After jaw surgery, attention must be given to things you normally don’t spend much time thinking about. Surgery causes swelling and numbness of your lips, making eating, drinking, and cleaning your teeth more difficult. Following these instructions carefully will improve your outcome and maximize your chance of success.

Medicine

You may receive prescriptions before surgery. Plan on taking 1000 mg acetaminophen (Tylenol) three times daily and 600 mg ibuprofen three times daily with meals. Prescription pain medication, such as hydrocodone or oxycodone, can be taken as needed for severe pain; use a stool softener such as Miralax while taking these medications to avoid constipation.

After upper jaw surgery, nasal congestion is common. Use saline nasal spray every 1–2 hours while awake for the first 3 days, and use oxymetazoline (Afrin) every 6–8 hours if recommended — but do not use Afrin longer than 3 days. If you had upper jaw surgery, do not blow your nose for 10 days. Keep lip ointment on the lips for the first two weeks so they stay moist.

Drinking

Numbness, swelling, sore throat, and incisions can make drinking difficult. Start with a cup as soon as possible. Use a towel under your chin, tilt your head back slightly, place a small amount of liquid in the cup, and use gentle finger pressure to bring your lips together if needed. If a cup is too difficult, use the provided syringe and small tube temporarily. Avoid straws for the first day or two. Aim for 8–10 cups, or about 2 liters, of fluid per day.

Eating: 1,500–2,500 Calories Daily

• Week 1: pureed or blenderized foods. Soups, baby-food consistency meals, mashed potatoes, applesauce, oatmeal, and pudding are good options. A baby-sized spoon may help.

• Week 2: extremely soft foods that require minimal chewing, such as scrambled eggs, pancakes, refried beans, small soft pasta, and soft casseroles.

• Weeks 3–6: gentle chewing can begin, but foods should still be soft, such as soft ground meat, soft flaky fish, or shredded chicken.

• Weeks 6–8: if a splint was placed, it is usually removed and eating becomes easier. Still keep foods soft and cut into small pieces. Avoid pizza, apples, tough meat, and similar foods until at least 10 weeks after surgery.

Diet changes and pain medicine can cause constipation. If you have not had a bowel movement within 2–3 days, take one capful of Miralax per day. If this does not help within a day or two, call our office.

Elastics (Rubber Bands)

Elastics may be placed between the upper and lower teeth to train your bite into the new jaw position and limit jaw function. They should be worn at all times except when eating or cleaning your teeth. Change them once or twice daily as they stretch. If they fall off, they will be replaced at your next visit.

Hygiene

Keep all areas inside your mouth clean. Brush your teeth and rinse after eating. During the first week, keep toothbrush bristles on or near the teeth and braces; soreness and limited opening may make cleaning difficult at first. Rinse thoroughly with warm salt water (8 oz water to ¼ tsp salt) or Peridex for 5–7 days. Do not use a Waterpik or electric toothbrush inside your mouth for the first week. Do not smoke cigarettes or marijuana for at least 4 weeks, as this can interfere with healing.

Dressings, Ice, and Swelling

• Ice packs can be used for the first 2 days: across cheeks and bridge of nose for upper jaw, and on the cheeks for lower jaw. Use 20 minutes on / 20 minutes off as needed.

• If you have a facial bandage, keep it in place as much as possible for the first 24 hours to reduce swelling. Wearing it at night can also help.

• Keep your head elevated on an extra pillow during the first several days to help prevent further swelling.

• Days 3–4 are often the worst for discomfort. Warm moist heat and gentle massage may be used as needed.

• If you had chin surgery, tape on the chin can usually be removed 3–4 days after surgery in the shower.

Physical Activity

Your energy level will be lower after surgery and will take time to return to normal. Start slowly and work up to your usual activity. Walking or running can begin 2–3 weeks after surgery; start with shorter distances and a slower pace, gradually increasing as your endurance and confidence return.

Jaw Exercises

• Immediately after surgery: specific exercises are not recommended during the first 7–10 days, but gently attempting to open and move the jaw side-to-side several times daily may help.

• Weeks 1–4: stand in front of a mirror and open/close as much as possible. By 10 days you should be able to fit one finger between your teeth, increasing to two fingers by 4 weeks. Move forward/backward, side-to-side, and open/close using jaw muscles only. Do not use finger pressure on your teeth.

• Weeks 4–8: you should comfortably fit two fingers between the front teeth and may begin gentle finger pressure between back teeth to stretch. Moist heat may help. By 8 weeks, some patients can fit three fingers between the front teeth.

Soft Diet Recommendations

Choose soft, smooth, moist foods. Avoid chewy, hard, crunchy, or spicy foods. Eat small, frequent meals, stay hydrated, and consider using a blender, food processor, or meal delivery service.

• Proteins: scrambled eggs, Greek yogurt, cottage cheese, soft tofu, smooth nut butters, and soft fish.

• Carbohydrates: mashed potatoes, oatmeal, white rice, soft pasta, pancakes without crust.

• Fats: avocado, olive oil added to mashed foods, and full-fat dairy.

• Restaurant ideas: omelets, mac and cheese, mashed sides, smooth soups, refried beans, soft noodles, and risotto.

Soft Food Recipe Ideas

• Creamy scrambled eggs with avocado

• Greek yogurt and banana smoothie

• Mashed potato bowl with soft fish

• Peanut butter oatmeal

• Silken tofu pudding

• Baked ricotta pasta, lentil dahl with soft rice, shepherd’s pie blended style, soft chicken Alfredo, and creamy tuna pasta