Broken jaw tips

Published August 27, 2006

Part of my normal exercise routine includes riding a bike. Even though I do it regularly, that did not prevent me from having an accident in early June. I flew over the handlebars and hit the pavement, landing on my chin. I was wearing a bike helmet, which didn’t even get scratched. I broke my jaw in two places (the middle break needed a plate to hold it together) and came out of surgery with my jaw wired shut. I am 55, female, and was in decent shape before the accident.

Here are some things that helped me get through the ordeal. I’m writing this because I couldn’t find much information on a broken jaw. I hope you never need this, but in case you do, here is what I learned. I am not a doctor, so this is not medical advice. Maybe some of what I’m doing is wrong, but it seems to be working for me.

One of the keys things that helped me get through this ordeal was having my husband take incredible care of me.  He made virtually every meal, encouraged me to exercise, and was there whenever I needed him.  I am fortunate to have such a wonderful care giver, and hope you are too.

## Food

Nutrition is critical to the healing process. And since you can’t chew, it’s difficult to get the proper amount of protein, fiber, calcium, and nutrients. I found drinking everything out of a glass worked best, rather than using a spoon (which I found difficult) or a straw.

Here are some suggestions:

Find out how many calories you need each day to maintain your weight. Go to the web site http://www.cancer.org and search for calories. A link will take you to a section called Calculate Your Daily Calorie Needs.

Determine the amount of protein and fiber you need. To calculate the amount of protein you need, take your weight in pounds divided by 2.2 = weight in kilograms (kg). You need between 1 and 1.8 grams of protein daily for every kilogram you weigh. The upper end of the range is recommended for people with illnesses. Example for a 154 lb person: 154 lbs/2.2 = 70kg x 1 = 70 grams of protein daily, or times 1.8 = 126 gm protein/day.

The amount of fiber you need each day depends on age and sex.

 Age 50 and younger Age 51 and older Men 38 grams 30 grams Women 25 grams 21 grams

## Keep track of everything

Keep track of what you eat every day. Write it down. I mean keep track of everything that's important for a healthy diet and a successful recovery. Most packaged drinks and foods show the amount of calories, fiber, protein, calcium, vitamins, and more. For things like fresh fruits and vegetables, get a book that lists the amount of calories and other important nutrients.

The Institute of Medicine advises that men consume roughly 3.0 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) a day, more if you exercise.

Calcium is great for bones, so choose food sources high in calcium (like milk or yogurt) when possible.

By keeping track of what you consume, you can easily see what you’re lacking and remedy it.

## Sample worksheet

Here are sample column headings for a daily food sheet. I just prepared a bunch of these sheets and put them in a binder.

• Food. Write the name of the food and how many ounces served. By tracking the ounces, you can easily adjust the nutrition information on future days if the serving size changes. So, yes, dust off those measuring cups.
• Calories. Total calories in the serving. Watch those labels as often a container is more than 1 serving.
• Protein. List the grams of protein in the serving.
• Fiber. Grams of fiber.
• Calcium. I listed the percent of the recommended daily amount, which is listed on milk, yogurt, ice cream cartons, and so on.
• Water. Keep track of how many ounces of water you drink each day. When you don't feel well and your jaw is wired shut, it's easy to get dehydrated.
• Exercise. Keep track of what you are doing for exercise. That helps keep it on your priority list.

## My eating case study

I started each day with a smoothie containing 2 tablespoons of Brewer’s Yeast, which is an excellent source of protein and nutrients. Get the debittered kind, which is typically available at health food stores. The smoothie also had 1 cup of plain non-fat yogurt (high in calcium and protein), one banana, 1 tablespoon of honey and almost a cup of frozen berries.

Actually, come to think of it, I started each day with two latte's. I am a Seattleite after all. Okay, the coffee's not great for you, but I'd have 8-10 ounces of steamed milk (measure it before steaming), so I got a good start on protein and calcium.

Note: It was hard for me to consume much of anything for the first few days after surgery. As a result, I wasn't getting anywhere close to enough calories. I felt I needed to get calories any way I could, regardless of nutritional value, so for a few days I used whole milk and regular yogurt. Once I got my calorie count up, I backed off these for the non-fat products.

For lunch, I got a lot of fiber and protein by pureeing a can of beans (white beans, black-eyed peas, chili with beans, etc.), with 2 tbsp of flaxseed oil (great source of omega 3 and other nutrients) and chicken broth to thin it and for flavor.  Some articles say to puree any food, or to eat baby food, but that didn't sit well with me.  I preferred to eat wholesome foods and vegetables wherever possible for better nutrition.

During the day I would have other drinks, like Gatorade and Odwalla, and plenty of water.

