Maxillofacial and oral surgery at Derby Hospital

Maxillofacial and oral surgery is a surgical specialty that treats diseases, injuries and abnormalities affecting your mouth, teeth, jaws and face. Because it combines training in both medicine and dentistry, it can treat conditions that need expertise from both fields, from wisdom teeth to facial injuries and jaw surgery.

What conditions does it treat?

• Wisdom teeth and other impacted or complex teeth, including buried dental roots.
• Cysts and tumours of the jaw or mouth, both non-cancerous and cancerous.
• Head, neck and facial cancers, sometimes including reconstruction with skin or bone grafts afterwards.
• Salivary gland conditions, including tumours, cysts and stones.
• Facial injuries, such as broken jaws, cheekbones or noses, and cuts to the face.
• Facial deformity, including jaw misalignment that affects chewing, speech or breathing.
• Facial pain and problems with the jaw joint (the temporomandibular joint, or TMJ).
• Problems affecting the lining of the mouth, such as recurrent ulcers or white patches.
• Skin cancer affecting the face.
• Sleep apnoea linked to the structure or position of the jaw.

What are the benefits?

• It can restore normal function, such as chewing, speaking or breathing, alongside improving how your face looks.
• Leaving these problems untreated can sometimes lead to complications such as infection, bone loss or a blocked airway, so timely treatment can help prevent this.
• For conditions such as cleft lip and palate, timely surgery can make a real difference to a child's speech and development.
• For facial injuries, prompt surgery can reduce scarring and help prevent long-term changes to how your face looks.
• More complex procedures are increasingly planned in advance using 3D imaging and computer-aided planning, to help improve accuracy.

Are there different types of surgery?

This is a broad specialty covering many different operations.

• Oral surgery tends to focus on the teeth, gums and structures inside the mouth, such as removing wisdom teeth.
• Maxillofacial surgery extends further, to reconstructive work, facial injuries and facial deformities.
• Many surgeons develop a particular interest within the wider field, such as head and neck cancer, facial trauma, or jaw surgery.
• For more complex procedures, especially jaw (orthognathic) surgery, computer-guided planning and custom 3D-printed guides are increasingly used to plan surgery precisely beforehand.

What happens before the procedure?

You'll usually be referred by your GP, dentist or another hospital department, and then invited in for a consultation.

• A physical examination.
• A discussion of why you've been referred and what you're hoping to get from treatment.
• An X-ray or other scans, if needed.

Once you've been assessed and surgery has been agreed as the right option, your surgeon will discuss your choices in detail and agree a treatment plan with you. Some consultations bring in more than one specialist at once, so you benefit from different areas of expertise.

What happens during the procedure?

The exact steps depend heavily on which procedure you're having, since this can range from a straightforward tooth extraction to major jaw or reconstructive surgery.

Simpler procedures, such as removing wisdom teeth or small lumps, can often be done under conscious sedation, where you stay awake but relaxed. More involved surgery, such as jaw realignment, facial trauma repair or cancer surgery, usually needs a general anaesthetic. Your surgeon will talk you through exactly what your own procedure involves.

What does recovery look like?

Whether you go home the same day or need a longer hospital stay afterwards depends on the type of surgery you've had, from straightforward day-case procedures through to more complex operations needing inpatient care.

Recovery time varies a great deal depending on what was involved, but many people gradually return to normal function over roughly 4 to 8 weeks. Where a minimally invasive approach has been possible, recovery tends to come with less swelling and pain along the way.

What are the risks and complications?

• Bleeding.
• Infection.
• Nerve injury.

As with any surgery, these risks vary depending on how complex your procedure is, and are generally reduced where precision techniques such as computer-guided planning or robotic assistance are used