Oral maxillo-facial, head and neck service

Homerton’s Oral Maxillofacial Head and Neck Service diagnoses and treats conditions affecting the face, neck, mouth, and jaws. It is a unique speciality as it requires a dual qualification in both medicine and dentistry. 

Our oral and maxillofacial surgeons diagnose and treat many conditions, for example:

  • head and neck cancers, including skin cancers in the head and neck area
  • salivary gland diseases
  • facial deformities, facial pain
  • impacted teeth
  • cysts and oral problems such as mouth ulcers and infections
  • jaw joint disorders, tumours and fractures

For more detailed information Homerton’s cancer head and neck services, see our webpage here: Homerton Head and Neck cancer services

Our team

Mr Leo Cheng
Consultant Oral, Maxillofacial, Head & Neck Surgeon
LLM, BDS, MBChB, FRCS, FDSRCS, FRCS (Oral MaxFac), FHEA

Ms Ishita Basu
Consultant in Oral and Maxillofacial Surgery, Head & Neck Surgeon
 BDS, MBBS, MFDS, MRCS, MSc, FRCS (OMFS)

Mr Will Rodgers
 Consultant in Oral and Maxillofacial Surgery, Head & Neck Surgeon
 FRCS (OMFS), MD (Res)

Mr Sukhpreet Dubb
 Consultant in Oral and Maxillofacial Surgery, Head & Neck Surgeon
 MBBS (Hons), BSc (Hons), BDS (Hons), FRCS (OMFS)

Dr Enamul Ali
 Associate specialist in Oral and Maxillofacial Surgery

Speciality doctors in Oral and Maxillofacial Surgery

Dr Rifat Qureshi

Dr Don Abraham

Dr Helen Al-Nakishbandi

Dr Maisie Owen-Johnstone

Team secretaries

Demetri Horsford
Tel: 020 8510 5209

Suzette Williams
Tel: 020 8510 5518

Dept email: huh-tr.maxfacsmedsec@nhs.net

Referral process for GPs and Dentists

All referrals from GPs should be made via the e-Referrals Service here: e-RS

Referral Quick View Summary

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Referrals from GPs

Urgent Suspected Cancer

  • complete the current version of Head & Neck Pan-London Urgent Suspected Cancer form, attach any supporting documents, including clinical photos, if available
  • select 'Urgent Suspected Cancer - Head & Neck RAS' on e-RS * and submit
  • clinical specialist will review and book appointment

Routine

select routine oral and maxillofacial on e-RS *
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Referrals from Dentists

Urgent Suspected Cancer

Routine

  • please note, we do not accept referrals for periodontal disease, endodontics, restorative and prosthodontic treatments.

Waiting times

The average waiting time for the maxillo-facial outpatient clinics is:

  • for cancer cases up to 2 weeks
  • for routine appointments is up to 18 weeks.

 

Urgent Suspected Cancer Referral Guidance

All urgent suspected head and neck cancer referrals are triaged by a clinical nurse specialist. For referral forms, criteria, and general guidance, see  NHS England — London » Urgent Cancer Referrals . Further information on the referral process is available for GPs and other healthcare professionals here: Homerton Urgent Cancer referrals. This includes referral pathways, procedures, preparations, our appointment letters and patient information leaflets.

Please ensure your referrals meet the NG12 guidelines, as detailed in the Pan-London urgent suspected cancer form. If we do not think a referral meets the criteria, we will ask the referrer to either give more details or withdraw the referral.

To help us quickly rule out cancer in benign lesions and prioritise urgent cases, we deliver a One Stop Oral Biopsy clinic. We strongly encourage you to attach clinical photos of lesions with your referral documents. Please inform your patients to be prepared for possible same day biopsy under local anaesthetic. 

GPs should refer head and neck lumps to the Urgent Suspected Cancer pathway. These cases will be managed by Oral Maxillofacial Head and Neck surgical team.

Dentists who spot a suspicious neck lump on a patient can refer directly to our urgent suspected cancer pathway. You do not need to refer the patient back to their GP for them to refer to us.

If any clinician refers a patient for a suspicious neck lump, please inform them they may receive an appointment for ultrasound scan with fine needle aspiration (FNA) within a few days of the referral.     

Routine Referral Guidance

The Homerton Maxillofacial Surgery Department is committed to providing specialist oral surgery services to patients requiring complex care. We do not cover periodontal disease, endodontics, restorative and prosthodontic treatments.

Our routine outpatient services include:

  • Head & Neck Lump Clinic
  • Maxillo Facial, Head & Neck Surgery
  • Oral & Denteolveolar Service.

We have noted an increase in inappropriate Tier 1 referrals for simple extractions that should be managed in primary care. As per NHS England guidance, the General Dental Services (GDS) contract and Personal Dental Services (PDS), expects primary care dentists to carry out extractions of teeth and retained roots that fall within their area of competence. The patient should ONLY be referred if they present with special difficulties that lie outside the competence of a general dental practitioner.

