Post-operative instructions for jaw fractures and orthognathic surgery


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Diet

Strict adherence to the diet schedule below is crucial to allow your jaw to heal appropriately. Advancing too quickly to hard foods can cause the plates and screws to break or bend and the jaw to re-break, possibly requiring further surgery. Occasionally, certain types of jaw fractures require a different protocol than the standard suggested below. You will be notified if this applies to you. Additionally, delayed healing or other problems may arise which could delay you from advancing as outlined below.

A suggested diet for standard cases is:

  • Week 1: Liquid diet For the first week, your diet should be liquids or pureed foods only. Taking adequate amounts of fluid, (no straws), after surgery is essential as it helps your body to heal. Suggestions include any clear fluids: water, soft drinks, Gatorade, clear soup and then progressing to milk shakes, smoothies, ice cream, Soya milk drinks, yogurts, protein drinks, tofu and protein supplements as well as nutritional supplements (such as Ensure, Boost, Whey, protein powders,) or anything you can puree in a blender.
  • Week 2 through 4: Non-chew diet. After 1 week, you can commence a non-chew food diet. A recommendation is to eat food that you can easily squish between your fingers and anything that does not make any noise (ie hard or crunchy foods). Examples include: mashed potatoes, scrambled eggs, fish and over-boiled/soft pastas cut into small pieces etc.
  • Week 5 and 6: Soft diet. After 4 weeks, you can progress to a soft-chew diet. At this point, just about any soft foods are okay as long as they are cut into small pieces and don’t requiring too much pressure on the jaw to chew. At this point Dr. Robertson may tell you that you can remove your elastics to eat and then replace them again afterwards.
  • After 6-8 weeks: Normal diet. After 6-8 weeks, you can progress to more normal chewing, but advance slowly (don’t progress right to hard, crunchy, chewy foods right away, slowly advance back to these foods).

Oral Hygiene:

Proper oral hygiene is extremely important for preventing infections of the surgical sites. The swelling in your cheeks may make it difficult to brush your teeth, but it is important to do so. You may brush the outside of all teeth starting the day after surgery with a soft toothbrush. Take care to brush the teeth only, avoid your gums where the incisions are. Keep braces and/or wires very clean. You may have elastics between your upper and lower jaws to support the lower jaw and to control the bite. If so, don’t worry about brushing the inside of your teeth.

In addition to brushing, you should use warm saline rinses (1/2 teaspoon salt in a tumbler of warm water) daily. You can rinse your mouth with salt water as often as you would like, even up to every 2 hours, but certainly after each meal and before bed. You cannot do enough rinses. This will keep your mouth clean and help shrink the incision lines. You may also be given a prescription for Chlorhexidine/Peridex, an anti-bacterial mouth rinse, which you should use as instructed on the bottle.

Activity:

You may begin gentle exercise (light jogging, swimming, light weight-lifting) after 2 weeks, but avoid strenuous exercises, such as heavy lifting or any activity that raises your blood pressure or pulse, for at least 4 weeks after the surgery. If you find that you have excessive throbbing or pain with physical activity, reduce the intensity. It is imperative that you do not play contact sports or do any activity where you could receive a blow to the jaw for at least 8 weeks.