Information regarding Jaw Surgery
SWELLING following surgery to the jaws is to be expected. This is often accompanied by bruising. Medication is given during surgery, and after, to minimize the amount of swelling. Cold compresses are also used for 2 – 3 days after surgery. The swelling will peak several days after surgery, and most of it will resolve by two or three weeks.
BLEEDING is a part of any surgical procedure. With modern techniques, blood loss is usually well controlled, and transfusions are rarely necessary. If you have concerns about transfusions for religious or other reasons, it is important to inform you surgeon and to discuss these concerns well in advance of your surgical date. There is usually minimal bleeding after surgery, although there may be a small amount of oozing which can be stopped by applying pressure on the wound(s).
The degree of PAIN is variable. Usually medication to relieve pain is required for the first few days after surgery. The discomfort will then begin to diminish and fewer painkillers, or milder ones, can be used. Tablets may be crushed if there is difficulty to swallow them whole. Stiffness and discomfort in the muscles may persist for several weeks.
INFECTION in the surgical site(s) is rare following jaw surgery. When it occurs, it is generally treated with antibiotics. If an infection is more severe, surgical drainage may be required.
NERVES are often affected by surgery. It is common for sensation to be altered in the lips, cheeks, chin, gums or tongue. Usually, the feeling is similar to that experienced when local anaesthetic (“freezing”) is wearing off, and the affected part feels partly numb, or has a tingling sensation. Very rarely, an area can be more sensitive than normal, or even painful. The change in sensation may be temporary and normal sensation may return gradually within a few months. Occasionally, the recovery of normal sensation is incomplete.
TEETH can sometimes be damaged by surgery to reposition the jaws. This is a rare complication unless cuts through the bone must be made between the teeth. If the teeth are damaged beyond repair, one or more teeth may be lost and may need to be replaced.
Small metal plates and screws are used to hold bone in the desired position while it heals. This method is called RIGID INTERNAL FIXATION (RIF), and it is not necessary to wire the jaws together while the jawbone heals. Occasionally the bone cannot be adequately stabilized with screws and plates, (a very rare situation), and, if so, the teeth may be wired together for 7 – 10 days only after surgery. Usually, elastic bands between the braces on the upper and lower teeth are used to hold the teeth lightly together in their new position.
The plates and/or screws normally do not need to be removed. If the screws loosen, or become inflamed or infected, they can easily be removed in the office.
If the jaw is not stable in its new position, the result will not be satisfactory. This can happen as the result of muscle pull on the bone, or a loss of stability of the screws and/or plates that hold the jaw in its new position. If the bite is not correct after the surgery, it can usually be corrected with braces. Rarely, it may be necessary to repeat the surgery.
Even though the jaws are not normally wired together, jaw movement is limited following jaw surgery. The muscles that move the jaw become very stiff, and opening the mouth and chewing are difficult. The stiffness usually disappears gradually over a period of a few weeks.
The temporomandibular joints can be affected by jaw surgery. This is usually related to stiffness affecting the muscles which move the jaw. The joints generally remodel during healing and normal function returns. Occasionally, physiotherapy may be necessary, or, on rare occasions, surgery to the joints themselves may be required.
Your throat may be sore from the tubes placed during surgery. Lozenges, frequent gargling with a mild salt and water rinse and drinking plenty of fluids will help.
It is important to keep your mouth as clean as possible. It is difficult to brush your teeth, but you must brush as far as you can reach. Compensate for inadequate brushing by rinsing with warm salt water.
Weight loss is normal, and can be as much as 10% of your body weight. It is difficult to maintain an adequate intake because the appetite is often decreased. It is also difficult to manage solid food immediately after surgery. You may have any type of food you wish, however it must be chopped or pureed first. It is advisable to take a multivitamin supplement. GOOD NUTRITION IS NECESSARY FOR HEALING.
FATIGUE may last several weeks.
TIME OFF work or school will depend on several factors, such as the operation performed, your age and the kind of work you do. Usually, ten days to two weeks is required but some patients will require more. Return gradually to a normal level of activity, but get as much rest as you can.