Jaw Cysts

A cyst is a sack or pouch which forms within tissues and contains fluid. This cyst is not a cancerous growth.
Cysts can develop in many places in the body. Around the face and mouth they can develop under the skin, under the mouth lining, within the saliva glands, and within the jawbones.

There are several different types of cysts within the jawbones. The commonest type is called a periapical cyst. These develop around the roots of teeth usually as a result of a chronic infection. Other cysts can develop around an uninterrupted tooth such as a wisdom tooth. These are called dentigerous cysts. The final common group of jaw cysts develop from cells that form teeth. These are known as odontogenic cysts.

Jaw cysts grow very slowly and in the vast majority of cases patients do not have any symptoms. They are often discovered as an incidental finding when x-rays are taken to look for other things. If the cyst becomes infected they can become painful. Cysts can grow very large and can cause damage to adjacent teeth which can become loose. Very large cysts can also expand the jaw and very occasionally can be so big that they can weaken the jaw leading to a fracture.

What will happen at the consultation?

The consultation is a very important part of the treatment, it is an opportunity to meet the consultant and team that will be looking after you. Following an examination and x-rays the consultant will be able to establish a diagnosis. Sometimes when cysts are large or close to other structures it may be necessary to obtain a CT scan which gives a 3-D view and aids the surgery. The consultant will explain what the surgery will entail and what to expect afterwards.

How are jaw cysts removed?

The treatment for cysts is to remove them. This is done by a small incision inside the mouth and removal of part of the bone. Occasionally when cysts are very large it is possible to treat them by surgical decompression. Following the surgery the cyst is sent to a specialist pathologist for examination under a microscope to confirm the diagnosis.

What type of anaesthetic will be used?

Your consultant will discuss the type of anaesthetic appropriate to your case, taking into account your general health and your previous experiences of having dental treatment. In many cases treatment can be carried out under local anaesthetic with you awake, but your teeth and jaw will be numbed. You may be advised or wish to have the procedure undertaken under a general anaesthetic. This will involve admission to hospital, usually as a day case, and means you will be asleep during the procedure.

Preparing to have your Jaw Cyst removed

Your consultant will explain how to prepare for your procedure. For example, if you smoke, you will be advised to stop as this significantly increases your risk of wound infection, slowing your recovery. Some types of medication you take may also require special consideration.

If you are having a local anaesthetic then you can eat and drink as normal beforehand though we advise that you keep the meals light. Any medication you are taking can be continued unless you are specifically instructed otherwise. You can even drive to and from your appointment though it is usually best (and nice) to bring a friend or relative with you.

If you are having a general anaesthetic, you will be asked to follow fasting instructions, this means not eating or drinking for some hours prior to the procedure. You will be given specific instructions by the hospital prior to your admission date.

During your consultation the consultant will also explain any risks or complications that can arise from treatment and how they can best be avoided or managed. Your surgeon will give you ample opportunity to ask any questions you may have and ensure that you are happy for the procedure to go ahead. If you are then you will be asked to give your informed consent by signing a consent form detailing the procedure agreed and any specific complications discussed.

What happens after surgery?

You will need to rest until the main effects of the anaesthetic (local or general) have worn off. After a local anaesthetic you will usually be able to go home straight after the procedure has been carried out. It may take a while before the feeling comes back to your jaw so it is best to avoid eating or drinking during this period as you could easily bite your lip or cheek or burn yourself on something hot, as you will not have your normal protective pain reflexes.

If you had a general anaesthetic or sedation you will need to stay longer and arrange for someone to drive you home. You should also have a friend or relative stay with you for the first 24 hours in case you experience problems and need help.

Your consultant will give you advice about looking after your mouth when you go home and suitable pain medication and appropriate antibiotics or mouthwashes to take home. You may also be given a date for a follow-up appointment.

Dissolvable stitches will disappear on their own in seven to 10 days. Non-dissolvable stitches are removed around a week after surgery.

Recovery from your procedure

You should expect some discomfort. If you need them, you can take over-the-counter painkillers such as Paracetamol or Ibuprofen. Follow the instructions in the patient information leaflet that comes with your medicine and ask your pharmacist for advice. Do not take Aspirin because this can make any bleeding worse. Avoid any medication that you have a known or suspected allergy to.
Do not vigorously rinse out your mouth during the first 24 hours. After 24 hours you can rinse gently after meals with warm salt water (half a teaspoon of table salt dissolved in a glass of water).

You should brush your teeth as usual, but keep your toothbrush away from the healing wound for the first couple of days. 
To begin with, you should eat soft foods, gradually returning to your usual diet once your jaw feels more comfortable. You may have some facial swelling, bruising, pain or jaw stiffness for up to two weeks. These symptoms are usually at their worst for the first two or three days and then gradually improve.

Most people do not experience any significant problems after having their cyst removed. However contact your dentist, your GP, or us immediately if you develop any of the following symptoms:

• bleeding that does not stop after applying pressure
• difficulty in breathing or swallowing
• severe pain that is not helped by painkillers
• a high temperature
• increasing swelling

Risks & Complications

Jaw Cyst removal is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side effects and the risk of complications from this procedure. Most of these are the unwanted, but mostly temporary, effects of a successful treatment, for example feeling sick as a result of a general anaesthetic, swelling or bruising but can include more significant problems such as:

• Bleeding
• Infection
• Accidental damage to other teeth and your jaw during your operation
• Numbness in your lower lip or tongue, or changes to taste – this can be caused by nerve damage and there is a small chance that this could be permanent
• Jaw stiffness – it’s possible that you may not be able to open your mouth fully for a while.

The exact risks will differ for every person and some may be more specific to your case. This is why the initial consultation is so important, your consultant will be able to assess the risks for you and advise you accordingly. In summary, cyst removal is a common and safe procedure. Whilst it is natural to have some anxiety about having this done, careful assessment and removal by our experts will alleviate you of the problems you are having whilst minimising any risks to you.