Oral And Maxillofacial Surgery Department

The Oral And Maxillofacial Surgery Department> The oral and maxillofacial surgery department, also called the surgical specialties department or oral surgery department, is a section found within many hospitals. Although this department has become more commonplace at most larger hospitals, it is primarily focused on those patients suffering from either birth defects of the face or tumors of the head and neck. The goal of this specialty department is to restore functionality to individuals who have suffered facial trauma or loss of function in their jaw or mouth.

If you’ve been unfortunate enough to have bad teeth, you might have heard about oral and maxillofacial surgery. This is an option for those people who want a better smile. People come to doctors in this field of dentistry when they are suffering from a number of issues related to their teeth or gums. For example, if some of your teeth are missing, then you could suffer with how the missing teeth look as well as how it is affecting the rest of your mouth. It might make it harder for you to chew your food and even impact your ability to speak.

What Is The Oral And Maxillofacial Surgery Department

The Department of Oral and Maxillofacial Surgery offers a comprehensive service relating to conditions of the face, mouth and jaws, including a routine assessment and treatment service for common oral surgical conditions.

Our consultants treat a range of conditions, including facial injuries, head and neck cancers, salivary gland diseases, facial deformities, facial pain, impacted teeth, cysts and tumors of the jaws, as well as mouth ulcers and infections.

The specialty is unique, requiring a dual qualification in medicine and dentistry.

Oral and maxillofacial surgeons frequently work alongside other specialists, including orthodontists, oncologists, neurosurgeons, plastic surgeons and ear, nose and throat (ENT) surgeons.

Specialist areas

• Dentoalveolar surgery
  Dentoalveolar surgery is surgery of the tooth-bearing part of the jaws, including impacted teeth, complex tooth extractions, cysts and lesions of the oral mucous membranes.
• Oral medicine
  Ulcers, infections and diseases of the mouth. The diagnosis and medical treatment of a wide range of conditions of the oral mucosa are carried out in the department.
• Orthognathic surgery/facial deformity
  This involves surgically moving the jaws and correcting anomalies of the face and mouth. Treatment planning is carried out in conjunction with our orthodontic colleagues, who prepare the dental arches prior to surgery. Craniofacial deformity, cleft lip and palate and post-traumatic deformities are managed in a multidisciplinary environment.
• Trauma
  The treatment of facial fractures, including orbital fractures, lacerations, craniofacial trauma and post-traumatic deformity.
• Oral and facial cancers
  There is a multidisciplinary approach to head and neck cancer according to NICE guidance. Combined clinics are held with Maxillofacial Surgery, ENT Surgery, Radiotherapy, Radiology, Histopathology and MacMillan Nurse input. Following assessment and treatment planning, patients are treated as appropriate. Radiotherapy +/- chemotherapy is provided where indicated.
• Treatment of neck lumps
• Salivary gland diseases
  Salivary gland obstruction (stones/strictures), inflammatory diseases, mucoceles/ranulas, benign and malignant tumors, parotid surgery and ‘minimally invasive techniques’ are provided.
• Facial pain
  A service for the diagnosis and treatment of facial pain is provided.
• Jaw joint disorders
  Treatment, including surgery for disorders of the temporomandibular (TM) joints. Most patients are seen on an outpatient basis in the Maxillofacial Unit, but surgery under general anesthesia is sometimes required.
• Secondary cleft lip and palate deformities
  Management of cleft lip and palate patients follows the established international protocol. Primary cleft treatment is performed by the plastic surgeon. Secondary bone-grafting of the cleft and subsequent orthognathic surgery are performed by the maxillofacial team.
• Medically compromised patients
  The management of medically compromised patients requiring dental surgery is an expanding area, with the increase in long-term management of cardiac patients (e.g. patients on anticoagulants), transplants and immunocompromised patients.

Outpatient services and case general anaesthetics

These are provided in the Oral and Maxillofacial Surgery Department, based at

• John Radcliffe Hospital, Oxford (the ‘hub’ center); and
• Horton General Hospital, Banbury
• Stoke Mandeville Hospital, Aylesbury
• Amersham Hospital, Amersham
• Wycombe General Hospital, Wycombe
• Royal Berkshire Hospital, Reading (‘spoke’ units).

Referrals come from general dental and medical practitioners, other hospital consultants, and the Accident and Emergency Departments of the hub and spoke centers.

The Department of Oral and Maxillofacial Surgery and Orthodontics is supported by maxillofacial technicians with special expertise in maxillofacial prostheses and orthodontic appliances.

Specialist clinics

• Facial Deformity (Orthognathic) Clinic
• Joint Cleft Lip and Palate Clinic
• Joint Head and Neck Oncology Clinic
• Craniofacial Trauma
• Craniofacial Deformity

Maxillofacial Surgery

Maxillofacial surgery is an operation performed by a highly trained dental surgeon. A variety of maxillofacial procedures can treat diseases, fix injuries or correct defects in your face, jaw or mouth. As with any operation, maxillofacial surgery has certain risks. But the procedures help many reduce pain, fix deformities and restore function.

