After Exposure of an Impacted Tooth

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will usually be a metal or rubber chain protruding through the gums and attached to the arch wire of your braces. Please take care to avoid heavy contact with the chain during eating or brushing. It is not uncommon for the chain to become loose or detached from the tooth. If this happens please keep the chain and bracket handy and call our office immediately.

SUTURES

Usually there will be sutures (stitches) placed to reapproximate the gingiva at the surgical sites. The sutures we place are usually resorbable and do not need to be removed. Please avoid tampering with the sutures, allow 7-10 days for sutures to dissolve. Occasionally sutures may break and fall out sooner than anticipated, this is not cause for alarm simply keep the area clean, healing typically progresses as normal.

BLEEDING

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding can be controlled by biting on a moistened gauze pad placed under pressure directly over the bleeding wound for 30 to 60 minutes. If bleeding continues profusely, please call for further instructions. Avoid the use of straws for 2-3 days.

SWELLING

Swelling is a normal occurrence after surgery. To minimize swelling apply an icepack, or towel filled with ice, on the face in the area of surgery. Apply the ice 20 mins on and 20 mins off at a time, as much as possible, for the first 24 hours.

DIET

Drink plenty of fluids. Avoid hot liquids or hard foods. Soft food and liquids should be eaten on the day of surgery and for 2-3 days. Return to a normal diet as soon as possible unless otherwise directed.

PAIN

• You should begin taking pain medication as soon as possible prior to the local anesthetic wearing off which typically occurs 2-3 hrs after the procedure. For mild or moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours not to exceed the max daily dose written on the bottle. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: up to 4 tablets may be taken at a time, four times daily, not to exceed the max daily dose written on the bottle. Consult our office for additional recommendations.
• For severe pain, you may be prescribed stronger medications. These medications should be taken as directed. Do not take any medication if you are allergic to it or similar medicines, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery and avoid alcoholic beverages while taking narcotic pain medications. Pain or discomfort following surgery should subside gradually. If pain persists, it may require attention and you should call our office.

ANTIBIOTICS

Antibiotics are sometimes necessary after exposure of an impacted tooth, especially when bone is removed or the tooth is luxated (loosened). If prescribed, antibiotics should be taken as directed to help prevent infection.

ORAL HYGIENE

• Good oral hygiene is essential to good healing especially since braces attract debris and bacteria. The night of surgery no rinsing or brushing should be done. The day after surgery, the prescribed oral rinse should be used twice daily; after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (one teaspoon of salt in a cup of warm water) should be used at least 3 times a day as well, especially after meals. Brush your teeth along with the braces well. Be gentle initially while brushing the surgical areas and be sure to use a soft bristle brush and avoid excessive contact to the protruding chain.

ACTIVITY

• Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment. This may weaken you and further limit your ability to exercise.

SMOKING

• Smoking not only disturbs and delays the normal wound healing but it also increases risk of excessive post surgical bleeding as well as infection hence should be avoided for 3-4 days after surgery.