What is an Oral and Maxillofacial Surgeon (OMS)?
Oral and maxillofacial surgery, also referred to as oral surgery, ranges from straightforward extractions to surgical procedures associated with the teeth, soft tissues, and jaws. “Maxillofacial” refers to the face and jaw, while “oral” refers to the mouth.
Oral and maxillofacial surgeons are board-certified dental specialists. They perform minor and invasive procedures full-time at local private practices and hospitals.
Other types of dentists (e.g., cosmetic, general, pediatric, and family dentists) can also perform minor oral surgeries, such as extractions. They do not, however, perform invasive surgical procedures.
Depending on needs, you will either visit a non-specialized dentist or specialized maxillofacial surgeon to receive proper care. Common maxillofacial procedures include:
- Minimally invasive tooth extractions.
- Surgical removal of worn down or impacted teeth, wisdom teeth, and retained tooth roots.
- Biopsies, which are mostly used to diagnose and treat oral cancers. The procedure involves removing a tissue sample of abnormal cells for lab testing.
- Exposing impacted canine teeth for patients receiving orthodontic treatment.
- Surgery to fix jaw discrepancies, which is also referred to as orthognathic surgery.
- Cyst removal from the jaw, mouth, or facial region (such as the lips).
- Tumor removal from the jaw, mouth, or facial region (usually caused by oral or mouth cancer).
- Facial or jaw reconstruction following an injury or trauma-related issue.
- Cosmetic procedures, including rhinoplasty, facelifts, nose reconstruction, and otoplasty (ears that stick out too far).
Oral and maxillofacial surgeons require up to 15 years of schooling and training to become a qualified surgeon. In particular, this schooling includes two to four years of undergraduate study (BS or BA) and four years of dental study. They must also complete up to six years of residency training, including two additional years to receive a medical degree. Most maxillofacial surgeons have their own private practice. Although, some work at local dentist offices or hospitals full-time.
Types of Procedures
Maxillofacial surgeons offer many different types of procedures, such as implants and extractions. Patients typically require oral surgery due to accidental injury, trauma, disease, deformities, periodontal issues, dental caries, or tooth loss.
A local anesthetic is also used for all oral surgeries. Depending on the type of surgery, an oral surgeon may recommend combining the local anesthetic with conscious sedation or general anesthetic. Common surgeries include:
Wisdom Teeth Removal
Oral and maxillofacial surgeons have extensive training in wisdom teeth removal (third molars). They are certified to use deeper levels of sedation than general or non-specialized dentists. During the surgery, the surgeon administers an I.V. sedation for patients who prefer to sleep through the surgery. The extractions take 30 minutes or less to remove all four molars.
After a tooth extraction or tooth loss, your oral surgeon may recommend an implant, which replaces your permanent tooth. Dental implants are also known as artificial tooth roots. They are surgically implanted into a patient’s jawbone and support artificial teeth (dental crowns). Maxillofacial surgeons are dental implant experts. They are also qualified to use deeper levels of sedation than other dentists during this procedure.
Oral surgeons play a direct role in diagnosing, treating, and performing surgery on those with oral cancer, along with doctors and physicians. In short, oral cancer begins with the development of abnormal carcinoma cells and results in the growth of mouth sores (cancerous lesions). Oral cancer can develop in the mouth, cheeks, gums, tongue, lips, palate, sinuses, throat, or the mouth’s floor. Without early treatment, the diseases are life-threatening.
Reconstructive Surgery (Trauma)
Oral and maxillofacial surgeons also perform surgeries that correct facial bones, soft tissue problems caused by trauma or an injury, and jaw reconstruction. The surgeries restore the function and form of the patient’s natural features. They often require skin, nerve, or bone grafting from other parts of the patient’s body. In addition, the same skills are necessary for cosmetic procedures, which are elective surgeries that improve facial features from aging or trauma.
Temporomandibular Joint Dysfunction (TMD)
TMD is the most common temporomandibular joint and muscle disorder (TMJD). Patients with TMD may suffer from constant headaches, earaches, or pain when opening or closing their mouths. Lifestyle changes and custom mouthguards often relieve symptoms and pain over time. Although, for more serious cases of TMD, an oral surgeon performs an arthrocentesis surgery, which uses sterile fluid to wash out the TMJ.
Cleft Lip and Palate
Cleft lip and cleft palate are birth defects that form when a baby’s lips or mouth do not grow properly. The defect happens early during pregnancy. The lip and palate also develop separately, which means a cleft lip, palate, or both can occur. Surgery to repair the lip or palate takes place when a child is between 6 and 12 months old. Older patients can also benefit from surgery, but it is less common.
This type of surgery involves dental specialists from both maxillofacial surgery and orthodontics. Orthognathic translates to “straight jaws,” and combines orthodontic treatment with surgical intervention to correct jaw deformities and discrepancies. This may include correcting the position and size of the jaw or fixing severe malocclusion (incorrect bite) in patients who will not benefit from minor treatment alone, such as braces or clear aligners.
Sleep Apnea Surgery
Sleep apnea is a common sleep disorder that is caused by a blockage in the upper airway. Snoring, sleeplessness, and gasping for air are the primary symptoms of the disorder. Surgery is considered the “last resort” for those with obstructive sleep apnea. If a patient has a minor case of sleep apnea (obstructive), they typically do not need surgery.