Oral surgeons generally do not perform dental fillings, as this procedure falls outside their specialized scope of practice as surgical specialists. The Oral and Maxillofacial Surgeon (OMS) focuses on the diagnosis and surgical treatment of diseases, injuries, and defects of the head, neck, face, and jaws. While they are fully qualified dentists, their clinical work centers on surgical intervention rather than routine restorative care. A general dentist is the primary care provider for regular dental needs, including the restoration of decayed teeth.
Primary Focus of Oral and Maxillofacial Surgery
The specialized scope of an Oral and Maxillofacial Surgeon encompasses a broad range of surgical procedures, distinguishing them from other dental professionals. This surgical expertise is applied to the complex structures of the maxillofacial region, including the mouth, face, and jaws. Common procedures involve dento-alveolar surgery, such as the extraction of impacted wisdom teeth and complicated tooth removals that a general dentist would refer out.
OMS professionals are trained in managing facial trauma, providing reconstructive surgery for injuries like fractured facial bones and lacerations. They also perform corrective jaw surgery, known as orthognathic surgery, to address skeletal deformities and ensure proper alignment of the jawbones and teeth.
The placement of dental implants is another significant part of their practice, often involving advanced hard and soft tissue grafting. Furthermore, they surgically treat pathology, such as cysts and tumors of the jaw, and manage severe odontogenic infections. Their training also includes comprehensive instruction in the administration of all levels of anesthesia for complex surgical cases.
The Practitioner Who Performs Fillings
The professional responsible for performing dental fillings is the General Dentist, who serves as the primary care provider for routine oral health. This professional manages the majority of dental concerns, including preventive care, diagnosis, and non-surgical treatments. A filling is a restorative procedure foundational to a general dental practice.
The process begins with diagnosing dental caries, or decay, usually identified during an examination and X-rays. The general dentist prepares the tooth cavity by removing the decayed structure using specialized dental burs. The goal is to create a clean, structurally sound space ready for restoration.
Once the cavity is prepared, the general dentist places a restorative material to seal the tooth and prevent further bacterial invasion. Common materials include composite resin, a tooth-colored mixture, and dental amalgam, a mixture of metals.
Understanding Dental Specialization and Training
The division of labor between an Oral and Maxillofacial Surgeon and a General Dentist is rooted in their distinct educational pathways and specialized focus. All dental professionals first complete four years of dental school, earning either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. Upon graduation, a general dentist completes a licensure exam and begins practicing, focusing on a broad scope of restorative and preventive procedures.
To become an Oral and Maxillofacial Surgeon, the graduate must complete an additional four to six years of hospital-based surgical residency training. This intensive, post-doctoral program is focused exclusively on the surgical management of the craniofacial region, including rotations in internal medicine, general surgery, and anesthesiology. During this residency, the OMS trainee does not maintain the routine practice of restorative procedures.
This rigorous specialization results in a surgical expert who is highly proficient in complex operations. They are typically referred patients for surgical needs by the general dentist. The general dentist, by contrast, maintains the skills and equipment necessary for the high-volume, routine restorative work like fillings, which are not considered within the scope of an OMS’s surgical expertise.