The following instructions are important following an expose and bond procedure.

General:

• After your surgery, do not disturb the surgical site or the packing that is placed inside your mouth. This packing is in place to keep the tooth exposed.
• Do not spit for the first week following your surgery.
• Do not be alarmed if this packing falls out or moves from its original position.
• If a small gold chain was placed attached to the impacted tooth, it is essential that your orthodontist activates the chain as soon as possible or per their instructions following surgery.
• If this chain becomes dislodged from the tooth, please contact our office immediately to have the chain replaced.

Bleeding:

• A small amount of bleeding is common for the first few days.
• If you experience excessive bleeding, place a gauze pad directly over the surgical sites and hold it in place with firm biting pressure for 30–45 minutes or until the bleeding can be controlled.
• Replace the gauze pads every 30–45 minutes.
• Bleeding may vary from person to person.
• Gauze pads will always appear red. The way to assess bleeding is to directly look at the sites after the gauze pads have been removed.
• If the bleeding does not slow down, please call our office.

Swelling Control:

• Swelling can be normal after surgery.
• Swelling can be reduced by applying an ice pack to the side of your face. Do this for 20 minutes on, 20 minutes off.
• Continue icing the face as much as possible for the first 24–36 hours. Do not apply ice directly to the skin.
• Please do not lay flat. Use 1–2 pillows to elevate the head to avoid or minimize swelling.
• These measures may not eliminate swelling but they will help reduce its severity.

Diet–Day of Procedure:

• Soft liquidy foods are strongly recommended on the day of the procedure. Pudding, JELL-O^®, applesauce, yogurt, ice cream, and smoothies are excellent options for the day of the procedure.
• Always cool down any hot foods or liquids during the first 24 hours following your procedure.

Diet–First Week:

• You should eat only soft foods for the first week, such as scrambled eggs, mashed potatoes, macaroni and cheese, soft fish and steamed vegetables.
• Do not use a straw.

Diet–Foods to Avoid:

• Avoid hard, crunchy, or very chewy foods until the site is fully healed, you are pain-free, and until the tooth becomes visible.
• Please consult your orthodontist at your follow-up visit.

Pain Control:

• Discomfort can be normal after the procedure.
• Pain medication may be prescribed. It is advised that you take pain medication on the first day.
• If you are not allergic or intolerant to nonsteroidal anti-inflammatory drugs, you may start taking ibuprofen (Advil^® or Motrin^®).
• If the ibuprofen alone doesn’t control your discomfort, take the prescribed narcotic in addition.
• It is recommended that you alternate between the narcotic and ibuprofen. Do not take them at the same time.
• Be certain to take your pain medication with food, as this will help prevent an upset stomach.
• Remember: narcotic pain medication will impair your judgment and reflexes, so do not drive or operate heavy machinery.
• Typically, minors will not be prescribed narcotics, as over-the-counter pain medications are effective for these procedures.

Hygiene:

• Begin brushing your teeth on the day of surgery. It is important to brush all of your teeth, even if the teeth and gums are sensitive.
• Avoid the surgical sites on the day of surgery. On the following day, gently brush over the surgical sites with almost no pressure.
• You may remove some stitches. Brush around the packing if one has been placed.
• It is important to keep surgical sites really clean to avoid infection or delayed healing.

Thank you for reviewing these post-operative instructions and following them carefully.