Oral and maxillofacial surgeons are unique among dental specialists in a number of ways. After completing four years of dental school, they go on to spend another four years in a hospital-based residency program for surgery. There, these specialists undergo training alongside other medical residents in the techniques of emergency medicine, general surgery, and anesthesiology. In fact, they are the only health care specialists (aside from anesthesiologists) who can administer all levels of sedation, up to general anesthesia.
Oral and maxillofacial surgeons focus on treating problems related to the hard and soft tissues of the face, mouth, and jaws (the upper jaw, known as the maxilla). While they sometimes work in a hospital, their practices are more often located in comfortable office settings. You may be referred to one of these specialists by your general dentist for a complex tooth extraction. Or, your orthodontist may send you for an examination if he or she suspects a problem with the alignment of your jaws.
It isn’t necessary to have an oral and maxillofacial surgeon perform every type of oral surgery; many dentists are experts at the more common procedures, such as simple extractions. However, for complex treatments that may require more invasive procedures or deeper levels of sedation, these specialists may be recommended. What kinds of procedures are oral and maxillofacial surgeons well-suited to perform? Let’s look at a few.
Procedures Performed by Oral Surgeons
Tooth extraction
Tooth extractions are possibly the most common procedure that oral surgeons perform. Oral surgeons often receive referrals of patients when wisdom teeth become impacted—that is, when they form in a position where they can’t erupt or grow into the bite properly. Usually, they perform minor surgery to remove impacted wisdom teeth and generally recommend it even if the impacted teeth aren’t (yet) producing any symptoms. Fortunately, Oral surgeons routinely perform this procedure in the dental office using the techniques of sedation dentistry.
Orthognathic Surgery
Oral and maxillofacial surgeons sometimes perform Corrective Jaw (Orthognathic) Surgery when orthodontics alone is insufficient to correct a misaligned bite. In other cases, surgical treatment is necessary to repair congenital abnormalities (birth defects), or to treat severe orthodontic conditions, skeletal problems, and other disorders.
In this procedure, which oral and maxillofacial surgeons usually perform under general anesthesia, they reshape and reposition the bones of the face and jaw, as well as realign the jaws and teeth. They often work closely with orthodontists in planning and carrying out this type of surgery, which may be necessary when orthodontics alone can’t correct the problem.
Oral and maxillofacial surgeons perform cleft lip/palate surgery, a special type of surgery, to correct the changes in facial structure caused by this birth defect.
Reconstructive surgery
Reconstructive surgery may be necessary after a traumatic dental injury or facial trauma, which can result from an auto accident, a workplace injury, and many other causes. This surgery is also sometimes needed following the removal of a tumor or another operation. Oral and maxillofacial surgeons specialize in repairing and reconstructing facial structures, and are adept at working with both hard and soft tissues.
Cosmetic work
These specialists can also set a solid foundation for cosmetic and restorative dental work, including the placement of dental implants, the system of tooth replacement preferred by many patients. Depending on the condition of the jaw, oral and maxillofacial surgeons may require bone grafting procedures to ensure proper placement of the implants in the jaw. When dentures are the chosen tooth replacement method, oral surgeons can smooth and reshape alveolar (jaw) bone as needed, to ensure a comfortable fit in the mouth.
Other consultations
In addition to performing these common procedures, oral and maxillofacial surgeons may actively consult on cases of obstructive sleep apnea, facial pain and infection, biopsies and removal of lesions, as well as the diagnosis and treatment of some oral cancers. These specialists bring extensive clinical experience to their patients, offering help when they need it most.
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