Home Care After Orthognathic Surgery
Recovery from orthognathic surgery will vary, depending on whether one or both jaws underwent surgery and whether or not the jaws will be wired shut following the procedure. In many cases, if the jaws need to be wired closed at all, it will be for a relatively brief period immediately following surgery. This is thanks to advances in orthognathic surgery procedures that rely on titanium screws and plates that act as splints, retaining the positioning of the bone from within. In some higher-risk cases, however, the jaws must remain wired together for a longer period of time, stabilizing the bones and helping them heal properly, kind of like a cast helps a broken bone heal. Sufficient healing is integral to the long-term success of corrective jaw surgery, and stabilizing the jaw is only one part of the equation. Following your oral surgeon’s instructions for home care after orthognathic surgery also plays a big part in the lasting success of the treatment and the continued oral and overall health of the patient.
After your orthognathic surgical procedure, your face will appear swollen for a few days, gradually returning to normal. You can minimize swelling by applying ice packs intermittently for the first 48 hours and sleeping with your head elevated, and your surgeon will provide medication that will address swelling along with other post-surgical symptoms, like pain. If your surgery included your upper jaw, your nose will probably feel congested for a few days after surgery, peaking at around day five. It’s very important to avoid blowing your nose, even if you do feel congested, as this can damage the surgical site. Many patients find relief with decongestant medications and by using a vaporizer to ease breathing while sleeping.
Your surgeon will prescribe narcotic pain medication for you to use, though you’re not required to take this medication if you’re not in pain. When narcotic pain medication is used, make sure to follow your doctor’s instructions for use, and call your surgeon if the medication provided isn’t sufficient or causes dizziness or other side effects. Some medications cause nausea, and some patients feel nauseated after surgery even when they don’t use these medications; call your surgeon in either case, as there are treatments that can prevent this uncomfortable symptom. If you’ve gotten a prescribed oral antibiotic, don’t forget to take it every day, and take all the pills as directed until they’re gone; infection can recur when an antibiotic cycle is interrupted.
Make sure to keep the mouth clean, rinsing with warm saltwater as instructed and using any prescription mouthwash that may have been provided. Brush your teeth carefully, avoiding delicate, easily damaged soft tissue that may feel numb following surgery. It may be difficult to fully open your mouth early on, and your surgeon will give you a special, smaller toothbrush so you can safely reach obstructed areas in the mouth. It may be difficult, or impossible when the jaws are wired, to speak following jaw surgery. Carry a whiteboard or pad to communicate when needed, and try to breathe through the frustration this might bring; stressful pressure on the jaws or trying too hard to speak could further delay healing.
Even if you don’t feel hungry or thirsty at first, make sure to drink plenty of water and maintain a healthy diet as you heal. You’ll be consuming a liquid diet for the first several weeks, and surgeons recommend a diet of pureed whole foods to ensure balanced nutrition and sufficient calories. While you won’t feel inclined to do any vigorous exercise at first, it’s important to move around throughout the day, changing positions and taking deep breaths to keep your blood flowing. Call your oral surgeon or medical provider immediately if you have a fever higher than 100.4 degrees, a foul taste or discharge in your mouth, nausea or vomiting, or pain that increases or remains despite taking provided medication.