Referrals Patient Information Leaflets
The Maxillofacial Unit is a supra-district specialty serving
the catchment population of Bradford and Airedale, of approximately
600,000.
The aim of the unit is to continue to provide a high quality service
in Oral and Maxillofacial Surgery, responsive to the needs of
the population of the district.
The service aims to be:
The key purpose of the unit is to identify needs of patients referred to it. The Unit also takes an active part in the provision of in-service training for dental and medical practitioners and students and ancillary workers. It also provides post-graduate training for hospital trainees.
The Out-patient Unit is situated in the new Horton Wing at
St. Luke's Hospital but clinics are also held at Airedale General
Hospital.
The clinical staff consists of two Consultants, Mr M J Carroll
and Mr S F Worrall (shared with Airedale), one Associate Specialist,
Miss D Keshani. There are four Senior House Officers, one of whom
is shared with Halifax and two part time Hospital Practitioners.
There is a consultant on-call rota which includes Mr P D Cannon
from Huddersfield and Mr J A H Jones from Halifax. The unit treats
approximately 2,500 in-patients and day cases annually.
The clinical staff provide an emergency on-call service via the
Unit in Bradford. "Out-of-hours" acute cases for Bradford,
Halifax, Dewsbury and Airedale are treated at Bradford Royal Infirmary.
There are three day case lists at St Luke's. The more major surgery
is carried out at the Bradford Royal Infirmary where there are
two operating lists a week. Out-patient and day-case facilities
also exist at Airedale General Hospital. In-patient facilities
are limited at Airedale and as the on-call resident staff are
based in Bradford, any cases requiring specialised surgery, nursing
care or prolonged in-patient care are transferred to Bradford.
Maxillofacial surgery is a branch of surgery which deals with the diagnosis and treatment of diseases, injuries and defects of the mouth, jaws and face. This treatment includes:
1. Management of Maxillofacial Trauma
The maxillofacial unit treats approximately 360 cases of facial
trauma a year. Of these, approximately half require admission
and treatment in theatre under general anaesthetic.
2. Dento-alveolar surgery
This is surgery of the tooth bearing part of the jaws including
impacted teeth, cysts and lesions of the oral mucous membranes.
3. Head and neck cancer
In Bradford we have a combined approach to head and neck cancer
according to Calman principles. Combined clinics are held fortnightly
with Maxillofacial surgery, Plastic surgery, ENT surgery, Radiotherapy,
Radiology, Histopathology and Mcmillan Nurse input.
Following assessment and treatment planing, patients are treated
as appropriate. Radiotherapy is provided at the regional centre
at Cookridge Hospital, where indicated.
4. Orthognathic surgery
This involves correction of oro-facial anomalies. Treatment planning
is carried out in conjunction with our Orthodontic colleagues
who prepare the dental arches prior to surgery.
5. Cleft lip and palate surgery
Management of cleft lip and palate patients follows the established
international protocol. Primary cleft treatment is performed by
the Plastic surgeon. Secondary bone-grafting of the cleft and
subsequent orthognathic surgery is performed by the Maxillofacial
team. We treat all of the cleft patients from Bradford, Airedale,
Halifax and Huddersfield.
6. Implants
Intra-osseous titanium implants are placed within the bone of
the jaws and after a period of time become integrated with bone.
These can then be used to support removable or fixed prostheses.
Priority is given to patients who have suffered loss of tissue
as a result of trauma or tumour surgery etc. We have also developed
the use of extra-oral implants to carry prosthetic ears and bone
anchored hearing aids.
7. Temporo-mandibular joints
Treatment, including surgery for disorders of the TM Joints. Most
patients are seen on an out-patient basis in the Maxillofacial
Unit, but extensive surgery under general anaesthesia is sometimes
required.
8. Oral medicine
The diagnosis and medical treatment of a wide range of conditions
of the oral mucosa is carried out in the department.
9. Facial pain
A service for the diagnosis and treatment of facial pain is provided.
10. Medical problems Management of medically compromised patients requiring dental surgery. This is an expanding area with the increase in long-term management of cardiac patients (eg on anticoagulants etc), transplants and immuno-compromised patients etc. 11. Out-patient services These are provided in the Maxillofacial Unit, based at the Horton Wing of St Luke's Hospital. There are approximately 10,000 out-patient attendances annually. Referrals come from general dental and medical practitioners, other hospital consultants, the Accident and Emergency departments of Bradford, Airedale, Halifax, Huddersfield and Dewsbury Hospitals. Day case surgical procedures are also performed in the Unit under local anasthaesia or with sedation.
