Oral and Maxillofacial

Oral and maxillofacial is the medical speciality concerned with diagnosing and treating defects, injuries, and diseases of the mouth, jaws, face and neck. An oral maxillofacial surgeon (OMS) has a dual qualification in medicine and dentistry.

At Ashtead Hospital our oral and maxillofacial surgeons are highly qualified and experienced in treating patients who suffer from facial and jaw pain, impacted and missing teeth, jaw joint disorders, facial injuries and disproportion, salivary gland disease, jaw cysts and tumours, breathing problems including sleep apnoea, and head and neck cancers.

Patients can utilise our first class imaging service to establish a diagnosis and to help their surgeon to assess the complexity of the case.

Our oral and maxillofacial service aims to improve functionality of your jaw and mouth, treat chronic conditions and cosmetically enhance your features.

Wisdom teeth extraction

Your wisdom teeth are the last teeth to come through. They are at the back of your mouth and sometimes there isn’t room for your them causing them to emerge abnormally or impacted, for example they may emerge at an angle or partially emerge.

If you have impacted wisdom teeth that are causing pain, inflammation or infection, it may be recommended that they are removed. Wisdom teeth extraction is a very common procedure.  You’ll be given a local anaesthetic injection to numb your tooth and the surrounding area, then your oral and maxillofacial surgeon or dentist will take hold of your tooth with dental tools and rock it backward and forwards, twisting slightly to loosen it, and eventually remove it completely. The process usually takes just a few minutes.

Occasionally, a wisdom tooth is difficult to remove and a cut will be made in your gum close to your tooth to help your oral and maxillofacial surgeon take the tooth away. They will then stitch the area to allow it to heal.

Jaw surgery

Corrective jaw surgery, also called orthognathic surgery, modifies many skeletal and dental imbalances such as jaw and teeth misalignment. It can be used to treat minor to major problems including: difficulty chewing, biting and swallowing, jaw pain, excessive wear of teeth, open bite (when you have a space between your upper and lower teeth whilst your mouth is closed), receding lower jaw and chin, protruding jaw, facial trauma, and chronic breathing problems such as sleep apnoea.

It can also be performed to enhance a patient's appearance, often increasing self-esteem in addition to improved functionality.

Jaw surgery will be performed under general anaesthetic. Any incisions are usually made inside your mouth so there are no external scars. Bone may be added, taken away or reshaped depending on your requirements and your jaw will be held in place using surgical plates, screws, wires and rubber bands. Your OMS will discuss the procedure in detail with you.

Facial trauma

Facial trauma or facial injury can be caused by events including: a sporting injury, accidental fall, car accident, assault, and work related incident. It can range from being a minor injury to disfigurement that lasts a lifetime.

Ashtead Hospital provides comprehensive care for patients with facial trauma from those suffering from dentoalveolar fracture (tooth and surrounding bone injury) through to extensive facial lacerations, burns, fractures and eye injuries.

Facial trauma surgery will depend on the type of trauma you have suffered. In general, it aims to: regulate your bleeding, create a clear airway, treat fractures and broken bones, prevent scars (if possible) and eye problems, and care for any other injuries.

Sleep apnoea

Sleep apnoea is a common sleep disorder that affects your breathing. If you suffer from sleep apnoea, whilst you’re asleep you will regularly and temporarily stop breathing, sometimes for over ten seconds at a time.

It is most often caused by an increase in airway resistance, frequently associated with snoring. Sleep apnoea can have a huge impact on the lives of its sufferers and their families.

Obstructive sleep apnoea (OSA) is a common sleep apnoea whereby tissue at the back of your throat is blocking or obstructing your airway. If you’re doctor suspects you’ve OSA they may use an overnight sleep study called polysomnography to monitor your eye movements, chest wall movements and brain activity during your sleep. Alternatively, a mini sleep study that monitors your heart rate and blood oxygen may be used.

Mild to moderate sleep apnoea may be treated by making lifestyle changes such as weight loss and mandibular advancement devices. Moderate to severe sleep apnoea may be treated with continuous positive airway pressure (CPAP) that involves wearing a nasal mask when you’re asleep to keep your airway unobstructed, or oral surgery to increase the width of your airways. Your OMS will advise on the best treatment option for your sleep apnoea.

Head and neck infections/cancer

Head and neck infections can be odontogenic (teeth), nasal and sinuses, ocular (eyes), otitis (ear) and pharyngeal (pharynx). They are common and your OMS will discuss the best treatment based on the type of infection and your individual needs.

Cancer of the head and neck are less common than many other cancers. There are many areas cancer can develop in your head and neck including your mouth (most common), voice box (larynx), throat (pharynx), salivary glands, nose and sinuses and the area at the back of your nose and mouth (nasopharynx).

Symptoms of head and neck cancers will be determined by its location although here are some general symptoms including: a non-healing sore in the mouth (most frequent symptom), a neck lump or swelling, red or white mouth patches for a few weeks, difficulty or pain when chewing or swallowing, voice changes (hoarseness), an ongoing sore throat and earache on one side.

The goal of head and neck cancer treatment is to remove or destroy all of the cancer and to decrease the likelihood of its return. Treatment varies depending upon where in your head or neck the cancer is, its size and your health. Your consultant will talk to you about the treatment options. They can include:

  • radiotherapy - high-energy rays destroy the cancer cells.
  • chemotherapy - anti-cancer (cytotoxic) drugs destroy cancer cells
  • surgery - removes the cancer and rebuilds tissue lost due to the cancer or surgery

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