NHS Forth Valley – Exposure of an Impacted Tooth

This page provides general information about exposing an impacted tooth. If you have further questions, please speak to your Orthodontist or Oral Surgeon.

What is an impacted tooth?

An impacted tooth is one that has failed to break through the gum.

Why do I need treatment?

If left untreated, an impacted tooth may not come through on its own and can damage the roots of nearby teeth. Exposure allows your orthodontist to guide the tooth into its correct position.

The procedure can be carried out under local anaesthetic, with sedation, or under general anaesthetic. Your surgeon will discuss which option is most suitable. Most patients can go home the same day after their procedure.

What does the procedure involve?

The gum over the tooth is lifted back and sometimes bone covering over the tooth is removed.

Two methods may be used:

Open exposure
The gum is left open and sometimes a special gum dressing is placed to keep the tooth uncovered and prevent food trapping. It usually falls out within a day or two. Brush gently around the area from the day after surgery.
Closed exposure with a gold chain
A small bracket and gold chain are glued to the tooth, and the gum is stitched back over it with the chain coming through the gum line. Your orthodontist will later use this chain to pull the tooth into position. The chain can be delicate – avoid sticky or chewy foods, and clean gently around it from the day after surgery.
Dissolvable (disintegrating) stitches are used, but the stitch holding the chain in place is not dissolvable and will be removed by your orthodontist.

After your surgery

Clean your mouth using toothbrush and toothpaste, carefully cleaning around your surgery area. You should start using a warm salted water mouth rinse the following day, after meal times for 7 days.
Take any prescribed medications as instructed.
Expect some soreness, swelling, bruising, or minor bleeding.
Apply an ice pack wrapped in a towel for up to 10 minutes at a time to reduce swelling.
Eat a soft diet for 2 – 3 days.
You should have a follow-up appointment with the Orthodontic Department within a few weeks. If you do not, please call 01324 566429 / 566437.

Preparing for your operation

You will receive a letter with details of where to attend and any fasting instructions.
Your surgeon or anaesthetist will discuss the risks of sedation or anaesthesia with you at your pre-assessment appointment. Please raise any concerns at that time.