An Oral and Maxillofacial Surgeon (OMS) is the surgical specialist of the dental profession, trained to treat conditions affecting the head, neck, face, jaws, and the hard and soft tissues of the oral and maxillofacial region. Oral and Maxillofacial Surgery is a recognized dental specialty that bridges the gap between dentistry and medicine. It focuses on both the functional and aesthetic aspects of the facial structure. The OMS doctor’s extensive education and hospital-based surgical training equip them to handle complex defects, diseases, and injuries. They manage surgical problems that extend beyond the scope of general dentistry, often collaborating with other medical and dental specialists.
Defining the Scope of Practice
The clinical practice of an OMS encompasses a broad spectrum of procedures in the craniofacial region. Common referrals include dentoalveolar surgery, which involves complex extractions, such as the removal of impacted wisdom teeth, and pre-prosthetic surgery to prepare the mouth for dental devices. These surgeons also handle the placement of dental implants, including necessary bone grafting procedures to reconstruct and stabilize the jawbone following bone loss.
OMS doctors are trained in managing facial trauma, often serving on hospital trauma teams to treat fractures of the jaw, cheekbones, eye sockets (orbits), and nasal bones. They realign and fix broken bones and repair associated soft tissue lacerations to ensure proper function and cosmetic outcome. This focus also includes performing corrective jaw surgery, known as orthognathic surgery, to address irregularities in the jaw bones.
Orthognathic procedures realign the jaws and teeth, improving the patient’s ability to chew, speak, and breathe, and are often necessary for treating severe bite problems or sleep apnea. The OMS also diagnoses and surgically treats pathology within the maxillofacial region, including cysts, benign tumors, and malignant head and neck cancers. They manage temporomandibular joint (TMJ) disorders, which can involve complex surgical interventions for joint replacement or repair.
The Path to Becoming an OMS
The educational journey to become an OMS is rigorous, beginning with four years of undergraduate study and four years of dental school to earn a Doctor of Dental Surgery (DDS) or Doctor of Medicine in Dentistry (DMD) degree. This is followed by a hospital-based surgical residency program, which lasts a minimum of four years, though some programs extend to six years. During this residency, the trainee rotates through various medical services, including internal medicine, general surgery, emergency medicine, and anesthesiology, providing them with a broad medical foundation.
The longer, six-year residency track offers the option for the surgeon to earn a medical degree (MD) in addition to their dental degree. This dual-degree pathway provides comprehensive training and a deeper integration into the medical system. Following the completion of their residency, many OMS doctors pursue board certification through the American Board of Oral and Maxillofacial Surgery (ABOMS). This voluntary certification requires passing a rigorous examination and demonstrates a commitment to high standards of surgical practice.
Distinctions from General Dentistry and Surgery
The primary difference between an OMS and a general dentist lies in the extent of their post-doctoral training, particularly the hospital-based surgical residency. This specialized training provides OMS doctors with the ability to administer all levels of anesthesia, including deep sedation and general anesthesia, for office procedures. Training alongside medical residents and general surgeons allows them to manage complex medical patients and intricate surgical issues that a general dentist would refer out.
An OMS is frequently the only dental specialist granted full admitting and operating room privileges in hospitals, reflecting their capability to handle severe infections, facial trauma, and reconstructive cases. This hospital access places them at the intersection of dentistry and medicine, allowing them to treat conditions affecting the structural and functional integrity of the face. While plastic or ENT surgeons also operate in the head and neck region, the OMS maintains expertise in dental occlusion, or bite, which is essential for successful reconstructive surgery of the jaws and face.