Oral and Maxillofacial Surgery (OMS) is the surgical specialty of dentistry focused on diagnosing and treating conditions affecting the mouth, jaws, face, and neck. OMS encompasses a wide array of procedures, ranging from routine outpatient surgery to complex hospital-based reconstruction. Oral surgeons manage the entire craniomaxillofacial complex, treating diseases, injuries, and defects of both hard and soft tissues in this region. They restore function and aesthetics to the facial structures, which directly impacts a person’s ability to speak, eat, and breathe comfortably.
Professional Training and Scope
The path to becoming an Oral and Maxillofacial Surgeon requires candidates to first complete an accredited dental degree, earning either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD). This is followed by a hospital-based surgical residency program lasting four to six years. The training includes rotations in internal medicine, general surgery, and anesthesia, providing a deep foundation in medical and surgical principles.
Many programs offer a six-year track that integrates a Doctor of Medicine (MD) degree, making the oral surgeon a dual-degree professional. This extensive experience in a hospital setting allows them to safely provide deep intravenous sedation and general anesthesia for their patients. Upon completion of residency, surgeons can pursue voluntary board certification through the American Board of Oral and Maxillofacial Surgery (ABOMS).
Routine Surgical Procedures
Oral surgeons manage common procedures requiring specialized surgical skill and anesthesia capabilities unavailable in a general dental office. The most common procedure is the removal of impacted teeth, particularly the third molars, commonly known as wisdom teeth. These teeth often lack sufficient space to erupt properly, becoming trapped in the jawbone, which can lead to pain, infection, or damage to adjacent teeth.
They also handle complex surgical extractions for teeth that are severely decayed, fractured at the root, or for patients with complicating medical conditions. Minor surgical procedures like an oral biopsy are performed when abnormal tissue requires diagnosis by a pathologist. Additionally, they perform pre-prosthetic surgery, which involves reshaping the jawbone to ensure a stable and comfortable fit for dentures or other prosthetic devices.
Reconstructive and Implant Surgery
Oral surgeons specialize in the replacement of missing teeth using dental implants, which are titanium fixtures surgically placed into the jawbone. The success of this procedure relies on osseointegration, the biological process where the titanium post fuses directly with the surrounding bone tissue, creating a stable root replacement. Surgeons are trained to place single implants, multiple implants, or support full-arch restorations like “All-on-4” systems.
Achieving a stable foundation often requires rebuilding lost jawbone structure through bone grafting procedures. Grafting replaces missing volume caused by tooth extraction, periodontal disease, or trauma. Specialized techniques include socket preservation, where graft material is placed immediately after an extraction to maintain the bone’s dimension for future implant placement.
Another common procedure is the sinus lift, which adds bone to the upper jaw where the sinus cavity may be too close to support an implant. Graft material serves as a scaffold to stimulate new bone growth and can be sourced from:
- The patient’s own body (autograft)
- A human donor (allograft)
- Animal or synthetic materials (xenograft)
Addressing Facial and Jaw Conditions
Oral surgeons treat complex conditions affecting the face and jaws, often working in hospital trauma centers. They manage facial trauma, treating fractures of the jaw, cheekbones, and eye sockets resulting from accidents or injuries. The surgeon’s goal is to precisely realign the fractured bones using plates, screws, and wires to restore proper function and facial form.
They also perform corrective jaw surgery, known as orthognathic surgery, to address severe functional and aesthetic discrepancies in jaw alignment. This procedure is necessary when bite problems or facial asymmetry cannot be corrected by orthodontics alone, improving the patient’s ability to chew, speak, and breathe. Oral surgeons diagnose and surgically manage pathology, including the removal of cysts, tumors, and infections within the jawbone and oral cavity. They also treat complex temporomandibular joint (TMJ) disorders, ranging from non-surgical management to total joint replacement.