Surgery
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Alveolar Bone Fraft for Adults
- When? Between 8 and 10 years
- Why? Children with a cleft lip can be left with a gap in their gum (alveolus). This needs filling with bone so that the teeth can grow/anchor in the correct place.
- How? This will be a daycase (home same day) operation with your child asleep. We will use some spare bone from their hip (iliac crest) and make some cuts in their gums so that we can insert the bone into the gap in the upper jaw. If your child needs to have some teeth removed (dental extractions), these will usually be done on the same day.
- Before the operation:
- Braces: Your child may require braces prior to their surgery. This can be for 6-12 months before the operation and are fitted by our cleft orthodontists
- Toothbrushing: It is very important your child brushes their teeth twice a day before your operation. We will give you some tablets (disclosing tablets) for them to chew that show up areas of plaque that they need to brush. They should use these 2 weeks prior to the operation
- On the day of surgery:
- We will give you specific fasting instructions depending on what time your child is likely to have their operation
- Come to ward 76 if you are having your operation in Manchester or [insert location] if you are having your operation in Alder Hey.
- Going home:
- Some children stay one night in hospital after their operation. Others go home on the same day as surgery. Your team will tell you what the plan is for you.
- Aftercare:
- Soft diet: A soft diet is important after an alveolar bone graft. You can find more advice on what counts as a soft diet here (link to nursing section)
- Sports: We advise your child to avoid PE, sports and swimming for 4 weeks
- Painkillers: We provide a range of painkillers to ensure your child is comfortable when they go home
- Toothbrushing: Tooth brushing with a soft brush must start 1 day after the operation. This will not dissolve your stitches. We will ask you to use the disclosing tablets again 1 week after surgery until the stitches dissolve.
- Dressings: You can soak the plaster of your child’s hip 5 days after the operation and do not need to replace it.
- What are the risks?
- Infection: signs of infection can be high temperature, vomiting, not feeding well, bleeding or foul smelling discharge from the wound. This can usually be treated with antibiotics and we use preventative antibiotics during the surgery itself to reduce the risk of this happening.
- Bleeding: some blood stained nasal discharge or saliva is normal. However, in rare cases there is fresh bleeding from the wound. If this does not settle within 10 minutes, you should bring your child to A and E. If this
- Abnormal tooth growth: We want adult teeth to grow through the grafted bone, but sometimes these do not grow correctly and require adjustment with braces.
- Resorption: This means that some of the grafted bone dissolves, which doesn’t provide such a good foundation for the teeth to grow into.
- Before the operation:
Some Questions You Might Have
Here are some frequently asked questions that provide straightforward answers about cleft lip and palate surgery, helping families understand the condition, what it means, and how it is treated. These questions cover the topics parents and carers often want to know first, offering clear information to support you from the beginning of your journey.