We have created this information to provide you with a comprehensive understanding of Orthognathic surgery and to help you prepare for the upcoming procedure. It outlines a typical hospital course for the surgery. We understand that you may have questions after reviewing this information, so please feel free to ask us about any concerns you may have. We firmly believe that a well-informed patient will encounter fewer surprises and will have a better overall experience, both physically and emotionally, when undergoing a major surgery.

Immediately Following Oral Surgery

  • Please keep the gauze pad, which was placed over the surgical area, in place for half an hour.
  • To promote proper healing, avoid vigorous mouth rinsing or touching the wound area following the surgery.
  • Take the prescribed pain medications as soon as you start to feel any discomfort.
  • On the day of the surgery, limit your activities, and only resume normal activity when you feel comfortable doing so.
  • Apply ice packs to the sides of your face where the surgery was performed. For more information on managing swelling, please refer to the relevant section.

BLEEDING

Following oral surgery, it is normal to experience a certain amount of bleeding. You may notice slight bleeding, oozing, or redness in your saliva, which is generally not a cause for concern. However, in the event of excessive bleeding, please follow these steps:
Rinse or wipe away any old clots from your mouth. Place a thick gauze pad over the affected area and bite down firmly for 30 minutes. If needed, repeat the gauze application. Should bleeding persist, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps contract bleeding vessels and promotes clot formation. During this period, avoid becoming overly excited, maintain an upright sitting position, and refrain from engaging in physical exercise to minimize further bleeding. If bleeding continues despite these measures, please contact our office for further instructions and assistance.

SWELLING

Typically, post-operative swelling is directly related to the extent of the oral surgery performed. It is common to experience swelling around the mouth, cheeks, eyes, and sides of the face. This natural reaction is part of the body's healing process after surgery. The swelling may not be immediately noticeable, usually becoming more apparent on the day following the procedure and reaching its peak around three days (72 hours) after the surgery.
To help minimize swelling, we recommend using ice packs as soon as possible. You can use two plastic bags filled with ice or ice packs, wrapped in a thin towel or cloth, and apply them to the areas where the surgery was performed. Keep the ice packs on continuously while you are awake. However, after 48 hours, icing may no longer have a significant effect on reducing swelling. Should you experience swelling or jaw stiffness for several days following the dental treatment, there is no need for alarm, as this is a normal part of the healing process. After 48 hours, applying moist heat to the sides of the face can be beneficial in reducing the swelling size. Please note that every individual's healing process may vary, and if you have any concerns about the swelling or your recovery, do not hesitate to contact our office for guidance and reassurance.

DIET

Post-Op (first 1 – 5 days) Liquids, puree Post-Op (first 4 weeks) Mashed foods Post-Op (4 – 8 weeks)Soft sandwiches, light chewing Post-Op (8 weeks +) Resume regular diet
During the initial stages of healing, you can modify your regular diet by blending or thinning the food you typically consume. Fresh fruit and vegetable juices are excellent sources of vital nutrients, vitamins, minerals, and fluids. In addition to regular blenderized food, commercial dietary supplements like Carnation Instant Breakfast, EnRich, Boost, EnSure, Sustical, and others can be helpful for individuals who find it challenging to consume regular blended meals. It is crucial to ensure an adequate intake of calories and protein during your recovery period to support the healing process. Following the surgery, you will be encouraged to have smaller, more frequent meals (approximately six times per day) to meet your nutritional needs. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot.

PAIN MANAGEMENT

For moderate pain relief, you may take one or two tablets of Tylenol or Extra Strength Tylenol every four to six hours. Alternatively, you can use over-the-counter ibuprofen (Motrin or Advil) in 200 mg tablets, taking two to three tablets every three to four hours as needed for pain. Please carefully follow the dosage instructions provided on the medication's package for over-the-counter drugs.
In cases of severe pain, it is essential to take the prescribed pain medication as directed by your healthcare professional. However, please be aware that the prescribed pain medicine may cause drowsiness and slow down reflexes. For your safety, refrain from driving an automobile or operating machinery while under the influence of this medication. Additionally, avoid consuming alcoholic beverages during this time. As you progress beyond post-operative day 3 (72 hours), you should experience a gradual reduction in pain or discomfort each day. If, contrary to this trend, pain persists or becomes a concern, please do not hesitate to contact our office for further evaluation and appropriate attention.

