What is Oral and Maxillofacial Surgery?

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What is Oral and Maxillofacial Surgery (OMS)?

Oral and maxillofacial surgery, also referred to as oral surgery, ranges from simple tooth 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 within the maxillofacial region (mouth, face, and jaw). Oral surgeons typically work full-time at local private practices and hospitals.

Other types of dentists, like general and pediatric 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 oral and maxillofacial surgery 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 cancer. The procedure involves removing a tissue sample of abnormal cells for lab testing.
  • Exposing impacted canines to prepare for orthodontic treatment.
  • Surgery to fix jaw discrepancies, which is also referred to as orthognathic (jaw) 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.
  • Facial cosmetic surgeries, including rhinoplasty, facelifts, nose reconstruction, and otoplasty (ears that stick out too far).

Qualifications of Oral and Maxillofacial Surgeons

Oral and maxillofacial surgeons require up to 15 years of dental school and training to become a qualified surgeon. This schooling includes two to four years of undergraduate study (BS or BA) and four years of dental study.

Oral surgeons 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. Some work at local dentist offices or hospitals full-time.

Oral and maxillofacial surgeons have either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. They are considered the same dental degree by the American Dental Association (ADA).


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Types of Oral & Maxillofacial Surgeries

There are many different types of oral and maxillofacial surgeries, 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 surgical treatments 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, your surgeon will administer 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.

Dental Implants

After a tooth extraction or tooth loss, you may need a dental implant, which is an artificial tooth root that replaces your permanent tooth. During dental implant surgery, the restorations are surgically implanted into your jawbone. They create a sturdy base to support artificial teeth (dental crowns).

jaw with teeth and dental molar implant

However, if you have a lot of missing teeth, dentures may be recommended instead of dental implants.

Oral and maxillofacial surgeons are dental implant experts. They are also qualified to use general anesthesia and other deeper levels of sedation.

Oral Cancer

Oral surgeons play a direct role in diagnosing, treating, and performing surgery on those with oral cancer, along with doctors and physicians. 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, or the mouth’s floor. Neck cancer and esophageal cancer are also considered oral cancer. Without early treatment, the disease is life-threatening.

Reconstructive Jaw Surgery

Another type of oral and maxillofacial surgery is called reconstructive jaw surgery. It is used to correct facial trauma, fix soft tissue problems caused by an injury, and/or reconstruct the jaw.

Reconstructive surgery restores the function and form of a patient's natural features. These surgeries often require skin, nerve, or bone grafts from another part of the patient’s body. 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 typically 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. For serious cases of TMD, a dental 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.

complete unilateral cleft lip

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.

Orthognathic Surgery

Orthognathic (jaw) surgery involves both oral and maxillofacial surgery, as well as orthodontics. Orthognathic translates to “straight jaws,” and combines orthodontic treatment with surgical intervention to correct jaw deformities and discrepancies.

Jaw surgery 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.


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Resources

Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.

“OMS Procedures | AAOMS.” header__brand, www.aaoms.org/education-research/dental-students/oms-procedures.

Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.

Updated on: September 3, 2020
Author
Alyssa Hill
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Medically Reviewed: January 17, 2020
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Lara Coseo
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