This information is about having an alveolar bone graft operation. It will tell you about what an Alveolar Bone Graft operation is, why you need to have one and what happens when you have your operation.
What is an alveolar bone graft?
Alveolar is another word for gum. The red part on the outside of the gum is called the mucosa (this is what you can see if you look in the mirror). The mucosa has bone inside it. Some people, like you, are born with a gap in their gum. This means that they do not have bone in that bit of the gum.
An Alveolar Bone Graft is the name for the operation to put a bit of bone into the gap in your gum. During an Alveolar Bone Graft operation a surgeon will take a really small bit of bone from your hip and will put this in the gap in your gum.
The operation takes place at the hospital. You will not be awake during the operation. Another type of doctor called an anesthetist will give you some special medicine to make you go to sleep.
Sometime people call Alveolar Bone Grafts operations an “ABG”:
- Alveolar – another word for gum
- Bone – what will go into your gum
- Graft – the special medical word for when something is taken from one bit of the body and put into another. In an alveolar bone graft a piece of bone from your hip will be put into your gum.
Why do I need an alveolar bone graft?
The gum has some important jobs to do. One of the gum’s jobs is to hold your teeth in the right place. When someone is born with a gap in their gum it means that the gum cannot hold their teeth in place properly.
When they are old enough, people with a gap in their gum can have an alveolar bone graft operation to put a little bit of bone in the gap. Having an Alveolar Bone Graft operation means that when your grown-up teeth grow they do not wobble and they will be as straight as possible.
Before the alveolar bone graft operation
Having braces
A while before you have an alveolar bone graft operation you might have some braces put on your teeth. These braces make the gap in your gum wider to make enough space for the surgeons to put the bone into your gum. Most people have their braces on for about a year before the gap in their gum is wide enough, but sometimes people have their braces for a bit longer before they are ready to have their alveolar bone graft operation.
When the orthodontist (that is a dentist that fits and looks after braces) thinks that the gap in your gum is big enough, they will swop your brace for a smaller brace which will hold your teeth nice and still for your operation.
What happens when I am ready for the alveolar bone graft operation?
When you are ready for the operation your parents or carers will be given a date for the
operation. You will attend a pre- admission clinic with the cleft specialist nurses where pre
and post care will be discussed. You will also be given a 5 days pre-operation patient pack,
which will include:
- 5 days of special toothpaste
- 5 days special anti-bacterial mouthwash
- 5 days of a special cream
Where will I have my operation?
You will have your operation in Newcastle at the Royal Victoria Infirmary. You will stay on
Ward 11 which is a ward just for children and young people
Can someone stay at the hospital with me?
Yes, your room will have a bed for you and another bed so that one of your parents or carers can stay overnight with you. You can also have people come and visit you during the day.
What is it like on Ward 11?
There are lots of things to do – you will have a TV in the room and the ward also has a
playroom for younger children and books, games and a games console for older children.
You can also bring a few of your own toys or games.
What should I bring to the hospital with me?
- Pyjamas/ nightclothes/slippers/clothes for during the day
- Toiletries – your toothbrush, soap, shampoo etc.
- You can bring some things to play with or do – like one or two of your favourite toys,
games or books.
What happens after I come to the hospital?
Most people come to the hospital the night before their operation, but sometimes people come to the hospital on the morning of the operation. The doctor will tell you and your parents and carers when to come to the hospital.
What happens when I come to Ward 11?
You can get settled in your room. You will meet the nurse who will be looking after you. Sometimes a member of staff will come and take swabs from inside your mouth to make sure that there are no germs in your mouth. The swabs look like big cotton buds and one will be gently stroked on the inside of your mouth; this does not hurt.
One of the doctors will come and talk to you and your parents or carers. This is to check that you are well enough to have your operation and to make sure that you don’t have a cough or cold. A lot of children have a sniffly nose when they come into hospital because it is so warm there. This is usually nothing to worry about. The doctor and anesthetist will decide if you are well enough to have your operation.
Sometimes people need to have other tests or checks done. For example, you might have some blood taken, go for an x-ray, a scan or to see the orthodontist. The staff at the hospit will tell you if you need to have more checks or tests.
Eating and drinking
You will not be allowed anything to eat or drink a few hours before your operation. This is because having something to eat or drink can make you really sick during or after your operation. One of the nurses on the ward will tell you when you can have your last food and drink before your operation.
What happens on the day of my operation?
On the day of your operation one of the doctors will come and see you. They will ask your parents and carers to sign a form to say that they give permission for you to have the operation.
There is a space on the form for you to sign too if you would like to. Meeting the anaesthetist and going to sleep Anaesthetists are doctors who give people medicine to make them sleep all the way through their operation. There are different ways that anaesthetists make people go to sleep during their operation. The anaesthetist will talk to you about which you can have.
- Some people have a needle put in their hand and they are given some medicine through the needle to make them go to sleep. If you are going to sleep by having medicine through a needle you can have local anaesthetic cream put on your hand. Some people call this ‘magic cream’ because it makes your hand numb so that you do not feel the needle.
- Some people have a mask put on their nose and mouth to breathe “sleepy air” that makes them fall asleep.
You will go to a room called the anaesthetic or ‘napping’ room to be given the medicine or
special air that makes you go to sleep. One of your parents or carers can come with you to
this room.