Then I could eat whatever I wanted for dinner, like mashed potatoes and a milk shake. Even though they have less than ideal nutritional value, since I was able to get the proper amount of nutrients earlier in the day, I looked forward to dinner as treat time. You gotta do what you gotta do to get through six weeks of nothing but liquids.

Also, take a liquid multi-vitamin, like Centrum, every day. If you can’t find it on the shelf, ask a pharmacist. They can easily order it in for you, it’s non-prescription.

Things like Boost and Ensure are loaded with calories, protein and nutrients. I found them very sweet, too sweet really, but they tasted a lot better when I would put it in a blender with ice cubes, creating a smoothie-type of drink. These are great for mid-morning or afternoon snacks.

You’ll need a good blender and/or Cuisinart to grind up everything so there are no particles. If you can afford it (about \$400), or can borrow one, a Vita-Mix (http://www.vitamix.com) is an excellent choice. That's what I ended up buying. (Please note that although I am mentioning products by name, this is not a commercial article. I'm just sharing what I did.)

For me, drinking my meal with others at a table who were eating wonderful meals did not work. It was hard looking at real food and other people chewing. Instead I typically drank my meal in front of my computer or while watching television or reading. Naturally this was my choice and will be different for others.

## Exercise

It helps the healing process enormously if you’re strong. Force yourself as soon as possible after your surgery to start exercising. Walking or bike riding each day, and then building up to more vigorous exercise, will help your recovery.

Try to exercise a minimum of an hour each day. But listen to your body. If you’re tired, rest, as that’s just as important for healing.

If you broke your jaw, there’s a good chance you injured other parts of your body. Using free weights helps to rebuild strength and muscle tissue, and are wonderful tools that don’t take up a lot of room.

Yoga and other types of stretching exercises help you both mentally and physically recover from your injuries. Try to do these at least 20 minutes each day. Doing it at the end of the day will help you relax and aid in sleeping.

I also treated myself to a weekly massage to help relieve sore muscles. It was wonderful. A few visits to a chiropractor also helped relieve some of my sore joints.

## Pain

I found that my jaw hurt very little after the surgery. It was the other body parts I injured that really caused pain.   The soreness from my jaw only happened after it was unwired, and I could finally open it.

For some people, grinding up pills and putting them in some milk or juice is fine. I found it to be very bitter. Liquid aspirin or ibuprofen was much better for me to help with pain, if you don’t have a prescription for something stronger.

Children’s medicines are often liquid. Just take roughly twice the dose if you’re an adult. It will typically say on the package the proper dosage for adults, or ask your pharmacist.

## Teeth Cleaning

You’ll want to make certain to brush your teeth and gums at least after every meal and snack, and to use mouthwash. Warm salt water rinses also help. I also used plastic toothpicks to get out anything stuck between my teeth. I used a mouth rinse called PerioGard  for several weeks to help with my gums since you can’t floss. But it turned my teeth grey (which will come off when you get your teeth cleaned), so I stopped.  But I think it was very helpful in keeping my gums healthy.

One week after the "braces" (I think my doctor called these "arch bars") are off your teeth, you’ll want to get your teeth thoroughly cleaned by a hygienist and have a dentist check for any tooth damage.   Your gums will be very sore when they initially come off, so it's best to wait a week so they can heal.

## Mental Exercises

Naturally, there’s nothing you can do to unwire your jaw, so why fight it. Just feel lucky you didn’t do more serious injury to yourself that could have resulted in far worse consequences. And focus on other important things like getting stronger by eating nutritious foods, and setting good exercising goals to help in your recovery.

Remember it takes time for bones to heal. If you broke your arm, you’d likely be in a cast for at least 4-6 weeks. I tried to keep talking to a minimum, as your jaw moves when you talk. And naturally the whole point is to try to move your jaw as little as possible so it will heal properly.

Many people are also nervous that they might vomit with their teeth wired shut. It worried me. This happens to very few people. And if you are nauseous, you can go to a clinic to get a shot or I.V.  There are suppositories you can purchase that will help if you don’t want to take anything orally. Just make sure you have your wire cutters with you to ease the anxiety.

If sleeping is difficult, go for a long walk or read until you’re very tired right before bed. Listening to yoga or meditation CDs, and/or using scented candles or aromatherapy can help as well. If you’re having major anxiety problems, talk to your doctor about getting a prescription.

## Time Line

Here’s how it went for me. Naturally it will be different based on the severity of your injury, your doctor, and how you’re healing. I injured my right arm badly in my fall, which prevented me from doing more vigorous exercises like riding my bike and doing weights in the first few weeks.   I was able to go back to work after the first week.  It helped to keep my mind off of my jaw.

Week 1—Really weak from surgery and other injuries. Difficult to eat at first, so having a lot of Ensure (or similar products), whole milk and high calorie items helped get the calories and nutrients in my body. Started walking each day 3rd day after surgery. Slept a lot and felt very weak.

