An oral and maxillofacial surgeon (OMS) is a highly specialized surgical expert focusing on the entire craniomaxillofacial complex, which includes the mouth, jaws, face, and associated structures. This dental specialty requires a comprehensive understanding of both dentistry and medicine to diagnose and treat a wide array of conditions. The profession is defined by an extensive scope of work, ranging from routine dentoalveolar procedures to complex facial reconstructive surgery.
The Distinction from General Dentistry
Oral and maxillofacial surgery is a specialty requiring significantly more training than general dentistry. After completing four years of dental school, an oral surgeon must complete a surgical residency program lasting four to six years in a hospital setting. This rigorous, hospital-based training occurs alongside medical residents, providing experience in fields like general surgery, internal medicine, and anesthesia.
A general dentist focuses on primary dental care, such as fillings, cleanings, and simple extractions. The extended residency allows an OMS to manage complex surgical procedures involving the hard and soft tissues of the mouth, face, and jaws that a general dentist would refer out.
Routine Dentoalveolar Surgery
The most common procedures an oral surgeon performs are categorized as dentoalveolar surgery, which involves the teeth and the bone that supports them, known as the alveolar ridge. A frequent procedure is the removal of complicated or impacted teeth, most notably third molars, or wisdom teeth. These extractions often require the surgical removal of bone or sectioning of the tooth, benefiting from specialized surgical expertise.
Oral surgeons are also the primary providers for the surgical placement of dental implants, which are titanium posts inserted directly into the jawbone to replace tooth roots. This process frequently involves managing the underlying bone structure, such as performing bone grafting to create sufficient height and width for the implant. Preparing the jaw for dentures or other restorations, often called pre-prosthetic surgery, is another routine procedure that falls under bone preparation and recontouring.
Management of Facial and Jaw Conditions
Beyond routine dentoalveolar work, oral surgeons handle complex maxillofacial conditions. They perform corrective jaw surgery, known as orthognathic surgery, to treat severe skeletal discrepancies and correct functional issues like misaligned bites or temporomandibular joint (TMJ) disorders. These procedures involve carefully repositioning the upper jaw (maxilla), lower jaw (mandible), or both, often improving speech, chewing, and facial aesthetics.
Oral surgeons are also trained to manage facial trauma, treating fractures of the jaw, cheekbones, and eye sockets resulting from accidents or injuries. Their expertise extends to the diagnosis and excision of oral and maxillofacial pathology, including the removal of cysts, benign tumors, and certain malignant lesions found in the jawbones and soft tissues of the mouth. Surgical management for severe, non-responsive TMJ disorders, which can involve arthroscopy or open joint surgery, is another complex area of the OMS role.
Anesthesia and Hospital Practice
A primary element of the oral surgeon’s training is their education in patient safety and anesthesia administration. Oral surgeons are trained and licensed to administer various levels of sedation, including intravenous (IV) conscious sedation and general anesthesia, for procedures performed in an outpatient office setting. This rigorous training, typically completed within the hospital’s Anesthesia Department, covers airway management, intubation techniques, and Advanced Cardiac Life Support (ACLS).
Oral surgeons are often the only dental specialists granted full clinical privileges within a hospital setting, allowing them to admit patients and perform comprehensive procedures. Their ability to manage complex medical and surgical issues, including performing a history and physical examination, ensures they can treat emergency trauma cases and medically compromised patients. This makes them a part of the hospital’s medical staff, especially in emergency rooms where they treat severe facial injuries.