It is imperative that the occlusal relationship and mandibular function be assessed early and on a regular basis. The patient is evaluated at 1 week to verify the occlusion and to assure adequate performance of functional rehabilitation exercises. The frequency of follow-up will largely be based on the findings of the 1 week appointment. Typically, if the patient is doing well at one week, they will not be seen for 2 more weeks. The necessity and frequency of future appointments will be based upon the findings from this appointment.
For pediatric condylar fractures, the parents should be advised, that the fracture can affect future mandibular growth in some rare cases. It is prudent to recommend they have their family dentist monitoring mandibular growth and refer to an orthodontist if aberrant growth is noted.
Postoperatively, patients will have to follow three basic instructions:
The patient can eat whatever is comfortable. If solid foods cause pain, the patient will self-limit their diet to softer foods. There is no contraindication to taking solid foods from the standpoint of their fracture.
2. Oral hygiene
The presence of the arch-bars and any elastics makes appropriate oral hygiene procedures a difficult task. A soft toothbrush (dipping in warm water makes it softer) should be used to clean the surfaces of the teeth and arch-bars. Any elastics are removed for oral hygiene procedures. Chlorhexidine oral rinses should be prescribed and used at least 3 times each day to help sanitize the mouth. With more gross debris, a 1:1 mixture of hydrogen peroxide/chlorhexidine can be used. The bubbling action of the hydrogen peroxide helps remove debris. A Waterpik® is a very useful tool to help remove debris from the wires.
Patients are instructed in physical therapy maneuvers to restore mandibular excursions. This includes maximum jaw opening, right and left lateral excursions, and protrusive excursions of the mandible. They should perform these exercises several times a day.