EXPOSURE OF TEETH
WHAT IS THE EXPOSURE OF A TOOTH?
Occasionally, some teeth do not erupt in line with the surrounding teeth. As part of orthodontic treatment, these teeth can be pushed into line with the surrounding teeth using braces. Before braces can be placed on these teeth, the gums around these teeth are opened, giving your orthodontist access to the tooth. The opening of the gums around unerupted teeth is known as an exposure
HOW WILL MY TOOTH BE EXPOSED?
Before I expose your tooth, I will apply numbing injections in the gums around your tooth. I will then leave this for 5 minutes for the anaesthetic to work.
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I will check that the anaesthetic has worked by pressing around the gums using a dental probe. At this point, you will feel pressure but you should not feel pain. If you feel pain, I will leave more time for the anaesthetic to work or apply more anaesthetic depending on what you can feel.
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Your treatment will only start when you are happy that you are numb.
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An opening will then be made in the gums around the tooth.
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This opening in the gums will be kept open using dissolvable stitches. These stitches will dissolve in 10 - 14 days after your treatment. This will provide enough time for your orthodontist to place an orthodontic appliance on the tooth.
WHY WOULD A GOLD CHAIN BE ATTACHED TO MY TOOTH?
Occasionally, rather than arranging another appointment with your orthodontist, I will attach a gold chain to your tooth after exposing it.
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Depending on the position of the tooth, the gums may then be left open or closed together using dissolvable stitches. These stitches will dissolve in 10 - 14 days after your treatment.
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The end of the gold chain will then be stitched to your brace or to the surrounding gums with a non-dissolvable stitch.
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Your orthodontist will then plan to attach this to your brace and 'pull' your tooth into line with the surrounding teeth over time. ​
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The decision to attach a gold chain onto the tooth at the same time as exposing the tooth will be made before your treatment following discussion between yourself and your orthodontist.
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WILL I BE AWAKE DURING THE EXPOSURE OF MY TOOTH?
Tooth exposures are are performed under local anaesthetic or intravenous conscious sedation.
Treatment under local anaesthesia only numbs the gums around the tooth. You will be awake throughout your treatment, but you should not feel any pain or discomfort.
Intravenous conscious sedation is administered through a vein in your arm or hand. However, this is not the same as a general anaesthetic which will put you completely to 'sleep'. Instead, intravenous conscious sedation will reduce your awareness of the procedure. The treating team will still be able to speak with you and identify if you are feeling discomfort.
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During your consultation I will discuss the advantages and disadvantages of treatment under both local anaesthetic and intravenous sedation at greater length.
WHAT WILL MY RECOVERY TIME BE AFTER MY TOOTH EXPOSURE?
You may experience pain, swelling and bruising after your tooth exposure.
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Pain usually worsens over the first 3 days after surgery. This may take up to a further 10 days to stop, with daily gradual improvements. Provided that you have no allergies, intolerances or reasons why you cannot take them, the following painkillers are advised:
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Paracetamol 1g every 6 hours for 7 days
Ibuprofen 400mg every 8 hours for 7 days
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I will confirm with you which are best in your case.
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Swelling usually worsens over the first 3 days after swelling. This may take up to a further 10 days to disappear, with daily gradual improvements. You may use an ice-pack applied to the outside of the face for 15 minutes in the morning and in the evening to help to reduce the swelling.
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Bruising after a tooth exposure is less common. This will usually resolve with any swelling that you may experience.
WHAT CAN I EAT AFTER MY TOOTH EXPOSURE?
Immediately after your surgery while you are still numb, avoid hot food and drink to prevent burning yourself without realising.
Once the local anaesthetic has worn off, you will find a soft diet for the first 3 days after surgery more comfortable. If you feel that you can return to a normal diet you may do so.
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Avoid small grains and pieces that may get caught in the surgical site for 5 days after your surgery.
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Avoid alcohol for the first 48 hours after your surgery.
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Avoid smoking for at least 72 hours after your surgery - the longer you are able to stop smoking the lower the chances of infection.
CAN I BRUSH MY TEETH AFTER MY TOOTH EXPOSURE?
You should return to toothbrushing as soon as possible after your tooth exposure. Ideally you should start on the same evening as your tooth exposure.
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You should not mouthwash with saltwater or mouth wash for the first 48 hours after your surgery. After this, when using rinsing your mouth, ensure that it is a gentle rinse only for the following 5 days.
DO I NEED A REVIEW AFTER MY TOOTH EXPOSURE?
Usually you will not need a review after your tooth exposure. However, depending on your surgery I will arrange a telephone review at least 5 days after surgery. Review will then be arranged with your orthodontist