occur days or even weeks following surgery. If swelling increases after the initial swelling period (2-3 days), or fails to decrease after several days, you may have an infection. Typically, persistent or worsening pain also accompanies it. You may feel unwell and a foul-tasting fluid may drain from the infected site. If you think you may have an infection, call the office.
If you had upper jaw surgery it is normal to have an occasional nose bleed. Avoid blowing your nose, bending down or lifting heavy objects in the first 5-7 days. Should you experience bleeding, use a Kleenex to pinch your nose for a few minutes, this should stop the bleeding. If the bleeding does not stop call our office for advice.