Exposing & Bonding of Brackets to Teeth Explanation & Warnings

[Anonymous]

This list of warnings might seem excessive to some however the legal ruling
in the case of Chester vs Afshar (2004) would suggest that it is quite
prudent / necessary to list them. Others might say that there isn’t enough
information but where do you stop?

The following list of warnings regarding tooth exposure & bonding is neither
exhaustive nor is it predictive. The most pertinent warnings have been
included here.

You are to have a tooth exposed ± bracketed. You can expect the
following:

Exposing ± Bracketing of Tooth Specific Warnings:

Stitches. The extraction site will often be closed with stitches. These are
dissolvable and ‘fall out’ within 10 – 14 days. If a pack has been sewn in or
the chain is ‘parked’ high up in the sulcus, non-dissolving stitches are used,
that will need to be removed at some point.

Brackets. These are small golden plaques with chains attached. These are
stuck onto the teeth that need to be moved. Sometimes, the cement
sticking the chain onto the tooth can break after traction is applied to the
tooth; if this happens, the bracket will need to be re-cemented on.
Occasionally, the chain itself breaks and this will mean that the chain and
bracket have to be replaced.

Gauze Pack. Sometimes, it is not possible to stick the chains onto the
teeth. If this is the case, a gauze pack impregnated with an antiseptic
(BIPP) is placed over the exposed tooth and sewn into place. The pack is
removed after approximately a week and the chain will be stuck on at this
point.

Ankylosis of Tooth. Occasionally, even if the tooth has traction applied to
it, it still refuses to move. If this happens, it is sometimes necessary to
explore the area – there may be a lip of bone preventing the tooth from
moving or the tooth has fused with the surrounding bone (ankylosis).

Repeated Operation. The gum can easily grow back over the exposed
tooth. If this is the case and the tooth doesn’t have a bracket stuck on it,
the tooth will need to be re-exposed, hence another operation.

General Surgical Warnings:

Pain. As it is a surgical procedure, there will be soreness after the
procedure. This can last for several days. Painkillers such as ibuprofen,
paracetamol, Solpadeine or Nurofen Plus are very effective. Obviously,
the painkiller you use is dependent on your medical history & the ease with
which the tooth was exposed.

Swelling. There will be swelling afterwards. This can last up to a week.
Use of an icepack or a bag of frozen peas pressed against the cheek
adjacent to the tooth removed will help to decrease the swelling. Avoidance
in the first few hours post-op, of alcohol, exercise or hot foods / drinks will
decrease the degree of swelling that may develop.

Bruising. Some people are prone to bruise. The bruising can look quite
florid; this will resolve but can take several weeks (in the worst cases).

Limited Mouth Opening. Often, the chewing muscles and the jaw joints are
sore after the procedure so that mouth opening can be limited for the next
few days.