Surgical exposure of teeth for Orthodontic Treatment

You have been referred to our office for surgical exposure of teeth to facilitate orthodontic treatment. This is a common and routine procedure usually completed with local anesthetic. This rationale for exposure of the teeth will have been reviewed with you already by your orthodontist and by the doctors at Langley Periodontics at your initial examination. Generally we request that the preliminary orthodontic appliances be in place prior to the surgical exposure appointments. The surgical procedures last anywhere from 45 to 90 minutes depending on the number of teeth to be exposed and their difficulty. Frequently remaining primary (baby) teeth are also requested to be removed at the same appointment. X-rays are utilized to locate the position of the un-erupted teeth, but we cannot be absolutely certain of the position of the teeth until we actually get in to the area surgically. Usually an orthodontic bracket with a chain attached is placed in the tooth at the time of the surgery. The bonding / cementing agents used to place the brackets require a dry tooth surface to place them; occasionally these brackets will come loose, it is not frequent. On the rare occasion when a bracket does does loosen or fall off, a small secondary surgical procedure may be necessary; some of the factors that relate to this may be out of our control and there may be a small fee levied for additional surgical management. Although the procedure is routine and highly predictable, occasionally teeth will not move. With most biological systems there is no absolute guarantee as to the success of the procedure. The actual orthodontic treatment is not our responsibility and is not within our control. Some cases require follow-up to watch the development of adequate gun (gingival) tissue aroung the teeth as they are brought in with the orthodontics treatment. Procedures may be necessary to augment or reshape the gingival after the teeth are actually brought in to the dental arches.

Post-operative course

Generally most patients experience only moderate, short-term discomfort for the exposure procedures. In most cases, there is minimal swelling although steroids can be prescribed if we think that there will be some swelling after the procedure. Generally there is an ache or throbbing sensation during the first twenty-four hours and the use of routine pain relievers such as Advil, Motrin, or Tylenol #1 are utilized. There is an emphases placed on a soft diet and good fluid intake. There is the need to see the orthodontist seven to ten days after the surgical exposure to check the area and adjust orthodontic appliances as necessary. There is usually a follow-up appointment at Langley Periodontics two or three weeks later and then generally a one year follow-up or post-orthodontics assessment relating to the final gingival form and tissue health following orthodontic treatment.

Taking care of yourself before Periodontal Treatment:
Eat a nutritious meals the night before and the day of the appointment.
Avoid the ise of alcoholic beverages
Of taking full doses of Aspirin (325mg) for medical reasons, please discontinue one week prior. Low doses of Aspirin (81mg) are fine.

One hour before the appointment:
Take Ibuprofen (Advil or Motrin) if recommended
            400mg for an Adult and 200mg for children under twelve.
            Or
            Tylenol #1 for a child under twelve.

You should plan on resting for the remainder of the appointment day.