What is maxillofacial surgery?

Maxillofacial surgery is a special type of dentistry. It involves operations to correct diseases, injuries and defects of your face, jaw or mouth. Maxillofacial surgeons are advanced specialists who diagnose and treat problems with:

• Bones and tissues of your jaw and lower face (maxillofacial area).
• Roof of your mouth (palate).
• Teeth.

Why is maxillofacial surgery done?

Maxillofacial surgery is performed to:

• Improve jaw function.
• Relieve pain.

Maxillofacial surgery can address a wide variety of dental problems and conditions, such as:

• Diagnosing reasons for chronic dental pain.
• Preparing the mouth for dental implants and prostheses (such as dentures).
• Placing dental implants.
• Removing (extracting) impacted teeth.
• Treat oral diseases.

Procedures can also treat jaw problems, such as:

• Bone grafting, or transplanting bone from another area of the body to replace bone that’s missing in your jaw.
• Reconstructing your jaw to correct an abnormal bite.
• Treating temporomandibular joint (TMJ) disorders that affect the area where your lower jaw attaches to your skull.
• Treating injuries related to trauma to your face, jaw and mouth.

Other reasons to perform maxillofacial surgery include:

• Correcting congenital (present at birth) abnormalities such as cleft lip and palate.
• Diagnosing and treating cysts, tumors, cancer and other growths in your head and neck.
• Diagnosing reasons for chronic facial pain.
• Treating facial trauma (injury), such as facial fractures or damaged maxillofacial tissue.

What’s the difference between oral surgery and maxillofacial surgery?

Maxillofacial surgeons and oral surgeons are the same thing. Training involves oral and maxillofacial surgery but some surgeons limit their practice to oral surgery and office-based procedures, while others prefer more hospital-based procedures.

PROCEDURE DETAILS

What happens before maxillofacial surgery?

If you need maxillofacial surgery, your healthcare provider (primary care provider or dentist) will refer you to a specialist.

The maxillofacial surgeon will meet with you for a consultation to:

• Ask about your symptoms, medical history, current medications and more.
• Examine your oral cavity and surrounding areas.
• Order tests as needed, such as dental X-rays or 3D scans, to get detailed images of the maxillofacial structures.
• Diagnose the condition and recommend surgery or other treatment.

What happens during maxillofacial surgery?

Maxillofacial surgery varies greatly depending on the problem and procedure. Some surgeries can be done in an outpatient setting, and you can go home the same day. Other treatment plans involve multiple surgeries to achieve the desired results.

Maxillofacial surgeons are trained and authorized to deliver anesthesia to prevent pain or put you to sleep. Your healthcare team will talk to you about whether you’ll need anesthesia and what type is best for you.

Toward the end of the procedure, your surgeon may use stitches to close any surgical wounds. Your surgeon also may place packing in your mouth to protect your teeth or the wound and to absorb fluids such as blood and pus.

What happens after maxillofacial surgery?

After maxillofacial surgery, your healthcare team will move you to a recovery room so you can wake up from the anesthesia. You may have some discomfort or pain as the medication wears off.

You’ll also probably experience:

• Bleeding.
• Bruising.
• Limited use of the jaw and teeth.
• Swelling.

Your surgical team will talk to you about how the surgery went, when you can go home and how to take care of yourself during recovery.

If you receive anesthesia, you should have someone drive you home.

RISKS / BENEFITS

What are the advantages of maxillofacial surgery?

Maxillofacial surgery can permanently improve pain, function and appearance.

What are the risks or complications of maxillofacial surgery?

As with any operation, there are risks with maxillofacial surgery, such as

• Bleeding.
• Dry socket, a painful condition that can occur after tooth extraction, involves problems with blood clots.
• Infection.
• Injury to teeth, lips, tongue, cheeks, chin, nasal cavity, sinuses, or maxillofacial bones or tissue.
• Numbness or changes in sensation in the mouth or other areas of your face.
• Pain.
• Possible damage to nerves that move some of the muscles of your face.
• Root fragments, a rare complication when a piece of tooth root breaks off and stays in place after surgery.
• TMJ disorders.

RECOVERY AND OUTLOOK

What’s recovery like after maxillofacial surgery?

Recovery after maxillofacial surgery depends on the type of procedure you have. You’ll likely experience some discomfort, sensitivity, swelling and bleeding for at least a few days. Your healthcare provider may recommend pain medications to keep you comfortable.

If you received stitches, they’ll either dissolve or be removed in about a week.

You may have to avoid certain foods and activities for days or weeks. Your healthcare provider will give you specific instructions, which may include:

• Apply ice packs to reduce inflammation.
• Avoid foods that are crunchy, chewy or hard.
• Avoid tobacco products and alcohol.
• Don’t exercise for a few days because it can increase bleeding and swelling.
• Rest to prevent complications.
• Rinse your teeth instead of brushing them to kill bacteria in the mouth

Conclusion