Jaw Fracture
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Information for Patients With Jaw Fracture(s)

This information is important.  Read it carefully and ask any questions that you might have about the information.  If you have sustained other facial injuries in addition to the jaw fracture(s) that are not discussed here, discuss them with your surgeon.

General Information

Jaw fractures are a very common result of facial trauma.  Fractures can involve the lower jaw (mandible), upper jaw (maxilla), or both.  

Goals of treatment include:

  • Reestablishing the bite 
  • Providing a solid union between bone fragments
  • Returning the jaw to its normal function

Some fractures can be treated simply by wiring the jaws closed with arch bars (surgical braces) until the fractures have healed.  Other fractures require surgical exposure by means of incisions in the mouth, on the face, or both.  After the fracture(s) is exposed, the bone fragments are moved into alignment and secured with bone plates and screws.  Uncomplicated jaw fractures typically heal in 6 weeks.

After an adequate period of healing, the wires/arch bars holding the jaws closed are removed, and the jaws are examined to determine if any mobility exists between the bone fragments.  If the jaws are not completely healed, the wires/arch bars holding the jaws closed will be replaced until satisfactory healing occurs.  

If the fractures are stable, jaw-opening exercises are started at this time.  Depending on the nature of your fractures, you may be instructed to wear small orthodontic rubber bands between your upper and lower jaw.  At the end of this period, if the fractures remain stable and the bite is stable, the arch bars are removed.  Removal of the arch bars is usually performed in the office with local anesthesia and intravenous conscious sedation approximately six weeks after the initial surgery to stabilize the jaw fracture.


Swelling of the face is common with jaw fractures. The swelling usually increases during the first 48 hours after surgical treatment.  The swelling will begin to subside approximately 72 hours after surgery.  Sleeping with your head elevated on two pillows for the first five nights can help decrease swelling.  If you notice a dramatic increase in swelling after the first 72 hours, contact our office; this may indicate infection.


The majority of the pain associated with jaw fractures is from bone fragments shifting and moving.  This pain will decrease after the fracture is stabilized with treatment.  The pain you will experience after treatment will be from the placement of dental wires, arch bars and surgical incisions. Keep in mind that this pain is temporary. You may notice sensitivity to hot and cold liquids on the teeth that the wires are secured to. This is also a temporary problem.

When you leave the hospital or our clinic, you will be given a prescription for liquid pain medication. Begin taking pain medication at the first sign of discomfort. For moderate pain, take a dose (400-600mg) of Ibuprofen (Advil or Motrin) every 4-6 hours as needed for pain. Do not exceed the maximum daily dosage suggested on the bottle. 

Do not take Ibuprofen if you:

  1.  Have an intolerance to it
  2.  Take blood thinners 
  3.  Have a history of stomach ulcers 
  4.  Have a history of kidney disease 

For severe pain, the prescribed medication should be taken as directed. To avoid stomach upset, take the pain medication after a meal or with a small snack. If you have allergies to any medications above, do not take them. If your doctor has advised you not to take any of the medications mentioned above, do not take them.

While taking pain medication, do not:

  • Operate a motor vehicle
  • Operate machinery (lawn mower, etc.) 
  • Drink alcohol 

If you still experience significant pain that is not improving 3-5 days after surgery, notify the clinic.

We recommend the following protocol for optimum pain management:

Take each medication with a small snack and a full glass of liquid.

Immediately Following Surgery: 1 Prescription pain dosage

3 Hours Later: Ibuprofen dosage

3 Hours Later: 1 Prescription pain dosage

3 Hours Later: Ibuprofen dosage

NOTE: The dosage of the prescription pain medication can be increased to 1 1/2 to 2 times the normal dosage if needed for pain management.


Take the prescribed antibiotics as directed to help prevent infection. If you experience a rash or an unfavorable reaction to the antibiotic, discontinue use and notify our office. Be sure to take the prescribed antibiotics as directed to help prevent infection. Complete the entire course of treatment. If you experience an upset stomach, we recommend taking acidophilus or a pro-biotic along with your antibiotic. 

