- Reference Number: HEY-143/2018
- Departments: Maxillofacial Department
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This leaflet has been produced to give you general information about your treatment. Most of your questions should have been answered by this leaflet. It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.
What is a fracture of the upper jaw?
Your upper jaw has been broken. The doctors who have examined you will have established the number of fractures including where they have occurred, and whether they need treatment to help them heal.
Why do I need treatment?
Sometimes when the upper jaw is broken it needs to be repaired otherwise the teeth do not meet together properly. The treatment that is about to take place involves a general anaesthetic i.e. you will be asleep during the procedure.
Can there be any complications or risks?
Infection can occur but is uncommon if the mouth is kept clean and because of the antibiotics that are used.
Bleeding from the cuts inside your mouth is unlikely to be a problem but should the area bleed when you get home this can usually be stopped by applying pressure over the site for at least 10 minutes with a rolled up handkerchief or gauze swab. If the bleeding does not stop please contact the department.
There is a nerve that runs through the centre of the lower jaw that supplies feeling to your lower lip, chin and bottom teeth. This nerve may have been bruised at the time of the fracture and as a result you might already feel some tingling or numbness in your lip and/or chin. This may feel to have been made worse by surgery. In the majority of people the numbness gets better on its own although it can take several months to do so. For some patients it does not get better.
Occasionally the screws that are used may damage teeth adjacent to the fracture site.
If it has been necessary to put any plates or screws in your jaw under the gum to hold it in position these are not normally removed unless they get infected because they tend not to cause problems. The metal that is used is titanium which does not set off metal detectors in airports, etc.
How do I prepare for the operation?
Please read the information leaflet. Share the information it contains with your partner and family (if you wish) so that they can be of help and support. There may be information they need to know, especially if they are taking care of you following this operation.
You will be given a letter detailing where you should attend, starving instructions and the time to report to the ward. Staff will greet you and show you around the ward. You will be seen by the doctor and possibly the anaesthetist. The type of anaesthetic you will be having is called a general anaesthetic. You will be prescribed pain relief medication to manage any pain you may suffer following the operation.
You will usually be invited to a pre-assessment before surgery where the nurse will check that you are fit for surgery and explain the operation. She will also answer any questions that you may have.
What will happen?
The operation involves opening up the fracture sites which involves making a cut inside the mouth through the gum above your upper teeth. The broken bones are then put back together and held in place with small metal screw and plates. The gum is stitched back into place with dissolvable stitches that can take a fortnight or longer to fall out. During the same operation it is often necessary to place wires or metal braces around your teeth. Elastic bands can be attached to them and guide your teeth into position so that they bite correctly after surgery. Screws inserted into the jawbone above the teeth are occasionally used instead of wires or mental braces. Any elastic bands are not usually attached until the day after your operation i.e. your jaws will be able to move freely when you wake up from surgery.
Occasionally it is necessary to remove decayed or damaged teeth and there may be other fractures of the facial bones requiring treatment. In most cases these are recognized and will have been discussed with you, but sometimes they are not apparent until the position of the upper jaw is corrected. Plates or wires may be needed which may involve further incisions on your face. These will be placed to minimize scarring.
What happens afterwards?
It is likely to be sore and regular pain relief medication will be arranged for you. The discomfort is usually worse for the first few days although it may take a couple of weeks to completely disappear. It is also necessary to make sure that the fractures heal without any infection and so you may also be given antibiotics through a vein in your arm whilst you are in hospital. You will be sent home with pain relief medication and a course of antibiotics.
You usually stay in hospital for at least one night following the surgery. As soon as possible the position of your fractures will be checked with X-rays before you are allowed home.
Although the plates and screws hold the fractures in place it still takes about six weeks for your jaw to heal completely. During this time you need to eat a relatively soft diet, the nature of which will be discussed with you by the doctors, nurses and dietician.
It is also important that you keep your mouth as clean as possible for the first few weeks after surgery to prevent infection. It may be difficult to clean your teeth around stitches because it is sore. It may be difficult to clean your teeth around stitches because it is sore. It is best to keep the area free from food debris by gently rinsing your mouth with a hot salt water mouthwash (dissolve a flat teaspoon of kitchen salt in a cup of hot water starting the day after surgery.
If any wires, metal braces or screws are used to help guide your bite into the correct position they will be removed in the outpatient department when your doctors are happy that your fracture has healed.
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Maxillofacial Unit on tel no: (01482) 463218
General Advice and Consent
Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.
Consent to treatment
Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.
The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:
- you must be able to give your consent
- you must be given enough information to enable you to make a decision
- you must be acting under your own free will and not under the strong influence of another person
Information about you
We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.
We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.
Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.
If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.