“The Plate Is Poking Through”: Infection and Plates After Jaw Surgery

Jaw surgery series · 13 min read · Published November 2026 · Reviewed November 2026 · Next review May 2027

By Dr Rosemary Listing, PhD (Law) · Medical negligence specialist, in practice since 2014 · Of Counsel, Peter Evans & Associates

If you've been through an infection after jaw surgery, with more antibiotics, more appointments and maybe another operation, you may be exhausted and wondering whether it should have gone this way. Those are fair questions.

This guide is part of our series on jaw surgery complications. Our broader article on hospital-acquired infections covers infection after surgery generally.

Start with your question

• How common is infection after jaw surgery?
• What are the signs of an infected plate?
• What should happen if it's infected?
• Will my plates need to come out?
• Is an infection negligence?

Why plates are used

How common is infection?

Sources: Verweij et al, J Craniomaxillofac Surg 2016 (infection and removal per patient);¹ Kantzanou et al, J Clin Med 2025 (removal due to infection).²

Reported plate removal rates vary widely, from about 3% to 27.5%, depending on the patient group, fixation system and how long people are followed up; a recent UK unit reported most removals happened within the first year, with infection the leading cause.³ Infection is much more common in the lower jaw than the upper: in one series of 41 infections, 93% were in the lower jaw, appearing on average about a month after surgery.⁴

Warning signs

• Swelling that returns or worsens after it had settled
• Pus, a lump or a weeping spot inside the mouth or on the skin
• A persistent salty or bad taste, or bad breath
• Increasing pain, or tenderness over one spot
• Being able to see or feel a plate or screw
• Fever, feeling unwell, or opening getting harder again

What should happen

An infection should be examined promptly by the surgical team, not managed by phone. Assessment usually includes a swab to identify the bacteria, an X-ray or scan to check the plates, screws and bone healing, and a clear plan: antibiotics, sometimes drainage, and follow-up to make sure it settles. In the series above, a small number needed drainage under general anaesthetic, about 12% needed hardware removed for loosening, and about 5% developed chronic bone infection (osteomyelitis).⁴

Questions to ask

• Has a swab been taken, and which antibiotic is it sensitive to?
• Has the plate or bone been imaged?
• Is the bone healing, and are the screws still secure?
• What is the plan if this doesn't settle in a week or two?

Will my plates need to come out?

Not always. Many infections settle with treatment and the plates stay. Where they keep getting infected, loosen or show through the gum, removal is often recommended, usually once the bone has healed enough to hold without them. Removal is another procedure with its own risks, so it's reasonable to ask why it's needed, when, and who will pay. Our article on the cost of jaw surgery covers Medicare and private health.

Expected, worth a review, or same-day help

What to look for in the records

Our guide to getting your medical records explains how to ask.⁵

How the law looks at it

Infection is a known complication of jaw surgery, and an infected plate is not, on its own, evidence that anyone was careless. In an infection case, the questions usually focus on what was done to prevent it, and how quickly and well it was dealt with once it appeared.

Prevention and recognition. Experts may look at antibiotic prophylaxis, wound care advice, and whether reported symptoms were acted on. Phone advice to “keep rinsing” for days, without an examination, can be very different from accepted practice, which is judged under section 5O of the Civil Liability Act 2002 (NSW).⁶

What difference it made. The question is whether earlier assessment and treatment would probably have avoided extra surgery, plate removal or bone infection. It has to be more likely than not; a lost chance alone isn't enough (Tabet v Gett).⁷

Consent. Infection and the chance of plate removal are usually part of the consent discussion (Rogers v Whitaker).⁸ In most infection cases, though, the follow-up matters more than the warning.

Who can claim, and when

The person who had the surgery can claim. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, and courts can sometimes extend it. See time limits in NSW or other states, and how a claim works.

In my practice

The clearest infection files are rarely about the operation. They're about the weeks after it. A patient rings, describes swelling and a bad taste, and is told it's normal. They ring again. The notes, when they exist, are brief. By the time someone looks, the plate is exposed or the bone is involved. Patients often have the best evidence themselves: call logs, texts and photos with dates.

Both things can be true

Infection may have been bad luck, and the response to it may still have fallen short. You can be grateful your jaw finally healed and still be upset about what it took. Both are allowed.

The bigger picture

Corrective jaw surgery in Australia is performed by oral and maxillofacial surgeons.⁹ You can check registration on the Ahpra public register, and complaints in NSW can go to the Health Care Complaints Commission. See complaint or claim, and how a claim is paid for.

Support

• healthdirect, 24-hour nurse advice: 1800 022 222
• Lifeline, 24-hour crisis support: 13 11 14
• Beyond Blue: 1300 22 4636

The woman in the stories still has the screenshot of her call log. She says it's the most important document in her file, and she made it herself.

With care,
Rosemary

Frequently asked questions