How to Survive Orthognathic Jaw Surgery (Maxillofacial Surgery)

Have you been told that jaw surgery is the only option to straighten your, or your child's, bite? If you're like us, the surgeon provides detailed instructions but leaves out a few useful tips. This eHow tries to fill in the gaps.

Things You'll Need

• Prescriptions, filled and in hand when the patient comes out of surgery
• Over-the-counter liquid pain medications like liquid Tylenol.
• Loose clothing (see Step Five)
• Vomit receptacle for the drive home
• Ice packs
• Popsicles
• Protein drinks
• Washable bedding
• Extra pillows
• Very soft lip balm or petroleum jelly

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Instructions

• 1

  Don't assume you'll have to pay out of pocket just because you don't have orthodontic insurance. In our case, the surgery came under our medical insurance, not dental or orthodontic.

• 2

  When your orthodontist calls it "elective" surgery, don't assume that means "cosmetic" or "not covered by insurance". It just means, roughly, that the problems it will fix are not life-threatening or disabling.

• 3

  Talk to all your providers -- orthodontist, surgeon, and dentist -- about the need for surgery. It was our dentist, the last one we talked to, who added the decisive bit of information: that our son had not only an overbite but an open bite. The open bite, where only the back teeth make contact top to bottom, made our son's decision much more straightforward because it meant there was a clearer health issue involved. Over his lifetime his teeth would probably have started cracking at the back because that was the only place they made contact with each other. You can see both the overbite and the open bite in the "Before" x-ray at the top of this page.

• 4

  Before the day of surgery, find liquids for your patient to live on while their jaw is closed. We had our son preview one of every kind of protein-rich drink we could find, and there were two he liked. Once we knew what he liked, we stocked up, and he pretty much lived on those two for the first three weeks after surgery. Other people we've talked to found popsicles to be the most palatable, at least for the first few days.

• 5

  Before the day of surgery, have crushed ice, Ziplocs, and paper towels ready for ice packs. Assembling several packs the day before surgery assures there will be no delay when your patient needs a new one.

• 6

  Have the post-surgery pain medications in hand when you go in for surgery. We had the prescription medications with us, and the operating room nurse recommended that we buy liquid Tylenol while our son was in surgery. It was a valuable tip: he didn't need full doses of the narcotic pain medications -- he preferred a half dose of normal liquid Tylenol, and a half dose of Tylenol with codeine.

• 7

  When they tell the patient to wear loose clothing, what they mean is the patient is going to have a huge ice pack around their head, and very tender flesh beneath the hard ice. Wear something with buttons or zippers, or that has a generous opening to slip over the patient's head. It needs to be big enough to pass a basketball through.

• 8

  Make sure you have something to puke in on the way home!

• 9

  Expect swelling and bruising. For our son, the most uncomfortable aspect of the swelling was cracked lips that were too tender for chapstick. We used Vaseline instead.

• 10

  Have enough pillows to let the patient sleep with head propped up -- the swelling and drainage can make it difficult to breathe.

• 11

  Expect some bleeding the first 24 hours -- use old bedding instead of that brand new snowy white dryclean-only duvet cover.

• 12

  Don't skip the physical therapy exercises! After our first six weeks of healing, our surgeon assigned stretching exercises using squash and racquet balls that had been pierced to be more squishy. Our son put them between his teeth and let them push his jaws apart for five minutes at a time. The goal was a three-finger-width space between top and bottom teeth. He had only a two-finger opening when his follow-up visits ended. He has the full opening now, but it was harder to get that last finger's worth of range late in the healing/scarring process.

• 13

  Be patient with the healing process. You're investing in a lifetime of a healthier jaw -- it'll be worth it.