Expose and Bond
Do not disturb the wound. Avoid rinsing or touching the wound on the day of surgery. There may be a metal or gold chain protruding through the gingival (gum) tissue. This is what your orthodontist will use to pull the tooth into the tooth site. Brush and floss teeth and be very gentle in the area of surgery. Rinse with mouth rinse as prescribed (usually this is peridex and use 15-30 ml, swish and spit twice a day for 7-10 days. Salt water rinses as needed to keep food out of the site. ( ½ teaspoon of salt with 8 oz of clean warm water.) Avoid gum or sticky foods. Avoid water picks until directed by your doctor
Maintain a soft non-chew diet until directed by your doctor (ie. mashed potatoes, soups, over cooked pasta, flaky fish, soft vegetables, protein shakes, or anything pureed). Try to maintain hydration and high protein and avoid chewing gum or candy while chain is in place.
If you wear a night guard, retainer, or tmj appliance, consult your doctor prior to putting it back in, on the next business day. However, if it contacts the temporary or the surgical area, please do not wear it until your doctor has evaluated this.
Antibiotics are usually not given for this procedure. Antibiotic rinse may have been given.
If able to take ibuprofen, take 2-3 over the counter tablets prior to the local anesthetic wearing off. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 4-6 hours as needed for mild to moderate pain. For moderate to severe pain, the prescribed medication should be taken as directed. You can alternate with the prescribed medication with ibuprofen taking one or the other every 2 hours. This may allow the prescribed pain medicine to work the full 4 hours. Do not take any of the above medication if you are allergic, or have been instructed by a doctor not to take it. Avoid ibuprofen if you have an internal ulcer, severe chronic asthma, severe asthma, kidney disease, or taking blood thinners like coumadin or plavix. Also, the pain medication we prescribed may have tylenol or ibuprofen already in it. If so, do not add any additional tylenol or ibuprofen to your regimen as this could lead to kidney or liver damage.
The most likely reason is the pain medication you are taking or the anesthesia you were given if sedated. Take prescribed nausea medicine if prescribed as long as it doesn’t require swallowing. Take this medicine prior to your next dose of pain medicine to avoid nausea.
Try taking less of the pain medication and take the Ibuprofen regimen above if directed by your doctor.If you don’t need the pain medicine discontinue it altogether.
If this persists please call the office or answering service (same number) to speak to a nurse or doctor
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 36-48 hours.
Upper teeth may have required a flap to expose the tooth or a bone graft may have also been done. This reflection of the tissue can cause significant swelling for the first 72 hours sometimes involving the eyes. This edema will be greatest at 72 hours and should start to subside after this time. The flap may have been on the palate and will create some swelling mostly on the palatal side.
This is common with surgery and may cause discoloration under the skin. Warm compresses may help to dissipate this and can be started after 48 hours.
A follow up appointment is usually not required for this procedure. However, if you have any concerns please call our office and we will gladly see you.
You should see your orthodontist within 1-2 weeks unless told otherwise. If you have no appointment with them please call them to let them know that you had this procedure done so they can schedule your next appointment.
If the chain comes off, call our office on the same or next business day to schedule a follow-up appointment.
If you have a temperature greater than 100.4 F, please call our office for an appointment.
If you have drainage from the surgical site, please call our office for an appointment.
If any may get loose and fall out within 5-10 days unless your doctor placed non-dissolvable ones, which he will likely need to remove in the next 1-3 weeks. The ones that fall out on their own are brown or yellow. The permanent ones are usually blue. It is not often that we use non-dissolvable ones for this procedure. These are usually used when grafting is done in conjunction with the procedure.