Oral surgery

Our service acceptance critera is based on national commissioning guidelines and standards. Information can be found here regarding acceptance criteria.  

Suspected head and neck cancer should be referred to Oral and Maxillofacial Surgery departments via 2ww pathway.

For information about our undergraduate oral surgery clinics please click here which includes emergency referrals via 111.

At the end of your oral surgery treatment, you will be discharged back to your dentist for all further dental treatment.

 

• Management of intra-oral benign and cystic lesions of the hard and soft tissues
• Management of benign disease of the minor salivary glands
• Dental Extractions/procedures with increased risk of complications e.g. nerve damage, antral communication, patients with complex medical histories. 
• Surgical removal of third molars or retained roots
• Management of ectopic teeth or supernumerary teeth
• Management of infections in the orofacial region 
• Surgical removal of teeth/roots/foreign bodies in the maxillary antrum
• Management of post-operative bleeding
• Soft Tissue Procedures e.g. Frenectomies 
• Management of necrosis of the jaw bone.  
• Non-surgical management of temporomandibular joint disorders that have not responded to initial therapy as per NICE guidelines. 

We will only provide oral surgery treatment as above. Oral surgery do not provide comprehensive dental care such as gum treatment, fillings, dentures.

Who is the service for?

The service provides treatment for patients who are not able to receive treatment in general dental practice or community dental service due to the complexity of the treatment they require or the complexity of their medical history; this includes head and neck cancer patients and severe bleeding disorders.  

How can I be seen at the dental hospital?

This is a referral-only service. If you meet our acceptance criteria your dental practitioner may refer you for treatment.

Preparing for your appointment

Please make sure to bring:

• Your appointment letter if you have one. This contains important information about where and when you will be seen. 
• Any relevant letter or results from your dentist or doctor.
• A snack, if you are a diabetic patient. 
• A list of current medication.
• A list of questions you wish to ask.

What does my first visit involve?

• When you arrive please make sure you check-in at reception before taking a seat- this is important as it lets the nursing staff know that you have arrived. 
• You will be assessed on a consultant-led clinic which may take 2-3 hours.
• Additional x-rays may be required to assist with planning and diagnosis.
• Arriving early for your appointment does not mean you will be seen earlier. 
• Sometimes appointments are delayed. This is usually for a good reason. Staff should inform you if and why a delay has occurred. 

If following assessment, specialist care is not required you will be discharged to your referring practitioner. 

We may discharge you back to your Dentist if you do not attend a scheduled appointment without informing us.

 

How will my treatment be provided? 

We offer treatment under:

• Local anaesthetic
• Conscious sedation
• General anaesthetic

Who will carry out my treatment?

This is a teaching hospital. All treatment is provided with consultant oversight. Depending on the complexity, treatment may be provided by:  

• Dentists undergoing further postgraduate training 
• Oral surgery specialists and consultants 

We work alongside our undergraduate oral surgery team, therefore undergraduate dental students may be observing or carrying out simple treatment under direct supervision. 

Will I still need to see my own dentist?

Yes. Patients should remain registered with their general dentist throughout treatment to provide routine care.  Once your oral surgery treatment is complete you will be discharged back to your dental practitioner.

 

The service provides treatment for patients who require dental extractions and fulfil the criteria:

• Multiple or single straight forward extractions (erupted teeth) on adult patients, not planned to be surgical but may become surgical. i.e., last standing upper molar extraction including fully erupted uncomplicated third molars 
• Any existing relevant radiographs must be included if available 
• This service will accept patients with the following : 
• Patients at low risk for MRONJ (i.e. patients treated with bisphosphonates for non-malignant diseases for less than 5 years, patients that had denosumab injections more than 9 months ago, NO RISK) 
• Patients on anticoagulants and antiplatelet drugs with low bleeding risk (i.e., patients on apixaban , dabigatran, rivaroxaban or edoxaban for simple extractions 1-3 teeth with restricted wound size, patients on aspirin alone or dual therapy in combination with clopidogrel, prasugrel) 
• or other complicated medical histories (i.e.hypertension asthma or angina well controlled by their regular medication)

Exclusion criteria and further information: Oral surgery undergraduate treatment clinic acceptance criteria and how to refer.docx [docx]

These links are for patient interest and support only.

Necrosis of the Jaw:

• Osteoradionecrosis - Head and Neck Cancer Alliance 
• Jaw problems after head and neck cancer treatment | Macmillan Cancer Support 
• Medication-related osteonecrosis of the jaw | Scottish Denta (sdcep.org.uk) 

Temporomandibular Joint Disorder:

• Temporomandibular disorder - NHS (www.nhs.uk)