Instructions After Impacted Tooth Exposure

After surgical exposure of an impacted tooth, avoid disturbing the surgical area. Depending on your procedure, surgical packing may have been placed to help keep the tooth exposed, or an orthodontic bracket and chain may have been attached to the tooth.

Surgical Packing, Bracket & Chain

If surgical packing was placed, leave it alone unless your surgeon has instructed you otherwise. If the packing becomes loose or falls out, this is usually not an emergency. Please contact our office if you have questions or concerns.

If an orthodontic bracket and chain were attached to the impacted tooth, do not pull, play with, or otherwise disturb the chain or bracket. Be careful when eating and brushing around the area. Your orthodontist will use the attachment to gradually guide the impacted tooth into the proper position.

If the chain or bracket becomes detached, please contact our office for further instructions.

Bleeding

Some bleeding or blood-tinged saliva is normal after surgery. If bleeding is more significant, place a gauze pad directly over the surgical area and bite with firm, continuous pressure for 30 minutes.

If bleeding remains heavy or your mouth is rapidly filling with blood despite firm pressure, please call our office for further instructions.

Swelling

Some swelling is normal after surgery. To help minimize swelling, apply an ice pack to the cheek near the surgical area for approximately 20 minutes on and 20 minutes off, as often as comfortable, during the first 24 to 36 hours.

Diet

Drink plenty of fluids after surgery. Avoid very hot foods and liquids on the day of surgery. Begin with soft foods that are comfortable to eat.

Gradually advance your diet as tolerated. Avoid hard, crunchy, or sharp foods that could irritate the surgical area or disturb surgical packing, an orthodontic bracket, or chain.

Pain

Some discomfort is normal following impacted tooth exposure. If you are able to take nonsteroidal anti-inflammatory drugs (NSAIDs), good options include one of the following:

Aleve (naproxen): 1-2 over-the-counter tablets every 12 hours
Advil (ibuprofen 200 mg): up to 3 tablets every 6 hours

Choose either ibuprofen or naproxen. Do not take both together.

If you are able to take NSAIDs, use one of the above options on a scheduled basis for the first 3 days following surgery, even if discomfort is mild. Staying ahead of postoperative discomfort often provides better pain control.

If ibuprofen or naproxen alone is inadequate, you may add 1-2 Regular Strength Tylenol (acetaminophen 325 mg each) every 6 hours.

If you are unable to take NSAIDs, 1 Extra Strength Tylenol (acetaminophen 500 mg), or 1-2 Regular Strength Tylenol (325 mg each), every 6 hours is often sufficient when started before the local anesthetic wears off.

Be aware that acetaminophen is also contained in many prescription pain medications and over-the-counter cold and flu products. Do not take additional acetaminophen without considering the total amount you are taking from all medications. If your surgeon has prescribed or recommended a different pain medication regimen, follow those instructions.

Oral Hygiene

Good oral hygiene is important for healing. On the day of surgery, avoid vigorous rinsing or disturbing the surgical area.

Beginning the day after surgery, gently rinse with warm salt water several times each day, especially after eating. Mix approximately one teaspoon of salt into a cup of warm water.

Continue brushing your teeth, but be gentle around the surgical area, surgical packing, and any orthodontic bracket or chain. Keeping the surrounding teeth and gums clean will help the area heal.

Activity

Rest on the day of surgery and limit strenuous physical activity during the early recovery period. Exercise can increase throbbing, swelling, or bleeding. Gradually return to your normal activities as you feel able.

Follow-Up With Your Orthodontist

If an orthodontic bracket and chain were placed, follow the instructions you were given regarding your next orthodontic appointment. Your orthodontist will determine when and how to begin applying orthodontic force to gradually guide the impacted tooth into position.

When to Call Our Office

Please contact our office if you experience heavy bleeding that does not respond to pressure, pain or swelling that is worsening rather than improving, a suspected medication reaction, problems with the surgical packing or orthodontic attachment, or any other symptoms that concern you.

Your surgery and recovery are individual. If the instructions provided specifically by your surgeon differ from these general recommendations, please follow your surgeon’s instructions.