Weeks 2-3—Better at eating, so ramped up to more nutritious items. Started doing yoga, and taking longer walks. Much stronger physically and mentally.   But still get tired frequently, so lots of rest.  Force yourself to massage and brush your gums with a soft brush to keep them healthy.

Week 4—Stitches taken out of my lower gums, on the outside of my teeth.  I was not given anything prior, and this hurt a little. Finally able to get on my bike again, and to start using weights. I noticed my gums were growing between a couple of teeth--my doctor said that's normal--it completely went away when the wires from my teeth were removed.

Week 5—Wires holding my teeth together were replaced with tight elastic bands. Still on a liquid diet, and couldn’t open my mouth.

Week 6— The elastics came off, and I can finally open my mouth!  But it's hard to open very wide (sore when I do) and difficult to chew. That's ok, I'll take anything I can get. Started a soft food diet (scrambled eggs, baked potato--stuff that requires little chewing and sort of "melts" in your mouth). My bite was off (right rear teeth hit before left), making chewing awkward.

Week 7—Braces (arch bars) off! (I think these are left on to make sure the elastics don't need to be put back on.  I had an i.v. sedative for this so I would not feel any pain.)  My gums were very sore afterwards.  But can now eat more "firm" foods.  You'll want to floss your teeth religiously and continue massaging your gums so they'll heal better.  Bite still off and lower teeth where I had the plate put in were very sore when chewing and opening my mouth.  But I exercise my mouth by opening wide and concentrate on using the muscles on the left side of my mouth to correct my bite.

Week 8—Got my teeth cleaned thoroughly and a good bill of health from the dentist (no damaged teeth, gums in great condition).  My lower gum where the plate was put in is still sore, as are the lower teeth, but I can eat normally.  Bite still off, and still sore to open my mouth wide, but getting better from exercising it.  I feel terrific, stronger than before I had my accident.

## Looking Good

Just because your mouth is wired shut is no excuse to look bad. Remember the motto, "To Look Good Is To Feel Good", and we certainly want to feel good. So wear those great outfits, make sure you have regular hair appointments and whatever else to help you look good each day. People won’t even notice that your jaw is not moving when you talk, and you’ll feel great.

Happy Healing!

Patty Dupre
August 6, 2006

### Epilogue To My Jaw Surgery

When the bands came off, the muscles were really tight and my bite was way off. About 2 weeks later, I had one tooth filed down slightly so the bite would be better. That helped enormously.

But everything was still pulling a lot to the right, and my teeth weren’t meeting together properly. I tried opening and closing my mouth as wide as possible, about 10 times, 4-5 times per day. But be careful not to overdo it. And your bite will likely never be the same, so don't worry about it.

About 3 weeks later, as I started to chew more, I developed TMJ on one side. TMJ is when bone is grinding against bone where your jaw is connected to your skull. This was likely caused by the disk which cushions that joint being thrown out of place when I had my accident. TMJ was a real problem for me. I sure hope it doesn't happen to you.

I was very careful about what I ate (no caramels, big sandwiches, etc. that causes you to open real wide or chew a lot). I cut my food into really small pieces, again minimizing the chewing action. And I also learned to really relax my jaw muscles by just letting it fall open naturally, and not forcing it into the correct position. I think that was an enormous help in letting the muscles figure out what to do.

I went to 9 different specialists about the fact my bite was off (orthodontists, oral surgeons, dentists, etc.). One in particular kept telling me don't do anything until at least one year after your injury, as your joint and muscles will continue to heal and change. After going to all those specialists, getting very different advice, and waiting one year, I decided to get a splint to help out the TMJ problem (which I really didn't want to do).

An orthodontist was where I ended up for the splint—but the splint is an artificial way (as they all are) of trying to correct the problem. Two days before I was to get the splint, the TMJ problem stopped. So I didn’t get the splint.

It's now 6 months later (1.5 years after I broke my jaw), and the TMJ or bite problems have not come back. I still don’t open my mouth wide, and cut everything into small pieces. So far, so good. So if something's not right, just be patient and wait. Don't get anything done, if possible, until at least one year later.

The body is truly an amazing thing.

Patty Dupre
February 7, 2008

## Update

January 2010: It’s now been 3.5 years since I broke my jaw. I’ve had no pain or additional dental work due to the accident. I still have the occasional "popping" noise that accompanies TMJ problems when I do open my mouth really wide—so I always try to avoid doing that.

And I continue to cut my food into very small pieces, and stay away from "chewy" foods. Although I still feel my bite is off somewhat, it’s never a bother.

March 9, 2010: Here's another good website: http://www.mccannjazz.wordpress.com

NOTE: Please ignore the comment below that you can read the complete article by setting up an account on our website. This is the complete article. You don't need to do anything more, except heal. Take care.

Editor's note: This is the complete article.

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