A general dentist performs many routine procedures, but when a complex operation involving the face, mouth, or jaw is necessary, a specialist known as a dental surgeon is required. This term is often used by the public to describe a highly trained individual who performs complicated extractions or reconstructive work. The most official and recognized title for this type of practitioner is the Oral and Maxillofacial Surgeon, which covers a broad range of surgical expertise beyond the scope of general dentistry. This specific specialist focuses on treating injuries, diseases, and defects across the entire craniofacial region.
The Primary Surgical Specialist
The formal designation for the dental surgeon who handles the most extensive procedures is the Oral and Maxillofacial Surgeon, frequently abbreviated as OMFS. This specialty is the only one in dentistry recognized as a surgical specialty by the American Dental Association, emphasizing its unique focus on complex operations. Oral and Maxillofacial Surgeons are the experts in the diagnosis and surgical management of problems affecting the mouth, teeth, jaws, and face. Their training encompasses both dental and medical principles, positioning them at the intersection of medicine and dentistry. While the formal title is lengthy, many simply refer to this specialist as an “Oral Surgeon.”
The scope of an Oral and Maxillofacial Surgeon is comprehensive, extending far beyond the teeth themselves to include the entire supporting facial skeleton and soft tissues. They manage a diverse range of conditions, from common dental issues to severe facial trauma and congenital defects. The extensive nature of their training prepares them to handle procedures that require in-depth knowledge of facial anatomy and surgical techniques. This broad mandate ensures they are the go-to specialist for any operation involving the hard and soft tissues of the lower face.
Procedures Beyond Simple Extractions
The work of an Oral and Maxillofacial Surgeon often begins where a general dentist’s capabilities end, involving procedures that require extensive hospital-based training. One of their most common procedures is the removal of impacted wisdom teeth, especially those that are deeply embedded in the jawbone. They are also highly skilled in the surgical placement of dental implants, often requiring bone grafting to rebuild insufficient jawbone structure before the implant can be secured.
OMFS specialists perform corrective jaw surgery, known as orthognathic surgery, to align the upper and lower jaws for functional and aesthetic reasons. They are also frequently the first responders for facial trauma, treating fractures of the jaw, cheekbone, and orbital bones after accidents. Furthermore, they are trained to diagnose and surgically remove cysts, tumors, and other pathology found within the jaw and oral cavity. These procedures highlight why their expertise is sought for complex issues throughout the head and neck region.
Other Dental Specialists Who Perform Surgery
While the Oral and Maxillofacial Surgeon is the primary surgical specialist, other dental specialists also perform specific, focused surgical procedures within their scope of practice. Periodontists are specialists who focus on the supporting structures of the teeth, including the gums and bone. They frequently perform surgical interventions like gum grafting to treat gum recession or pocket reduction surgery to manage advanced periodontal disease. Periodontists also use regenerative procedures, such as bone grafts, to restore bone lost due to gum disease.
Endodontists, who focus on the dental pulp and roots, also perform a specific type of surgery when a standard root canal treatment is not sufficient. The most common endodontic surgical procedure is an apicoectomy, which involves removing the tip of a tooth’s root and sealing the root canal from the end. This allows the specialist to access and treat infection that persists in the bone surrounding the root tip. These specialists’ surgical roles are highly specific to the tissues they treat, differentiating them from the broad scope of an OMFS.
The Path to Becoming a Specialist
The rigorous education required for an Oral and Maxillofacial Surgeon is what establishes their authority as a surgical specialist. The process begins with the completion of four years of dental school, earning either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. Following dental school, candidates must complete a hospital-based surgical residency program accredited by the Commission on Dental Accreditation.
This residency typically spans a minimum of four years, providing intensive training in general surgery, internal medicine, anesthesia, and emergency room procedures. A significant number of OMFS candidates pursue a six-year track that integrates medical school, resulting in a dual degree (DDS/MD or DMD/MD). This additional medical training enhances their understanding of systemic health and complex surgical environments. After completing their residency, many specialists seek board certification by passing a comprehensive examination process, which signifies the highest level of competence in the field.
Procedures Beyond Simple Extractions
OMFS practitioners regularly perform corrective jaw surgery, known as orthognathic surgery, to reposition the jaws for improved function and alignment. They are often called upon to treat facial trauma, repairing fractures of the cheekbone, eye socket, and lower and upper jaws. Furthermore, they diagnose and surgically remove cysts, tumors, and other pathology of the oral and maxillofacial structures. These procedures demonstrate their deep involvement in the treatment of the entire facial skeleton.
Other Dental Specialists Who Perform Surgery
While the Oral and Maxillofacial Surgeon covers the broadest surgical territory, other dental specialists also perform highly specific surgical procedures within their focused areas. Periodontists are specialists in the gums and the bone that supports the teeth, and they frequently perform surgical treatments for periodontal disease. These interventions include pocket reduction surgery, which cleans and reshapes the bone around the teeth, and gum grafting to cover exposed tooth roots. Periodontists are also trained to perform regenerative procedures using bone grafts to help rebuild lost supporting tissue.
Endodontists, who specialize in the pulp and roots of the teeth, also execute surgical procedures when root canal treatment fails to resolve an infection. A specific procedure they perform is an apicoectomy, which involves surgically accessing the root tip to remove the infected tissue and seal the end of the root. This specialized surgery is reserved for cases where traditional root canal access is not possible or adequate. These specialists’ surgical roles are highly focused on the specific dental structures they treat.
The Path to Becoming a Specialist
The path to becoming an Oral and Maxillofacial Surgeon is exceptionally rigorous, reflecting the complexity of their surgical practice. It begins with the completion of four years of dental school, resulting in a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. Following this, the candidate must enter a mandatory, full-time, hospital-based surgical residency program.
This residency is typically four to six years in length, involving rotations in general surgery, internal medicine, and anesthesia. A significant number of programs offer a six-year pathway that integrates a medical degree, resulting in a dual-degree qualification (DDS/MD or DMD/MD). This added medical training provides a deeper understanding of systemic conditions and complex surgical management. After residency, many pursue board certification, a voluntary status requiring a comprehensive examination that attests to their mastery of the specialty.