We Do Not Accept (Tier 1 Procedures):

  • extractions of fully erupted teeth with favourable root formation
  • simple retained roots that are accessible
  • routine extractions in medically fit patients (ASA I-II)
  • third molars that are fully erupted and not in close proximity to the inferior dental canal

 

We Do Accept:

  • s urgical Orthodontic dental extractions including expose and bond procedures. Referrals must include original treatment plan with letter from the orthodontist.
  • failed extractions with documented attempt (please send post-extraction radiograph)
  • patients with severe dental anxiety requiring sedation/GA (with completed anxiety assessment)
  • teeth with abnormal root morphology (demonstrated radiographically)
  • impacted teeth requiring bone removal and surgical division
  • teeth with significant cystic changes requiring histological analysis
  • extractions with high risk of damage to anatomical structures
  • patients with severe medical complications as outlined in guidelines13

 All referrals from dentists must include high-quality radiographs showing the entire tooth. Failure to include these may result in rejection and delay in patient care.

If you feel unable to perform a procedure that is within the scope of general practice, please consider:

  • seeking support from colleagues within your practice
  • attending continuing professional development courses to improve skills
  • contacting our department by telephone for advice before referring

Please consider referral to IMOS/ Community dental services for the following:

  • failed extractions with documented attempt (please send post-extraction radiograph)
  • ASA1/2 patients with severe dental anxiety requiring sedation (with completed anxiety assessment)
  • teeth with abnormal root morphology (demonstrated radiographically)

For further information on improving extraction skills, Health Education England provides regular hands-on courses for dentists.

Inappropriate referrals to our routine clinics will be rejected and returned to the referring practitioner. Thank you for your understanding and cooperation in improving the oral surgery care pathway.

Oral and Maxillofacial Services at Homerton Hospital

Oral and maxillofacial cancers

We work in partnership with the Royal London Hospital Head and Neck Cancer team, following the NICE guidance of a multidisciplinary approach. This is when a group of clinical specialists meet to discuss your care

All suspected cancer cases are discussed in the multidisciplinary team meeting. Further specialised investigations may be required urgently to help with treatment planning. The tests may include:

  • CT scan
  • MRI scanning
  • Biopsy.

Head and Neck Lumps

If your GP or dentist asked us to check a neck lump, we will meet you in clinic to carry out a clinical assessment. A consultant radiologist will then give you an ultrasound guided fine needle aspiration (FNA). This is a thin hollow needle that extracts a small sample of tissue of fluid. After, we will meet you to discuss the results of the FNA. If you need further treatment, we will agree a personal treatment plan with you and arrange a follow up appointment to take place after 5 to 10 days.

Most neck lumps are not cancer. However, if we are not sure, we investigate neck lumps as part of our Urgent Suspected Cancer Pathway . This means, if they do turn out to be cancer, we can treat you quickly.  

For more information about how we investigate and treat head and neck cancers, please see here: Homerton Head and Neck cancer services 

Routine (Non-Cancer) Oral and Maxillofacial Conditions

Our service diagnoses, treats and manages several conditions, including:

  • problems in the lining of the mouth such as ulcers, lichen planus and thrush.
  • salivary gland disease, such as inflammatory diseases and benign and malignant tumours.
  • surgery for benign and malignant lesions. We have combined dermatology-maxillofacial clinics to manage skin cancer referrals under a multi-disciplinary approach.
  • facial pain - diagnosis and initial treatment).
  • dentoalveolar surgery (on the tooth-bearing part of the jaws). This includes impacted teeth, complex tooth extractions, cysts and lesions of the lining of the mouth and management of dental infection. We give priority to patients who need surgical extraction of teeth, including wisdom teeth, and more complex dentoalveolar problems such as cysts and other types of jaw pathology. Treatment is carried out under local anaesthetic and intravenous sedation. If necessary, we will give a general anaesthetic.

Appointments

Where to come for the neck lump/oral and maxillofacial surgery outpatient appointment

You will get a text message and sometimes a letter inviting you to come to the outpatients’ department. This is situated on the ground floor near the main entrance to the hospital.

Patients under 16 years of age are seen in the Starlight ward. This is next to the Fertility department.

Clinic times

Please allow a minimum 2-3 hours for your appointment.

What to expect in this clinic

Your letter or text message gives you details about your appointment and how to prepare. You may also get a phone call from a nurse or a doctor.

If you need treatment for cancer, Homerton Hospital carries out thyroid surgery. Radiotherapy, chemotherapies and other surgeries are carried out at our partner organisations (usually Barts Health NHS Trust and University College London NHS Trust). We have more details about cancer treatments here: Homerton Head and Neck cancer services

How to contact us

Your letter or text message will give you our contact details. Sometimes we will phone you to confirm your appointment.

To change or cancel an appointment in our department, please contact the central booking team on: huh-tr.Centralbookingsreferrals@nhs.net  0208-510-5544

If you are being investigated for cancer, you can contact us on: huh-tr.Cancerreferrals@nhs.net / 020 8510 5099.