DISCOLORATION

On occasion, after swelling, there may be some skin discoloration. The appearance of black, blue, green, or yellow discoloration is caused by blood spreading beneath the tissues. This is a natural postoperative phenomenon that can occur around two to three days after the procedure. To facilitate the resolution of the discoloration, the application of moist heat to the affected area may help speed up the healing process.

KEEP YOUR MOUTH CLEAN

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least five to six times a day with a cup of warm water mixed with a teaspoon of salt especially after eating.

ANTIBIOTICS

If you have been prescribed antibiotics, please take the tablets or liquid as directed by your healthcare provider. The purpose of these antibiotics is to prevent infection. However, if you experience a rash or any other adverse reaction while taking the antibiotics, discontinue their use immediately. Should you have any questions or concerns regarding your medication, do not hesitate to contact our office for clarification and guidance.

NAUSEA & VOMITTING

If you experience nausea and/or vomiting after surgery, refrain from consuming anything by mouth for at least an hour, including the prescribed medication. Allow your stomach some time to settle. After this period, you can start sipping on Coke, tea, or ginger ale. Take slow sips over a 15-minute span, and if the nausea begins to subside, you can gradually introduce solid foods and resume taking the prescribed medicine as directed. However, if the nausea persists or you have any concerns, please contact our office for further guidance and assistance.

Other Complications

  1. If you notice numbness in your lip, chin, or tongue post-surgery, there’s no need to worry, as it’s typically a temporary condition, as discussed before the procedure. However, please be cautious as you may not feel if you accidentally bite your lip or tongue. For any questions or concerns, feel free to contact our Clinic.

  2. A slight rise in temperature immediately after surgery is not uncommon. If the fever persists, kindly inform our office, and you may take Tylenol or ibuprofen to help reduce it.

  3. When moving from a lying down to a standing position, exercise care. The fasting before surgery and difficulty in consuming fluids, combined with the effects of pain medications, can lead to dizziness or light-headedness upon sudden standing. To mitigate this, take a moment to sit up before standing.

  4. On occasion, patients may feel bony projections in their mouth with their tongue. These are not roots but rather the bony walls that supported the tooth. In most cases, these projections will smooth out by themselves. If they persist, our surgeon can remove them.

  5. To prevent dryness and cracking of the corners of your mouth, apply an ointment like Vaseline to keep your lips moist.

  6. It’s common to experience sore throats and discomfort while swallowing due to muscle swelling after the surgery. However, this discomfort usually subsides within two to three days.

  7. You might face difficulty opening your mouth due to stiffness (trismus) in the jaw muscles. This is a normal post-operative occurrence and will resolve over time.

Finally

Sutures are placed in the surgical area to minimize post-operative bleeding and aid in the healing process. Occasionally, sutures may become dislodged, but there is no need for concern. Simply remove the suture from your mouth and dispose of it. In most cases, any remaining sutures that do not fall out will dissolve on their own.

As the days progress following the surgery, you should notice a gradual reduction in pain and swelling. However, if your post-operative pain or swelling worsens, or if you experience any unusual symptoms, please contact our office for further instructions.

After the tooth extraction, there will be a cavity at the site where the tooth was removed. This cavity will gradually fill in with new tissue over the course of the next month. In the meantime, it is essential to maintain cleanliness, particularly after meals, by using salt-water rinses or a toothbrush in the area.

Each case is unique, as no two mouths are alike. Refrain from accepting well-intended advice from friends and instead, discuss your concerns with the individuals best equipped to assist you effectively: our Clinical staff or your family dentist.

You can continue brushing your teeth; however, be gentle around the surgical sites.

A dry socket is when the blood clot is prematurely dislodged or dissolves from the tooth socket. Symptoms may include pain at the surgical site and even pain extending to the ear, typically occurring two to three days after surgery. If you experience these symptoms, please contact our office for prompt attention.

If you engage in regular exercise, be mindful that your normal nourishment intake may be reduced. Exercise could potentially weaken you, so if you feel light-headed, it is essential to stop exercising.