Antibiotics may make oral contraceptives less effective. You should use an alternate form of birth control while on a course of antibiotics.


Nausea and vomiting are common side effects of anesthesia. Because there is only liquid in your stomach, vomitus can escape through your nose and mouth even though your teeth may be wired together. Your surgeon will give you wire cutters to remove the wires holding your teeth together in case of an emergency. Most of the time, removing these wires is not necessary due to nausea and vomiting. You will be given a prescription for nausea medication. Notify your surgeon if the prescription is not relieving your nausea. 


During the healing period, whether your jaws have been wired shut or not, you will only be able to have a liquid diet. We recommend supplementing your diet with ready-to-drink high-calorie supplements like Boost and Ensure. 

Eat a high-calorie, high-protein diet. Eating regularly and not missing a single meal will help you to feel better, have more strength, and heal faster. Drink plenty of fluids throughout the day to ensure you remain well-hydrated. Since your food intake will be limited for the first 1-2 days, you should compensate by drinking at least 1-2 liters of fluid per day. 

Caution: You may feel dizzy or faint when standing up from a lying or sitting position. If you are lying down after surgery, sit up slowly and place your feet on the ground.  Stay seated with your head elevated for one minute before standing. On occasion, a patient may faint following sedation/anesthesia due to a lack of blood flow to the brain. If the escort witnesses the patient fainting, please elevate the patient’s legs above their head for 30 seconds. This will allow oxygenated blood to return to the patient’s brain and restore consciousness. Staying well hydrated following surgery will also help prevent fainting.  

Oral Hygiene

Keeping your mouth clean following surgery is essential to good healing and is one of the best ways to avoid infection. You should brush your teeth after each meal.  Use a child’s soft toothbrush, paying particular attention to keeping the brush in direct contact with the teeth.  It is very important to keep your mouth clean as the wounds heal. 

You will be prescribed a bottle of Chlorhexidine mouth rinse, begin using it the night of surgery after brushing and flossing. This mouth rinse should be used twice daily, after breakfast and before bed, until gone. Rinse for at least 30 seconds before spitting it out. Do not drink or eat food for 15 minutes after using the mouth rinse.

You can decrease the accumulation of debris on the inside surface of your teeth and tongue by rinsing with warm tap or salt water after each meal/snack.  Rinse with warm salt water (1/2 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete. To make the salt water rinse, mix one teaspoon of salt with a cup of warm water. In addition to a saltwater rinse, mix 50% hydrogen peroxide/50% water. Dip a Q-tip in the solution and gently wipe over the surgery site. This will ensure plaque doesn’t accumulate on the sutures or teeth surrounding the area. Try to avoid over-the-counter mouthwashes that contain alcohol. 

Arch Bars/Wires

After your procedure, you will have arch bars secured to your teeth with wires.  You can use soft orthodontic wax to cover the wires if any of them are irritating the inside of your mouth or lips. Remove the wax at least once a day before brushing.  If one of the wires breaks or loosens, contact our office.

Bone Plate/Screws

Small bone plates and screws may have been used to repair your fracture(s). These are designed to be left in place indefinitely. A plate may need to be removed if it irritates the overlying gum tissue or skin and becomes exposed. 

Nasal Stuffiness

When the jaw is wired closed, nasal stuffiness can occur. Stuffiness should be treated initially with Afrin nasal spray.  If the nasal spray does not clear your nose, contact our office. You may occasionally feel shortness of breath. If this happens, hold the lips and cheeks away from the teeth with the handle of a spoon, a toothbrush or other such object. This will improve mouth breathing until the Afrin clears your nose. Use a bedside humidifier at night while your mouth is wired closed. Contact our office if you experience nasal stuffiness that is not relieved by the nasal spray. 


