After Exposure of Impacted Cuspids

During the procedure, the gum was lifted up to expose the impacted tooth underneath. Once exposed, an orthodontic bracket was attached to the tooth, and attached to the bracket is a miniature gold chain. The end of the chain will be loosely tied to the arch wire, or a nearby bracket, with a stitch. The patient will need to see their orthodontist within 5-10 days to attach an elastic to the chain to put a light eruptive pulling force on the tooth.

Until then, do not disturb the wound, or pull at the chain or the stitch that secures it to your braces.  If surgical packing, gauze strip or perio paste dressing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out do not get alarmed.


Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding which results in your mouth filling rapidly with blood can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.


Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag or a plastic bag or towel filled with ice cubes on the cheek in the area of surgery. Ice can be applied for the first 24 hours; after that, it has minimal effect.


It is important to be very cautious with chewing in the arch of the surgery so as not to dislodge the chain and bracket inadvertently. A soft diet is preferred; avoid things like, chips, raw vegetables and ice chewing. Chew on the back teeth only.  Avoid incising with the front teeth.


You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed.

Oral Hygiene

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (1/2 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.


Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.