Jaw surgery (orthognathic surgery) corrects significant skeletal and dental irregularities of the jaw and face. The primary goal is to improve function, such as chewing and speaking, while enhancing facial harmony. A successful outcome depends on meticulous preparation, which begins long before the operation. This process requires careful coordination between the patient, the oral surgeon, and the orthodontist, addressing medical, logistical, and home environment details.
The Clinical Road Map: Pre-Surgical Medical Requirements
Pre-surgical orthodontics is the first phase, often lasting 6 to 18 months. This treatment uses braces or aligners to move the teeth into a position that allows them to fit together correctly once the jaw bones are surgically realigned. The bite commonly appears worse during this phase as the teeth are moved out of their pre-existing, compensatory positions.
As orthodontic preparation nears completion, the surgical team begins final planning. The surgeon takes detailed records, including facial measurements, photographs, and advanced imaging like Cone Beam CT scans. These records are used for virtual surgical planning, where the procedure is simulated on a computer to precisely determine bone movements and create custom surgical guides.
The patient must obtain medical clearance from a primary care physician and often an anesthesiologist. This process typically involves blood work and, depending on age or pre-existing conditions, may include an electrocardiogram (EKG). A comprehensive medication review is mandatory to identify items that could interfere with the surgery or increase the risk of bleeding.
Patients must stop taking blood thinners, such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, usually for one to two weeks before the procedure. Certain herbal supplements, including high doses of Vitamin E, garlic, and ginseng, must also be discontinued as they possess blood-thinning properties. On the day of surgery, patients follow strict fasting instructions, prohibiting eating or drinking anything for eight hours before the scheduled time.
Logistics and Administrative Planning
Securing pre-authorization from the insurance provider is paramount, confirming coverage for the surgeon, the anesthesiologist, and the hospital stay. Insurance carriers often require extensive documentation, including cephalometric X-rays and medical records. This documentation must detail the functional impairment being corrected to establish medical necessity.
Patients should plan for a significant period away from work or school, typically requiring two to four weeks off, depending on the surgery’s extent. Arranging for a designated caregiver is necessary, as the patient will need continuous assistance for at least the first few days following discharge. Restricted jaw movement makes tasks like preparing meals and managing medications difficult without help.
Transportation must be secured for the ride home from the hospital and for follow-up appointments. Driving is prohibited due to the effects of anesthesia and pain medication. Because swelling and elastics may restrict clear speech, prepare alternative communication methods. These include a small whiteboard, a notepad, or a texting application.
Nutritional and Home Environment Preparation
Patients will be on a liquid or non-chewing diet for several weeks. Stocking the pantry with high-protein, calorie-dense liquids is crucial to support the body’s increased nutritional needs for healing. Recommended items include protein shakes, meal replacement drinks, smooth broths, and pureed soups, all prepared without lumps or chunks.
Acquiring specialized tools is necessary for consuming the liquid diet comfortably. A powerful blender or food processor is required to liquefy meals into a thin, drinkable consistency. Patients should purchase specialized soft cups, small spoons, or plastic condiment bottles that can be used to sip or squirt liquids into the mouth without needing to open the jaw widely.
Setting up a comfortable recovery station is important, ideally in a recliner or a bed where the head can be kept elevated at a 45-degree angle to help reduce facial swelling. This area should have easy access to prescribed medications, a basin for rinsing or spitting, and entertainment. The first 48 to 72 hours require constant application of cold compresses, so having several ice packs or bags of frozen peas ready is advised.
Oral hygiene is paramount for preventing infection near the surgical sites. Patients should obtain a child-sized toothbrush with soft bristles, which is easier to maneuver inside a restricted mouth. A prescription mouth rinse, often containing chlorhexidine, will be provided for use starting the day after surgery. Comfort items like lip balm or petroleum jelly are necessary to prevent chapping of the lips, a common side effect of the procedure.