What does it feel like to go to a sleep for an operation?
If you are having the medicine through the needle then once you have been given the
medicine you will start to feel sleepy.
If you are having the air then you will have a mask put over your nose and mouth. You will breathe the air through the mask and after a few minutes you will go to sleep.
How long will I be asleep?
When you are asleep you will be taken to the room where the operation takes place. You will be asleep until the operation is finished. The amount of time the operation takes is different for everyone. When the operation is finished you will be taken into another room to wake up
What happens after the Alveolar Bone Graft operation?
Once the alveolar bone graft operation is finished you will be taken to another room with a
nurse in. You will be woken up in this room.
When you wake up you will probably still feel very sleepy. Most people do not even
remember this bit of being in the hospital!
When you have woken up your parents and carers will come to see you and your nurse will
take you back to your room on Ward 11.
What will I look like when I wake up?
Your face might look a bit swollen. You will have some stitches in your mouth but they will
dissolve and disappear over a few weeks so you do not need to have them taken out.
There will be a very thin tube coming out of your hip that is attached to something that looks
a little bit like a small balloon.
The balloon has “pain busting” medicine in it and the tube gives you the medicine straight
into your hip to stop your hip from hurting.
The tube will be taken out before you go home. There will also be a plaster on your hip- if you get it wet it must be carefully dried with a hairdryer. During the operation your hip will be wiped with an orange liquid to make it very
clean. You might be able to see some of this orange liquid on your hip and legs when you wake up.
You might be given some other medicines if you need them. After your operation you won’t
be able to get out of bed until the next day. This means that when you need the toilet
someone will help you in your room.
You may have a brace on your teeth to keep your new bone graft secure. If you do have a
brace this will stay on for about six months
Will the operation hurt? What will it feel like?
You will be given medicine to stop your mouth and hip hurting. If it does hurt, tell a doctor or
nurse and they will help you. Sometimes children are sick after their operation. This is usually because some blood has
got into their tummy during the operation. This does not harm you.
What are the possible risks of having an alveolar bone graft?
As with all operations there are risk associated. Some of the rare side effects of having an
ABG could be bleeding, infection, scarring, numbness around the hip, abdominal injury (very
small risk) and failure of the bone graft.
When can I eat and drink after the operation?
As long as you are not feeling sick you can eat as soon as you want to after the operation,
but you must only eat soft or sloppy food. After having food you must rinse your mouth out
with water to keep it clean.
You will only be able to eat soft food for a few weeks after the operation; that means you
cannot eat anything sharp or pointy like chips or crisps.
When can I go home?
As long as the doctor thinks you are well enough and you do not feel sick or have a
temperature then you can go home two or three days after your operation.
How do I take care of myself after my Alveolar Bone Graft operation?
You need to look after your mouth and hip carefully. You will be given a pack with some
things that will help you to look after your teeth and mouth. Your pack will include:
A soft toothbrush – For 2 to 3 weeks you should brush all of your top teeth and
gums very carefully using the soft toothbrush. You can use your normal
toothbrush on your bottom teeth.
Mouthwash and syringe – Use the syringe to rinse mouthwash around your
whole mouth twice a day for up two to three weeks.
You will also have an appointment with your specialist nurse 7 to 10 days after your
operation.
Will I look different after the operation?
You will have a scar on your hip. This is usually about 4-6cm long.
Once the swelling in your face has gone down you probably won’t notice any difference in
how your face looks after your operation. However, as you grow bigger your Alveolar Bone
Graft will help to keep your teeth and nose in the best possible position.
When can I go back to school?
Once we are happy with your recovery, you can go back to school three weeks after your
operation.
When can I go back to playing sport?
You will need to have two to three months off doing PE and playing sport. The length of time off depends a little bit on the activity you are doing, talk to your doctor about how long you will need off sport.
Will I have to come back to the hospital?
About three months after the operation you will need to come back to the Royal Victoria Infirmary or go to a clinic nearer where you live so that the doctor can check that your gum and your hip are healing well.
After six months you will see the orthodontist who will arrange a scan or an x-ray of your mouth to check that the piece of bone from your hip has fitted into the gap in your gum properly.
You will usually have your brace taken off about six months after your operation.
What should I do if I have any questions or worries?
It is normal to feel a bit worried about having an operation – but there are lots of people who
can help!
If you have any worries then talk to your parents and carers. Sometimes people have lots of
questions about having an operation or about having braces. There is a special page in this
leaflet where you can write down any questions or worries that you have. You can talk to
your parents and carers about these.
Question and worries:
Use a piece of paper to write down any questions or worries that you have about having an
alveolar bone graft operation. Talk to your parents and carers about these questions and
worries.
Contact details
The Cleft Psychology team is also available to help support you and your family. The team can help you feel ready to have the Alveolar Bone Graft operation and can help you with any worries that you might have.
Your parents and carers can contact the cleft team on 0191 282 0195 (Monday-Friday 9am to 5pm) if they want to discuss any questions or worries. PALS (Patient Advice and Liaison Service) for help, advice and information about NHS services.
You can contact them on freephone 0800 032 02 02, email northoftynepals@nhct.nhs.uk or text to 0167 051 1098
