Wired Shut

Have you been wired shut for a broken jaw or surgery? 

Maxillomandibular fixation (or MMF) is used by Oral & Maxillofacial surgeons to stabilize the lower jaw, by securing it to the upper jaw.  Thin wires are placed around each tooth, and brace-bars (called Erich arch bars) with small hooks are first secured to the teeth in the upper jaw, and then the lower jaw.  Those brace-bars are then secured top to bottom with 4-5 wire loops to stabilize the lower jaw.  Alternatively, just wires are used sometimes (called Ivy loops), or bone screws (called MMF screws) depending on where stabilization is needed.

Regardless on how the jaws are stabilized against one another, the period of being wired shut typically lasts 4-6 weeks.  This allows the bones to heal.  In a basic fracture, the broken jaw will gain 80% of its strength by 3 weeks, and 90% by 4 weeks.  By 12 weeks near 100% of the strength has returned.  Your surgeon will give you recommendations on your period of fixation depending on nature of the injury or surgery.

Ensure that you always have a pair of wire cutters on your person.  Cutting the wires that join the top jaw to the bottom jaw will allow the bones to move, but is sometimes necessary if health care personnel need quick access to your mouth.  If, for instance, you’ve fallen unconscious.

People typically lose 5-10% of their weight while wired shut.  Taking care to keep your nutrition up is important.  You can find some specific recipes here (Source: Hamilton Health Sciences), or Google ‘dinner through a straw’ for more ideas.

Oral hygiene is important.  Once given the go ahead by your surgeon that the wounds are adequately healed, use a diluted mouth rinse solution and syringe to help keep debris from collecting in the bars, and brush 2-3 times per day.   The wire and bars will collect food and bacteria so cavities and swollen gums will occur more frequently unless you’re careful.