DO NOT SMOKE for a minimum of 4 weeks following surgery. The toxic chemicals and heat in cigarette or marijuana smoke is harmful to the healing of wounds. Ideally, you should quit smoking as this will give the surgical site the best chance of healing. 


If other injuries allow, you may do anything you feel up to except for swimming. Jogging or aerobics could lead to an increase in pain and should be limited to an amount that is easily tolerated.  You may return to work when you feel up to it.  If you have any questions about your activity and work, please discuss them with your doctor/nurse.

Jaw Opening Exercises

Temporary restriction in jaw opening is very common following treatment of a jaw fracture(s).  This can be a more serious problem with fractures that involve the jaw joint.  After satisfactory healing of the fracture(s), you will be given jaw opening exercises. When your doctor instructes you to begin the exercises, you should do them 3-4 times a day for 5 minutes at a time. Your progress will be measured each time you return for follow-up visits.


The following is a list of complications that we believe to be the most important; however, this is not a discussion of all the possible complications that could occur.


There is a risk that any jaw fracture, especially a lower jaw fracture, may become infected.  If you notice increased swelling, pain, and/or skin redness, or a temperature greater than 101.5 degrees Fahrenheit you may have an infection. If any of these symptoms present themselves after leaving the hospital or clinic, contact our office. 

If prescribed antibiotics, begin taking them immediately after surgery. . If you experience a rash or an unfavorable reaction to the antibiotic, discontinue use and notify our office. Be sure to take the prescribed antibiotics as directed to help prevent infection. Complete the entire course of treatment. If you experience an upset stomach, we recommend taking acidophilus or a pro-biotic along with your antibiotic. 

Antibiotics may make oral contraceptives less effective. You should use an alternate form of birth control while on a course of antibiotics.  

Management of an infection is usually straightforward but may at times require hospitalization. Infection of the bone can delay healing or may even lead to a failure to heal. If this happens, long-term antibiotic treatment and/or additional surgery may be required.

Delayed Healing

There are several reasons why a fracture may heal slowly. Delayed healing may require your jaw to be wired closed longer than the usual time and could also require a second operation to adjust the stabilization of the bone fragments. In rare circumstances, the fracture may require a bone graft to heal satisfactorily.

Failure of Healing

There are several reasons why a fracture may remain mobile even after an adequate healing period. Additional treatment, such as a bone graft, may be required to allow for satisfactory bone healing.


One of the goals of jaw fracture treatment is to reestablish a satisfactory bite; however, this is not always achieved. Malocclusions (problems with your bite) after the fracture(s) has healed may require a surgical procedure. Minor changes to the bite can often be improved with a slight adjustment of the chewing surfaces of the teeth.  Fractures involving the jaw joint are often associated with a long-term bite change.

Tooth Loss

Tooth loss at the time of fracture or during the treatment of the fracture is common. Missing teeth can be replaced with a dental prosthesis or dental implants after the fracture has healed completely. 


Jaw fractures can result in nerve damage that may lead to partial or complete numbness involving the lower and upper lip, teeth, cheeks, chin, gums, on one or both sides of the face.  Usually, there will be a slow return of sensation, though occasionally, the numbness is permanent when the injury to the nerve has been severe.

Jaw Joint Problems

Problems with your jaw joint (TMJ) can occur following any lower jaw fracture but are most common when the fracture extends into the joint.  You may experience joint pain, arthritis, a fusion of the joint surfaces, or decreased jaw opening. If you have pre-existing jaw joint abnormalities, these may be aggravated by a lower jaw fracture.  Problems with the TMJ can usually be managed with medical treatment, but there are occasions when surgery may be required. If you experience a fracture that extends into the joint, it is important to perform jaw opening exercises to reestablish adequate mouth opening.


We want you to have a smooth and pleasant recovery. Following these instructions will ensure the best possible outcome. Please call the office if you have any questions or concerns about your progress. We are available 24 hours a day.

Thank you for trusting us with your oral and maxillofacial surgery needs.

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