After speaking with many patients, I have been asked to write a blog on how to brush your teeth after orthognathic/ maxillofacial surgery.
On leaving hospital you may be given a mouthwash to rinse with. This mouthwash is often used after any type of surgery or dentistry work to decrease bacteria and to reduce the risk of infection. You will be encouraged to start brushing your teeth as soon as possible. In the beginning, I found using a soft baby brush was beneficial and Corsodyl mouthwash to ease the ulcers and to stop bacteria. However, it took me several weeks to get to this stage.
With the combination of scarring, swelling, bleeding and bands/wires it was nearly impossible to brush my teeth. I was in a huge amount of pain and found opening my mouth wide enough for a syringe was very challenging. To ensure that my internal wounds did not get infected and my mouth was hygienic, I rinsed with medicated mouthwash and salt water every 2 hours.
When I was discharged from the hospital I was given a bottle of Chlorhexidine Gluconate Mouthwash. This is a medicated mouthwash which can be used alongside regular brushing to help prevent everyday issues such as gum disease. Chlorhexidine belongs to a group of drugs known as antimicrobials. This chemical is found in very low doses in many mouthwashes and some contact lens solutions. Chlorhexidine works by decreasing the amount of bacteria in your mouth and can aid in reducing swelling and redness of the gums. If you are not issued with a medicated mouthwash when you leave the hospital you can often pick up a bottle at your local supermarket or pharmacy. Corsodyl is a branded name for this type of mouthwash. However, the non-branded Chlorhexidine Gluconate rinse is significantly less expensive than the branded mouthwash.
Due to my limited opening I resorted to using the mouthwash in a syringe and ensuring it was squirted on the stitched and sore wound areas. I would usually alternate the mouthwash with salt water rinses and chose to clean my mouth every 2 hours with one or the other. I also ensured I drank plenty of water to flush out my mouth. Unbelievable as it may sound, my oral hygiene was great and both my surgeon and orthodontist could not believe how clean my teeth and wounds were. I believe this was mainly due to my liquid diet of watered down fruit juice, milkshakes and smooth soup, which was administered through a syringe straight onto my tongue.
After several weeks of being unable to brush anything but my front two teeth I managed to brush some of my teeth. I used a soft baby toothbrush and a very small amount of Sensodyne toothpaste. I was terrified that the stitches would become trapped in the brush and I would rip my scars open. By this stage in my recovery the stitches were hanging low on my gums and my scars were quite tight and sore. I lightly brushed my teeth and as I became more confident I would brush more thoroughly. I continued to use the medicated mouthwash and salt rinses up until the scars and stitches had completely dissolved. Do not be disheartened if you find it difficult and your jaw aches. Take your time and brush where you can. Something is always better than nothing.
The last point I would like to discuss is gargling. In the early stages after surgery you may experience a sore throat so this may impede your ability to gargle with mouthwash. Secondly, you may also find with swelling and pain that your stitches and wounds pull and make it hard for you to swish liquid around your mouth. If you find this challenging you may want to use a syringe and aim the mouthwash along the gum line and effected areas to ensure the highest level of hygiene. If you can not spit, let the mixture run out of your mouth into a bowl. This is messy business, so ensure that you have a wet wipe and towel to hand.
Steffie’s Top Tips: Brush your teeth 30 minutes after eating anything. If you are unable to brush your teeth do not be upset as this can be a very challenging task. Instead, ensure that you rinse your mouth with medicated mouthwash and salt water rinses every couple of hours and always use mouthwash after eating or drinking anything other than water. This will ensure that the wounds remain clean and free from food or bacteria.
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