Oral & maxillofacial surgery

Our Oral and Maxillofacial Consultants are dentally and medically qualified. This means that surgeons within this specialty are trained to recognise a huge range of conditions and injuries affecting the:

• Head
• Neck
• Face and jaw
• Hard and soft tissues which make up the oral and maxillofacial region.

Some of our team trained in dentistry first, while others underwent medical training first, but in order to be a Consultant within oral and maxillofacial in the UK, you need to be trained in both.

Our Consultants also completed surgical training – including basic surgical (e.g. in general surgery and orthopaedics) before training for up to seven years in the oral and maxillofacial speciality.

As a result, there are quite a lot of areas our Consultant Oral and Maxillofacial Surgeons cover, including:

• Cancers of the head and neck, including skin cancer
• Head and neck trauma – which includes broken bones in the face, not just around the jaws, but the orbit, the eye sockets etc. Occasionally, our Consultants work alongside neurosurgeons for trauma patients.
• Cleft lip and palate work
• Surgical dentistry
• Cosmetic and functional work.
• Temporomandibular Joint (TMJ) problems

Below, we take a closer look at some other areas our Consultants might work across.

Cancer Resection and Reconstruction

Oral and maxillofacial surgeons work alongside ear, nose and throat consultants too, on surgeries such as free tissue transfer, which sees them take a piece of tissue from elsewhere from the body and transfer it – using microsurgery – to reattach the blood supply at the new site in the body requiring reconstruction. 

Craniofacial Surgery and Referral Elsewhere

Craniofacial surgery is more esoteric. Often, in children with conditions that cause deformity to the skull and the face, larger centres like Liverpool, Glasgow and London will perform necessary surgeries, with our Consultants referring patients on.

Orthognathic Surgery

The oral and maxillofacial team works alongside orthodontic colleagues, who will straighten the teeth up. Sometimes even with straight teeth, the discrepancy between bones of the jaw is still too big, so this will mean someone needs to move the jaws around – for example, the top jaw will often be moved forward and up, with the bottom jaw being moved back or forward to fit.

At the moment this surgery is not done at Albyn hospital.

Temporomandibular Joint (TMJ) problems

There are various things our team might do to the jaw joint; the vast majority of patients with problems relating to the temporomandibular joint (TMJ) don’t require surgery.

There are several other things our Consultants can do to manage patients’ discomfort – for example, injecting joints, or rinsing joints.

Finally, if the joint is severely damaged, we may need to replace the joint. We would tend to use a custom-made joint, built by computer, based on a CT scan. The joints are manufactured in the USA and sent over; they aren’t cheap, but they’re very good in the right circumstances; if someone is miserable due to joint degeneration, it can be life-changing.

Oral Medicine

While we are a surgical specialty, we deal with a lot of oral medicine: conditions of the mouth that effect the oral mucosa, which may be part of a systemic problem, including:

• Recurrent mouth ulcers – and other conditions that affect the inside of the mouth and do not require surgery but need some specialist intervention
• Rashes and skin conditions
• Facial pain syndromes, such as trigeminal neuralgia.

We’re careful to ensure that people with these sorts of (painful) conditions know that they are able to call our secretaries and, if necessary, we can inject the nerve and take the feeling away, even if it’s just for 24 hours.

We have very good contacts and colleagues within neurology, too; sometimes, these patients are amenable to decompression surgery, too – and we manage them up until that point.

Surgical Dentistry

Much of the work that our Consultants do at Albyn comes into this category, such as removal of wisdom teeth, cysts within the jaws, or buried teeth. Sometimes, that’s seen as less glamorous, says our Consultant, but it can be tricky work to do. Involving the nerves that run through the jaw and bone, we use a large team here at Albyn to perform this kind of work.

Facial Feminisation Surgery for Transgender Patients

While this is not offered at Albyn Hospital, patients may be referred elsewhere. We can change the shape of the jaw (jawline contouring), as well as the shape of the chin in transgender patients.

Rhinoplasty (nose jobs) and brow contouring may also be offered, if required.

Occasionally, our team can perform surgeries involving the soft tissue as well. There is Scottish Government Guidance on the sort of treatments we can offer, and these patients are very carefully assessed first by a specialist mental health professional.

In the oral and maxillofacial clinic at Albyn Hospital, we see patients with everything from mouth ulcers to jaw joint pain – and in many cases, surgery isn’t required.

We see patients face-to-face, but if needs be, we all offer telephone and video consultations. Commonly, appointments will be face-to-face, depending on whether we need to do a biopsy or we decide if surgery is required.

Usually, there will be some form of investigation, including:

• An X-ray
• A CT scan
• An MRI scan.

Our Consultants don’t talk people into surgery if that’s not appropriate for them – and every patient receives the same high-quality service. If our specialists don’t think that surgery is required, for any reason, they will make that clear.

Pre-surgery Consultation

We try to give as much information as possible, if surgery is recommended, and often offer two consultations before going ahead with more complex surgery. In these cases, we leave plenty of time between the two consultations to give patients time to consider what’s involved and if they would like to go ahead.

A Multidisciplinary Approach

Ours is a multidisciplinary approach that covers everything from conditions which affect both the function of the face and mouth, to those that affect their appearance.

Sometimes people are shy about telling us they are concerned about their appearance, but appearance is important, particularly facial appearance. The face is the first thing people see of you – and with all of the surgery we do, function is important, but appearance is considered too.

People sometimes feel that that is somehow not a noble motivation to have surgery, but we’ve changed lives for people; we’re always thinking about appearance as well as function.

Below is an at-a-glance look at some of the reasons you might choose Albyn Hospital for your oral and maxillofacial consultation:

• Reduced waiting times – Patients who visit Albyn Hospital can benefit from shorter waiting times than they would if, say, they were to pursue treatment on the NHS.
• Flexible appointments at a time to suit you – You can choose an appointment time to suit you and your schedule – and in some cases, remote consultations will be offered.
• Consultant-led appointments – Your appointment will always be Consultant-led, and you’ll see the same person each time you visit. You will also see a Consultant who has a special interest in your problem – and if investigations or surgery is required, most can be done at the Albyn Hospital. For your convenience, consultations can be either face-to-face or telephone based.
• Patient satisfaction and personalised care – In an independent survey* in 2020, 98.9% of our patients said they would recommend the hospital and its treatments.

Our team sees patients from the Highland region, as far away as the Inner Hebrides – people come from all over to visit our Consultant Oral and Maxillofacial Surgeons at Albyn.

There isn’t another maxillofacial surgery centre in the Highlands. For trauma, for instance, at the moment we cover the whole of northern Scotland, including the islands.

For anyone considering an oral and maxillofacial consultation at Albyn Hospital, you can book an appointment with our Consultant Oral and Maxillofacial Surgeon online.