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Services

Here are some of the services that Mr Smith specialises in treating at his private consulting rooms in Kettering and Northampton. The numbers in brackets are the OPCS codes which are sometimes useful to know if you need to talk to your private insurance companies representative.

Oral Surgery

Impacted wisdom teeth

A typical wisdom toothThird molars or “wisdom” teeth, are the most common tooth to be impacted (embedded) in the jaw bone. Cyst formation, recurring infection and dental decay commonly occur around these teeth which require surgical removal. Surgical removal can be carried out under a local anaesthetic (dental injection) or under a day case general anaesthetic. Impacted wisdom teeth are covered by private medical insurance and necessitate one day in hospital. Overnight stay is rarely required. Patients require 3-7 days off work following surgery under general anaesthesia.

Bill Smith has treated over 1000 patients privately for wisdom teeth (1500 impacted teeth) in Northamptonshire. Complication rates are below the reported average. He has published his data in peer reviewed journals (see link below*). Damage to the nerves of lip and tongue are rare, being lower than published data. Lip numbness after wisdom tooth removal is less than 1%. Tongue numbness is less than 0.1%. Bill Smith databases all patients undergoing treatment for the surgical removal of impacted wisdom teeth (OPCS code F0910).

* Smith W P (2012): The Relative Risk of Neurosensory Deficit following Removal of Mandibular Third Molar Teeth: the Influence of Radiography and Surgical Technique.
Click - view publication - to read the full paper (PDF document).

For more information please take a look at our 'Removal of Impacted Wisdom Teeth' information page by clicking on the link.


Facial skin cancer

Bill Smith specialises in the surgical management of facial skin cancer.

A typical Basal Cell Carcinoma (BCC)Facial skin cancer is of three principal types:

  1. Basal cell carcinoma (BCC) “rodent ulcer”
  2. Squamous cell carcinoma (SCC)
  3. Malignant melanoma

Patients requiring surgery for these facial skin lesions frequently require an immediate reconstructive procedure to not only provide an adequate removal but also achieve a good reconstruction and cosmetic result.

Bill Smith audits all facial skin cancer and to date has removed over 900 facial BCC's. Complete removal is reported in 96% of cases (personal database).


Orthognathic Surgery

What is Orthognathic Surgery?

Typical jaw movements during orthognathic surgeryThis is the surgical repositioning of one or both jaws to achieve a stable and balanced working occlusion (bite). It is carried out in cases where orthodontics alone can not provide a suitable or stable occlusion at end of treatment. Surgery can also improve a patients profile and give them greater self-confidence.

Where surgery has been recommended for you, you will find a highly motivated team of professionals doing their best to make the treatment outcome a successful one. The team will include:

  • Your general dentist - looking after your oral health
  • The Orthodontist - aligning your teeth
  • The Maxillofacial Surgeon - carrying out the surgery
  • The Maxillofacial Technologist - carrying out model planning and constructing appliances

If you would like to find out more about this type of treatment, please have a look at our 'Guide for Patients Undergoing Orthognathic Surgery' information page which we hope will answer some of your questions.


An x-ray of a dental implant supporting one toothDental implants

Dental implants involve the insertion of “fixtures” into the jaw bones which are used to support dentures, crowns or fixed bridges. They are extremely successful (95% success over 20 years) due to the process of osseo-integration. Osseo-integration is the term devised for the direct contact and healing between bone and the load-carrying dental implant/fixture.

Dental implants are placed into the jaw bones to replace missing teeth. Surgery can be carried out under local anaesthetic or general anaesthetic. The implant is allowed to integrate/heal to the jaw bone over a period of 2-6 months. Following a period of integration, a specialist in restorative dentistry, constructs a fixed crown, fixed bridge or a specialist denture.

Dental implants require adequate jaw bone. Where jaw bone does not exist an augmentation procedure may be required to increase the amount of bone to receive dental implants at a later date.

Bill Smith uses a variety of augmentation materials included the patients own bone but more frequently uses Bio-oss (an artificial bone with a good record in dental implant treatment). Bio-oss is placed in a region where a dental implant is required either under a local or general anaesthetic. Three to four months after the surgery, known as an alveolar bone graft (V1930), a dental implant is then inserted. Go to the Bio-oss website by clicking here.

Before single tooth replacement.Bill Smith works with specialists in restorative dentistry in both Northamptonshire, Leicestershire and Cambridgeshire to provide a comprehensive service.

Dental implants require adequate jaw bone. Where adequate bone does not exist, a bone graft may be required to allow the insertion of dental implants at a later date.


After single tooth replacement.Bill Smith uses the Astra Tech implant system which has an excellent and reliable record of success. Bill Smith has inserted over 1000 implants/fixtures with an overall success rate of 95% (personal database). To view an audit of Bill Smith's implant cases called - A series of 1000 implants (2014) - How successful are dental implants? - click here.

Patients who are interested in consultation and discussion are invited for an outpatient consultation at either the Three Shires Hospital or Woodland Hospital. Dental implant treatment is rarely covered under private medical insurance. Some dental insurance policies cover part of the cost

If you would like to know more about implant replacements, visit the pictorial guides by clicking on the following links:



Salivary Gland Problems

There are four main salivary glands:

  • Two submandibular glands
  • Two parotid glands

There are also multiple minor salivary glands. These occur under the lining of the mouth and throat.

Bill Smith provides a comprehensive service for salivary gland problems having published a definitive text in world-renowned chapters in surgical textbooks (see publications).

An example of a salivary gland swelling.Minor salivary glands

The commonest problem with the minor salivary gland is the development of a mucous retention cyst. This produces a translucent swelling usually on the lower lip. (photo right).

Management

Treatment involves removal under a local anaesthetic as an outpatient (F0200).

Typical submandibular gland swelling.Submandibular gland

The commonest problem with the Submandibular gland is the development of stones which cause blockage. This produces swelling of the gland under the jaw bone particularly at mealtimes. (photo right).

Management

Treatment involves removal of the stones, sometimes the removal of the gland (F5120) or sometimes removal of the gland and stone together (F4440) + (F5120).

See our information page on submandibular gland surgery.

Parotid gland

The commonest problems of the parotid glands are:

Parotid gland swelling in an adult.Parotid lumps

Most lumps are painless and slow growing with 95% of lumps being benign or non-cancerous.

Treatment is in the form of surgery to remove the lump by an operation called Parotidectomy (F4400). This involves an anaesthetic and two nights in hospital. (photo right).

See our information page on parotid gland surgery.

Parotid gland obstruction

This causes intermittent painful swelling of the gland particularly during mealtimes. It is often due to a stone in the gland or the duct system. Treatment involves antibiotics and stone removal if required but in many patients the problem resolves spontaneously. Occasionally investigation in the form of sialography is required to identify the obstruction.