Patient Surgical Instructions
What do I need to know about jaw wiring?
This surgery, under general anesthesia, threads heavy-gauge wire around each of the teeth that survived a blow from your horse’s hind hoof, after you fell off at dusk in mid-summer. You knew this could happen, given your inexperience. Slack in a horse’s understanding of what you expect leaves ample rein for trouble.
The heavy wires will hold arch bars, like orthodontic braces, through which a second, lighter wire will be threaded top-to-bottom, stitching your upper jaw to your lower.
As a stern precaution, you will carry a pair of wire-cutters in the event of an emergency such as choking. Vomiting is not an emergency.
Note: Everything you learn here could be valuable if your husband says to you one night, out of the blue, his arm thrown over his eyes, where he lies beside you: “So, I haven’t been true to you.” You will press your hands along the condylar arms of your jaw and ask, through the ringing in your ears, “Wait. You have been? Or you haven’t?”
What will happen during surgery?
- Your healthcare provider(s) will guide the broken pieces back together and attach them by whatever means necessary to prevent you from moving them before they have healed.
What should I expect after jaw wiring?
- When you wake up, you may not remember what has been done. The first thing to remind you will be the jagged edge of the broken molar, the one with two points missing and the enamel still flaking into the vault of your mouth, where your trapped tongue finds it, again and again.
- Initially, you may have pain. Take prescribed medication as needed. Make sure you get food or a drink in your system before taking pain medication, as it can cause nausea.
- It may be difficult to talk or be understood. You might find it easier to write or type on an electronic device.
- You will consume only liquid foods—pureed to the clarity of broth—through a straw wedged between your molars and your cheek. Anything fibrous, such as a fleck of tomato skin, will clog the straw or worse, catch in your wires like litter in chain-link fence, sealing off air passage through your mouth. At times, the ache for some remembered texture will be so acute, you will stand with the refrigerator open, willing something more that you can swallow to appear. You may lose 10-15% of your body weight.
- Your sleep may also be disrupted, as familiar positions may be painful.
What are the risks of jaw wiring?
You may be further damaged during the procedure, and you may not heal properly, even with this intervention.
Seek care immediately if you have:
Lightheadedness or shortness of breath
Discover your wires have come loose
Pain that does not go away with medicine
When will healing be complete?
Your healthcare provider will remove your wires and arch bars when X-rays confirm your fracture has healed sufficiently, usually in 4-6 weeks. If you have healthy gums, your physician can pull out the heavy wires without anesthesia. This will cost thousands less than the recommended general anesthetic and will feel, at worst, like maniacal flossing.
Your physician may tell you, after it’s over, that he would have chosen this method of removal for himself, and his confidence will make you smile—a nothing-but-teeth grin. You are cleared to get back in the saddle, too, he says. But you’ve already been at it, learning where your trust may have been faulty, where you need a firmer grip. You keep stumbling over bad behavior you accepted before and feeling out where your own habits allowed it.
The break itself, however, may not fully ossify for 4-6 months, perhaps a year. It will show up on X-rays for the rest of your life. You’ll find, too, that the crown capping your broken molar will feel fake when you bite hard together, and your skull, under your fingers when you wash your hair, feels stretched in the direction of the blow. You will wonder if there’s room, in the dark matter of your brain, for thoughts to circulate reliably or if they get hot and frantic as they squeeze too close to the point of impact.
The best practice, your physician will say, is to push yourself a little every day: Open as wide as you can, then a little wider.