4 weeks post-op: Bite splint removal, teeth question?

[macve004]

Hey all,

So I'm 4 weeks post-op double jaw surgery for underbite/crossbite (so maxillary advancement with saggital split combined with mandibular setback). I'm not sure on my exact numbers, but I know they weren't too much.

Anyway, they wired my jaw shut for a total of 29 days post-op (a nuisance, if I may say the least). Went into the oral surgeon to get unwired and my bite splint out and experienced the usual muscle soreness/joint pain one has from atrophy. What I wasn't expecting, however, were that my back molars (the three behind the lower and upper canines), though touching, were hitting in a really awkward way!

I immediately mentioned this to my surgeon (well, post swishing mouthwash for 4 minutes to clear that stank out of my gob), and he said everything was fine as the front teeth were in place and that's what was important. I had some tight elastics put in to secure my bite for another week; I can open only very slightly right now--he said no jaw stretching exercises until week 8. My ortho (went to him right after), said everything looked "great!" after 2 minutes of observation. Still, the teeth misalignment thing is really gnawing at me (ho ho ho, puns). Please, would anyone share their experience of teeth alignment immediately after the splint removal or even just post-surgery and how the post-op ortho helped? I know I won't be able to chew like this anytime soon, and my next ortho appointment is 4 weeks out (what?!). How oh how will I ever eat food again?

Thanks!
-Josh

[macve004]

Excuse my mistake: Didn't mean to say week 8 for jaw stretching exercises, but rather week 5. I begin stretching exercises next week.

[boodles8]

Don't fret about how your teeth meet at this point. You are still very early in recovery. A lot changes on its own in time, and anyway, that is what post-op ortho is for: to get everything exactly right. Orthos really can tell all they need to know about your bite in a two-minute exam. They look at bites all day every day, and they learn what they need to know in that short time. 4 weeks for your next ortho visit sounds about right. The surgeon won't release you to have orthodontic work done until at least 6 weeks post-op. And if you were truly wired shut and not just tightly banded, it sounds like something slightly out of the ordinary may have gone on (most folks skip wires and go directly to bands). It may be your body will need the extra 2 weeks to begin post-op ortho.

I am about one year post-op. I remember around one month out I was still worried about if they had done the right surgery, put everything where it really should be, etc etc. I was eager for each post-op visit. In fact, I think I wasn't really comfortable with things until about 6 months out. You'll get there, and I promise there will come a day when you don't wake up each morning and think about how your jaw and bite feel! Keep your chin up, and try not to worry. I doesn't make the time pass any faster.

[macve004]

Thanks Bood. Really helps to have an experienced person tell me everything's alright! I just got out of my post-op this week and the surgeon finally gave permission to start jaw exercises. I'm about a finger and a half wide now and plan to hit the PT hard in the 3 1-hr sessions I have to w/o elastics every day this week! Swelling's looking good too!

As a question of personal experience, did you find anything especially helpful in regaining jaw ROM? Let me know! Thanks again for the help!

[macve004]

Ah yeah, about the wiring:

My surgeon had said the reason he wired the jaw shut was due to the incision site for the mandibular setback (he cut farther up, behind the nerve). For proper healing he said complete immobility was best. Even though it was a complete pain, I never lost any feeling in my chin or lower face. In fact, practically all feeling has returned to my face, and just waiting on the palate and upper gums to regain feeling now!

[boodles8]

I never had PT for ROM. In fact, I was never instructed to do anything special to regain it. I figured I ought to do some simple stretching to speed the process along, though. I would open as far as I could without pain, hold for 5-10 sec, repeat 5 tiimes, 3x daily. But don't take that as any kind of professional advice. It did cause pretty significant TMJ pain for a half hour or so after each session. I honestly have no idea if my little routine helped or not. If you're going to PT, your best bet is to ask the pros.

Ah, IVRO. I forget what it stands for, but now that you mention it, I have seen one or two other folks on this board who had it done. It's certainly nice not to have the risk of numbness. If I had been given the option, in hindsight, I would have wanted that. I have some permanent numb spots on both sides and hyperesthesia on one side of my face.

Keep up the good work!

[sirwired]

My back teeth were all messed up from the splint. (The splint had intruded them, or produced an effect similar to that.) Your braces, elastics, and normal bite forces should be able to get things re-integrated. Make sure your ortho stays on top of it... took elastics about a month to get my molars meshing properly again.