If there is a cleft of the gum then an operation to place some bone into the gap in the gum (alveolar bone grafting) may be needed to enable normal teeth development. This happens between 8-10 years of age.
What is an alveolar bone graft?
An alveolar bone graft (ABG) is surgery to repair a cleft of the gumline (alveolus). It uses bone from elsewhere in the body (usually the hip) to fill the gap in the gum.
Who is an alveolar bone graft for?
Some children born with a cleft lip have a gap in the their gum too. Your surgeon will tell you if they suspect this.
The operation might be offered from the age of 8 years and upwards, depending on how your child’s teeth are growing. The best time will be decided by the surgeon and the orthodontist (who will help to change the position of teeth using braces).
How do these operations help?
Your gum holds your teeth in the right place. Often children might have missing or extra teeth around the area of the cleft. This operation will fill the gap in the gum and keep the teeth in the right place.
What does the operation involve?
Your child will need to attend some pre-operative assessments at the hospital where you can ask any questions you might have. Your child will need to have an x-ray taken of their mouth before the operation.
Sometimes children need braces before the operation to move the teeth gently and slowly.
The operation uses bone from elsewhere in the body, usually the hip, to make it stronger. This small piece of bone is inserted into the gum to fill the gap. Your child will have a small scar on their hip.
Your child will need to stay in hospital for between 1-3 nights. A parent / carer can stay next to their bed.
Are there any risks/ side effects?
As with all surgical procedures there are risks involved.
- Very rarely bleeding may occur following the operation requiring urgent return to theatre. This occurs in fewer than 1 in 100 patients.
- There is also a small risk (less than 1 in 10 patients) of the wound breaking down as a result of infection. This may heal by itself. If not, another operation might be needed, usually several months later.
The surgeon will discuss these risks with you before the operation and answer any questions you might have.
What will happen next?
The team will talk to you about what foods your child can eat following the operation. Immediately afterwards, they should only eat very soft foods. They will also discuss how to clean their teeth and any other pre-operative care that is needed.
Your child will also have a sore hip after the operation and so care should be taken until this heals. Your child can go back to school 2 weeks after the operation. They will need to avoid contact sports, such as rugby or football and gymnastics for about 6 weeks.
Your child will need to attend a review appointment. This is so the surgeon can check that their gum and hip have healed.