Exposure of Impacted Teeth Treatment Guide
Helping a tooth that can't come in on its own. Here's what the next week looks like.
The Full Guide
An impacted tooth, most often an upper canine, stays below the gum or bone instead of coming in. Exposure uncovers the tooth and, when appropriate, bonds a small bracket with a tiny chain to it, so your orthodontist can gently guide it into place. Dr. Han chooses between a closed approach, where the gum is stitched back with the chain coming through, and an open approach, where the gum is left open with a protective dressing, based on where the tooth sits.
An impacted tooth may not come through on its own, and it can affect the roots of neighboring teeth. Guiding it into position protects your bite and completes your smile. Orthodontist Dr. Kim creates room first and begins guiding the tooth once it has been exposed, so the two steps are planned together.
Questions about a tooth that has not come in? Book an Evaluation and we will look at the next step.
If you choose sedation, follow the fasting instructions our office gives you, typically no food for about six hours beforehand, and arrange for a responsible adult to drive you home and stay with you. Wear loose, comfortable clothing with short sleeves, and tell us about every medication and supplement you take. Keep your orthodontic appointments so Dr. Kim can coordinate the timing.
Sedation is available for this procedure, and it is often the most comfortable way to have surgery. You can be relaxed and comfortable from start to finish, and many patients choose it. Patients of all ages, including teens, often choose sedation for this procedure. We also place local anesthetic at the surgical site to keep the area numb.
The gum over the tooth is lifted, and a small amount of bone may be removed to uncover it. A bracket with a small chain is usually bonded to the tooth, and the gum is stitched back or left open with a dressing, as Dr. Han explains beforehand.
Bite on gauze as directed, and expect numbness for several hours. Take your first dose of pain medication before the numbness wears off. If you had sedation, go straight home and rest for the day with your adult. For at least 24 hours, do not drive, drink alcohol, use machinery or make important decisions.
The chain is delicate. Avoid hard, sticky and chewy foods, and do not touch the area with your tongue or fingers. For the first 24 hours, do not rinse vigorously or use a straw.
Starting the day after surgery, clean gently around the area with a soft brush and rinse gently with warm salt water after meals, as directed.
Stay with soft foods that can be mashed with a fork for the first 2 to 3 days, then return to your regular foods as comfort allows, keeping the chain in mind.
Take pain medication and any antibiotics exactly as directed. Ibuprofen and acetaminophen are common choices when they are right for you; we will tell you what is best.
Expect some soreness, mild swelling, possible bruising and a little oozing. Ice the outside of your face in short intervals the first day. Swelling is usually milder than after wisdom teeth.
Soreness and swelling steadily improve. If a dressing was placed, we will tell you how long to keep it, and any stitches that do not dissolve are removed at your follow-up.
You will return to be checked, and Dr. Kim then begins gently guiding the tooth into position with your braces, usually after the area has healed.
The tooth moves gradually into place as part of your orthodontic treatment. Keep every orthodontic visit, and call Dr. Kim's team right away if the chain or bracket comes loose.
the bracket or chain comes loose or the dressing falls out, bleeding does not slow after 30 minutes of firm gauze pressure, swelling keeps growing after day 3, you have a fever, pus or a bad taste that does not clear, or pain is not controlled by your medication.
rapidly spreading facial swelling, trouble breathing or swallowing, or signs of a severe allergic reaction. These are rare, but go to the nearest emergency room or call 911 rather than waiting for a callback.
A note on this guide: this is general guidance. Your treating doctor's specific instructions for your individual case always take priority over anything written here. If something feels off or you're unsure, call us. Don't wait it out.
Orthodontic & Oral Surgery Care
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