The Unit has an active educational programme with weekly journal
clubs. Monthly clinical governance meetings are held which are
attended by junior and nursing staff. There is active participation
in audit, at local, regional and national levels.
Departmental meetings attended by all staff are held regularly
to maintain good communication and disseminate information.
Undergraduate dental students are accepted for their electives
and school leavers interested in either a medical or dental career
are also accepted for "work experience".
Postgraduate teaching in the form of lectures and "hands-on"
participation courses are also organised for general dental and
medical practitioners.
1 Consultant maxillofacial surgeon. Full time. 1 Consultant maxillofacial surgeon. Full time with sessions at Airedale General Hospital. 1 Associate Specialist in Maxillofacial Surgery. Full time. 1 Consultant in Restorative Dentistry. Part time shared with Wakefield. 4 Senior House Officers. 1 shared with Halifax. 3 Hospital Practitioners. Part time. 2 at Bradford (three sessions), 1 at Airedale (2 sessions). 1 clinical assistant. 1 session at Airedale. 1 Hygienist part time shared with orthodontics. 4 Registered dental nurses. Full time. 1 based at Airedale. 5 Registered dental nurses. Part time. 1 based at Airedale. 1 Chief maxillofacial technician. Full time. 1 Senior maxillofacial technician. Full time. 1 Maxillofacial technician. Full time. 3 Secretaries. 2 full time at Bradford, 1 part time at Airedale. 2 Receptionists. 1 full time and 1 part time, both at Bradford.
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The aim of the Department of Orthodontics is to provide a high quality orthodontic service, providing orthodontic advice for any patient referred to the Department and to provide specialist orthodontic treatment for those patients with severe and/or handicapping malocclusions.
The Hospital Orthodontic Services in Bradford are provided on an outpatient basis in a purpose designed unit in the Horton Wing of St Luke's Hospital, Bradford. The Department is adjacent to the Department of Oral and Maxillofacial Surgery and Restorative Dentistry, and close to other outpatient services.
Most referrals to the service are made by General Dental Practitioners and Community Dental Officers, along with the Consultants in Oral & Maxillofacial Surgery, Plastic Surgery and Restorative Dentistry. Patients are also referred by other Hospital Consultants including Paediatrics and ENT, General Medical Practitioners, Specialist Orthodontic Practitioners and transfer cases from other Hospital Orthodontic Departments.
In addition to providing advice, the Department also provides treatment for patients with handicapping malocclusions and/or those requiring interdisciplinary care with other specialities. A full range of fixed, functional and removable appliance techniques are offered.
Regular joint clinics are held with Plastic Surgery and with Oral and Maxillofacial Surgery. Patients are also seen jointly with the Consultant in Restorative Dentistry.
Babies born with a cleft lip and/or palate and/or other facial deformity are seen as soon as possible after birth on the ward. Then subsequent follow up and treatment is provided on a multidisciplinary basis, involving Plastic Surgery, Maxillofacial Surgery, Speech and Language Therapy, a specialised Health Visitor, Paediatric Dentistry and ENT Surgery. Regular multi-disciplinary clinics are held in the Orthodontic Department.
Consultant Orthodontist (1). Full time with sessions also at Airedale General Hospital and Leeds Dental Institute. Consultant Orthodontist (2). Full time with sessions also at Airedale General Hospital, Honorary Consultant/Lecturer. Part time 2 sessions per week (based at Leeds Dental Institute). 2 Registrars. Part-time (total of 4 sessions) 2 Trust Orthodontists. Part-time (total of 2 sessions) 2 Clinical Assistants. Part time (1 session each per fortnight) 1 Hygienist. Part-time shared with Oral Surgery 1 Chief Orthodontic technician. Full time 1 Technician. Full time 1 Assistant Technical Officer. Part time 2 Registered Dental Nurses. Full time 2 Registered Dental Nurses. Part time 2 Receptionists. Part time 2 Secretaries. Part time
The Orthodontic Consultants are involved in Postgraduate teaching of junior hospital staff, General Dental Practitioners, both at the chairside and in the form of courses, lectures and seminars. The Department takes an active role in clinical research and clinical governance.
Audit/Clinical Governance
All clinical Staff actively participate in orthodontic audit,
locally, regionally and nationally. Clinical governance meetings
are held monthly. Emphasis is given to clinical effectiveness.
Regular Departmental Meetings are held to improve communication, patient care and to disseminate the results of audit.