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Plastic and Reconstructive Surgery

Alveolar Bone Grafts (Cleft Lip & Palate Surgery)

Contact: (0191) 282 0660 - Cleft Team or (0191) 282 5001 - Ward 1, RVI

IntroductionShow [+]Hide [-]

What is an alveolar bone graft (ABG)?

One of the jobs of your gum is to hold your teeth in the right place. For some people there is a gap in the gum and this means the gum can’t do its job properly. One way of helping the gum to work properly is to have an alveolar bone graft (ABG). Your gum is made from mucosa- the red outer bit- with bone inside.  An ABG is where a little bit of bone that is taken from your hip is put inside your gum to make it stronger.

What does it mean?

  • Alveolar is just another word for gum 
  • Bone is what will go into your gum
  • Graft is the name used when something is taken from one bit of the body and put into another.  A piece of bone from your hip will be put into your gum.

Why do I need to have an ABG?

The gap in your gum has been made bigger by wearing braces so that a small bit of bone taken from your hip can be put in your gum.  This is done to make your grown-up teeth as straight as possible and to give them a strong base so they don’t wobble about as they grow. It can help to support the base of your nose too. It is not an operation to make your face look different.

Before your procedureShow [+]Hide [-]

What will happen first?

You have probably been wearing braces for some time.  Now the gap is big enough in your gum, the brace you have been wearing will be changed by your Orthodontist for a smaller one which will hold your teeth nice and still for your operation.

When will I have my operation?

Once the orthodontist has moved your teeth and the gap in your gum is big enough, you will be ready for your operation.  For most people they have had their braces on for about a year, but sometimes it may take a bit longer.

Where will I have my operation?

You will have your operation in Newcastle at the Royal Victoria Infirmary.  You will stay on ward one which is a ward just for children and young people. 

Can my someone stay with me?

Yes one of your parents or carers will be able to stay with you in your own room.

What is it like on Ward One?

On Ward One you will have your own room with a TV and payphone.  There is also a play area for younger children and books, games and a Playstation for older children.  You can also bring a couple of your own toys or games if you like.

What should I bring with me?

You will need to bring your nightclothes, toiletries and maybe one or two of your favourite toys, books or magazines.

Why can’t I have anything to eat or drink before my operation?

It is really important not to eat or drink anything before your operation.  This is because it can make you really sick during or after your operation.  You will be told when you can have your last food and drink by one of the nurses on the ward.

What happens when I come to ward one?

When you come to ward one you will get settled into your room and meet a nurse who will be looking after you.  Sometimes someone will come and take swabs from inside your mouth.  These look like big cotton buds and it doesn’t hurt.  This is to make sure there are no germs in your mouth.

One of the doctors from Mr Hodgkinson’s team 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.  This is usually nothing to worry about.  The doctor and anaesthetist will decide. 

Sometimes you will have some blood taken. You might go for an x-ray, a scan or to see the orthodontist.

What happens on the day of my operation?

Before your operation Mr Hodgkinson (or sometimes one of his assistants) will come to see you.  He will talk to you and your parents or carers and ask them to sign the form that allows him to carry out the operation.  There is a space for you to sign if you would like. 

An anaesthetist will also visit you.  Anaesthetists are doctors who give medicine to make people sleep all the way through their operation.  If you are going to sleep by having a needle you will get Emla cream put on your hand so that you don’t feel the needle scratch.  Some people have a mask put on their nose and mouth to breathe special air that makes them fall asleep instead of a needle.  The doctor will talk to you about which you can have.

Can someone come to the napping (anaesthetic) room with me?

You will go to a different room when you are ready for your operation.  This is the napping room where you will have the special medicine or air to make you drift off to sleep.  One of your parents or carers can come with you. You can tell the doctor what sort of things you want to dream about.

During your procedureShow [+]Hide [-]

What is it like going to sleep for an operation?

When the medicine goes into your hand you will start to feel sleepy.  By the time you have told the doctor what you want to dream about, you will have fallen asleep. 

Some people go to sleep by having a mask on their face that gives them a special kind of air to breathe which makes them fall asleep.

It only takes a few minutes to fall fast asleep.

How long will I be asleep?

You will be asleep until your operation is finished.  This is different for everyone but usually takes around an hour and a half. When the operation is finished you will be taken into another room to wake up. 

After your procedureShow [+]Hide [-]

What will happen when I wake up?

When you wake up you will be in another room with a nurse.  You will probably still feel very sleepy and most people don’t even remember this bit.  When you have woken up your parents/carer will come to collect you and take you back to Ward One with your nurse.

What will I look like?

Your face might look a bit swollen and your hip will have a tiny tube coming out of it.  The tube gives you medicine to help stop your hip hurting until you go home.  There will be a little dressing blocking up your nostril on the side of your operation.  This will come out before you go home.  You might also have some other medicine if you need it.

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 on your hip and legs when you wake up.

You will have a little plaster on your hip - if you get it wet it must be carefully dried with a hairdryer.  You will have some stitches in your mouth but they will dissolve so you don’t need to have them taken out. 

After your operation you won’t be able to get out of bed until the next day.  This means that if you need the toilet someone will help you in your room.  You will have a brace on your teeth to keep your new bone graft secure.  This stays on for about six months.

Will it 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 who will be able to help.  Sometimes children are sick after their operation.  This is because some blood has got into their tummy during the operation.  This does not harm you.

When can I eat and drink?

You can usually have a drink straight after your operation as long as you are not feeling sick.  You will be able to eat very sloppy foods the next day.  After food you must rinse your mouth out with water to keep it clean.

When can I go home?

You can go home after two or three days as long as the Doctor thinks you are well enough and you do not feel sick or have a temperature.

What do I have to do at home?

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.  You should brush all your teeth very carefully using the very soft toothbrush in your pack.  The mouthwash and syringe in your pack should be used to rinse around your whole mouth twice a day.  You will only be able to eat soft food after the operation, so that means you cannot eat anything sharp or pointy like chips or crisps.

You probably won’t notice any difference in how your face looks after your operation but as you grow the ABG helps to keep your teeth and nose in the best possible position.

When can I go back to school?

You can go back to school three weeks after your operation if your doctor is happy with your recovery.

Will I have to come back to the hospital?

You will need to come back to the hospital or to the nearest available clinic about three months after your operation.  This is so Mr Hodgkinson can check your gum and hip have healed up.  You will also have a scan and x-ray to check that the piece of bone from your hip has fitted into the gap properly.  You will usually have your brace taken off about six months after your operation.

If we have any questions or worries what should we do?

  • You can telephone the cleft team on (0191) 282 0660 (Mon-Fri 9am-5pm)
  • You can telephone Ward One on (0191) 282 5001
  • You can talk to any member of the team in clinic
  • You can talk to your family doctor

This information was made with the help of a young person who has had an Alveolar Bone Graft.

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