Jaw Wiring

Jaw wiring is known in the medical community as maxillomandibular fixation. This procedure connects your lower and upper jaw bones together.

Your doctor may use wires or other materials like elastic bands or metal devices to keep the jaw together. While your jaw is wired shut, you’ll need to maintain a liquid diet. You’ll also need to practice good dental hygiene.

You may need to have your jaw wired shut for a number of reasons, including:

• you’ve been in a traumatic accident and have injured, fractured, or broken your jaw
• you have a jaw deformity
• you have temporomandibular joint dysfunction
• your jaw doesn’t align properly
• you have other jaw-related dental issues that cannot be corrected with orthodontics

Your doctor will likely wire your jaw shut following surgery to correct one of these conditions. The wires will help your jaw heal properly the way a cast or other protective device would stabilize a broken bone elsewhere.

• It is recommended that you sleep with your head on two or three pillows. This helps to decrease the swelling in your face and also will make it easier for you to breathe.
• Avoid doing anything that requires heavy lifting, pushing, or straining while your jaws are wired together.
• Do not try to work your jaw back and forth against the wires. This will loosen the wires and teeth and prevent the bones from healing.
• Avoid water-related activities such as swimming and water-skiing while your jaws are wired because it’s hard to clear water out of your nose and airway.
• Do not drink alcoholic beverages while your jaws are wired.
• Your jaws are held together by elastics that are hooked to the wires on your upper and lower teeth. Over time elastics can loosen, fall off or break. Losing a few elastics is not a problem as long as you cannot open the mouth. If you find that you are able to open your mouth due to loss of elastics, keep your teeth together and call the office so we can add more elastics.
• Use the saline nasal spray as frequently as necessary to help keep your nose clear.

Care of Your Mouth and Teeth

Brush your teeth after every meal and at bedtime. Meticulous oral hygiene is extremely important to prevent tooth decay and gum inflammation caused by food build-up between the wires and your teeth. These bits of food can also cause bad breath. Thorough tooth brushing is the single, most important part of good oral hygiene, it is best to use a child-sized, soft-bristled toothbrush with toothpaste. The head is smaller and will be more comfortable for you. Brush your teeth and wires by using rotating motions directly on the teeth and wires. Brush until the wires are shiny clean.

Use the Peridex (Chlorhexidine) mouth rinse prescribed by Dr. Turesky twice a day after brushing, Swish in your mouth for one minute then spit out. In addition to the Peridex use a dilute mouth rinse (Scope, Lavoris, etc.) after meals and at least four times a day. The rinse will help to clean the inside surfaces of your teeth which you cannot reach with a toothbrush.

Run your tongue along the inside of your teeth several times a day to help clean them. A Waterpik is helpful to loosen food and debris trapped between the wires and elastics. Use Waterpik several times each day in addition to brushing and rinsing.

If the wires are rubbing against your lips or cheek and causing pain, irritation or burning, you may find dental wax helpful. Dental wax is available at most drug stores. Pinch off a small piece of wax and apply it directly over the wires that are irritating you. The wax will act as a cushion between the wires and your gum. You should remove dental wax before brushing your teeth; then replace it if necessary.

Elastic fixation is released approximately six weeks after treatment (except in cases of condyle fractures where elastics are usually removed 10-14 days after treatment). Wires are usually removed approximately two weeks later. Approximately four to six weeks after your wires are removed you will need to visit a dental hygienist for thorough cleaning of your teeth.

Diet

A blender or food processor will be required to prepare your meals. Almost any food can be liquefied in a blender. You will need to add enough liquid (juice, milk, water) to liquefy solid foods. You may also need a food strainer if your teeth are very close together with no space between them. The strainer can be metal mesh or cheesecloth. After food has been liquefied in the blender a strainer will remove any small residual pieces of food which could get caught in your wires or elastics.

Most people prefer foods that are neither hot nor cold. Very hot liquid may injure tender or numb mouth tissues. The very cold liquid may be painful to sensitive injured or fractured teeth. It is easiest and most efficient to drink right out of a cup. Drinking from a straw requires puckering and suction which is inefficient and difficult when your jaws are wired. Basic good nutrition is essential to keep you healthy, speed up recovery and assist in healing. Even though you cannot chew, you still need a balance of protein, fruits, and vegetables, dairy products, and grains. It is easier to get proper nutrition if you eat five to six times a day.

It is difficult to maintain your weight on a liquid fracture jaw diet. You should monitor your weight regularly while your jaws are wired together. Commercial nutritional supplements such as Ensure or Sustical are a convenient way to increase calories and protein. You can find them at most drug stores and many grocery stores. These nutritional supplements should not be used to replace other foods; they should be used in addition to other foods. Drink one can of Ensure three times a day in addition to your meals. An over-the-counter daily liquid multivitamin supplement is also recommended.

If You Vomit

If you feel that you are going to vomit, follow these steps:

• Bend forward or roll onto your side.
• Put your finger inside your cheek and pull your cheek out.
• All the vomit will come out of your nose and mouth while you continue to lean forward.
• It is not recommended that you try to cut your elastics when you think you are going to vomit.
• Remember that everything you are taking in is liquid. If anything comes out it will be liquid as well. The most important thing is to BEND FORWARD AND HOLD OUT YOUR CHEEK to make it easier for the vomit to get out of your mouth.

Anti-nausea medicine can be prescribed if nausea persists.

If You Have Trouble Breathing

If you have so much difficulty breathing that you cannot catch your breath, follow these steps to open your airway as much as possible:

Place a spoon inside your mouth between the teeth and your cheek and stretch the cheek outward to create breathing space.

If you are not breathing well because of nasal stuffiness try an over-the-counter saline nasal spray. Saline nasal spray can be used as often as necessary with no adverse side effects. If this problem persists, call your doctor.