Care After Jaw Surgery: Surgically Assisted Maxillary Expansion Surgery (SARPE/SAME)

Pain and swelling

Pain and swelling are normal after jaw surgery. Pain and swelling are usually strongest for 2-3 days after surgery. Here are some do’s and don’ts for pain and swelling:

Do

• Use non-narcotic pain relief first. This includes acetaminophen (Tylenol®) and ibuprofen (Motrin®).
• Only use narcotic pain medications if the non-narcotic ways do not work. Eat something before you take a narcotic medication. Narcotics can cause upset stomach and vomiting.
• If you feel constipated (cannot have a bowel movement) while taking narcotics, take an over-the-counter stool softener or laxative.
• Use ice packs on your face for the first 2-3 days after surgery. Use ice packs for 20 minutes on and 20 minutes off on each side of your face.
• Sleep on your back in an almost upright position on 2 pillows placed on top of each another.

Do not

• Do not drive if you take narcotic medications. Narcotics can make you feel sleepy.
• Do not take narcotics on an empty stomach. Eat something before you take a narcotic medication.

Taking care of your teeth and gums

Taking care of your teeth and gums is very important after jaw surgery. This includes brushing your teeth and using mouthwash. This can help prevent infections, cavities and gum disease. Here are tips for taking care of your teeth and gums:

• Brush your teeth 3 times a day. Brush after breakfast and lunch and before bed. You can use a regular or electronic toothbrush.
• Take out your elastics before brushing your teeth. Put them back in when you are finished.
• Rinse your mouth with Peridex® (chlorhexidine) twice a day. Rinse twice (2 times) a day. Do not eat or drink for half an hour (30 minutes) after rinsing with Peridex®.
• Rinse your mouth with warm salt water after you eat and for a total of 4 times a day. If you rinse with Peridex® first, wait 1 hour before rinsing with warm salt water.
• Use a Water-Pik® if you have one. A Water-Pik® uses a gentle stream of water to clean between teeth. It is okay if you do not have one.

Upset stomach and vomiting

It is normal to have an upset stomach or to vomit after surgery. This happens if you swallow a little blood during or after your surgery. Here are some tips to relieve an upset stomach:

• Drink small amounts of soda every hour for 5-6 hours. The bubbles in soda can help settle your stomach. Ginger ale, Sprite® and 7-Up® can relieve upset stomach.
• If you have an upset stomach for more than a few days, call Pediatric Oral and Maxillofacial Surgery (OMFS) at 617-726-2740. We can help you find ways to feel better.

Food and drink

Staying on a liquid or “blenderized” diet for 6 weeks after surgery is very important for your recovery. You cannot chew food or gum for 6 weeks. Here are some do’s and don’ts about food and drink while you recover:

• Put any food that is harder than applesauce in the blender before you eat it. You can put almost any food in a blender. This way, you can enjoy your favorite foods while letting your jaw heal.
• Add dietary supplements (extra nutrition) if your doctor tells you to. This includes nutritional drinks like Carnation® Instant Breakfast shakes and Ensure®.
• Follow your doctor’s instructions for wearing your elastics.

Do not

• Do not eat only low-fat or fat-free foods for 6 weeks after surgery. It is important that you eat all of the calories and nutrients you can. This can help you heal and keep you fuller for longer.

Activity

Taking it easy is important for your recovery. Here are some tips for activity as you recover:

• Do not take part in activities that cause trauma (injury) to your face for at least 6 weeks.
• Do not run, lift weights or play contact sports. This includes any sport where you tackle, jump or hit another person.

Showering and bathing

• Shower or take a bath every day. Wash your wound twice (2 times) a day.
• Do not peel off the Dermabond® over your incision. It will flake off on its own.

Who can I call with questions or concerns?

If there is an emergency, go to your closest emergency room. If there is no emergency, call:

• Pediatric OMFS at 617-726-2740
• Mass General for Children 617-726-2000

Ask for the oral surgeon on call. An oral surgeon can talk with you 24 hours a day, 7 days a week.

When should I turn the key on my palate expander?

• Start to turn the key 24 hours (1 day) after surgery.
• Turn the key twice (2 days) a day after the first turn – 1 time before breakfast and 1 time before bed.

Your follow-up appointment

Schedule a follow-up appointment in Pediatric OMFS. To schedule your appointment, call Pediatric OMFS at 617-726-2740.

Rev. 11/2017. Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.