What is Oral and Maxillofacial Surgery (OMS)?
Oral and maxillofacial surgery is also referred to as oral surgery and sometimes dentoalveolar surgery. Surgeries include simple tooth extractions and 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 your needs, you will either visit a non-specialized dentist or a specialized maxillofacial surgeon to receive proper care.
Common oral and maxillofacial surgeries 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 facial injuries or trauma-related issues.
- Facial cosmetic surgeries, including rhinoplasty, facelifts, nose reconstruction, eye socket 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 surgical training to become qualified surgeons. 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 training at a residency program. This includes 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).
When to See an Oral and Maxillofacial Surgeon
There are many different types of oral and maxillofacial surgeries, such as implants and extractions. Patients typically require oral surgery due to:
- Accidental injuries
- Periodontal issues
- Dental caries
- 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.
After a tooth extraction or tooth loss, you may need a dental implant. This 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).
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, Neck, or Head Cancer
Oral surgeons play a direct role in diagnosing, treating, and performing oral cancer surgery. Doctors and physicians also play a role. Oral cancer begins with the development of abnormal carcinoma cells. It 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, or corrective 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 grafting from another part of the patient’s body.
The same skills are necessary for cosmetic procedures. These 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 arthrocentesis.
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.
Craniofacial 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 (jaw) surgery involves both oral and maxillofacial surgery, as well as orthodontics.
Orthognathic translates to “straight jaw.” It combines orthodontic treatment with surgical intervention to correct jaw deformities and discrepancies.
Jaw surgery may include correcting the position and size of the jaw. It can also involve 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.
In addition to dental implants, oral surgeons perform many different types of cosmetic treatments.
Cosmetic procedures can change the shape/look of your face, improving your appearance and self-confidence. These surgeries are elective, which means they aren't covered by insurance.
Other Skeletal Discrepancies
Jaw misalignment is the most common skeletal discrepancy oral surgeons treat. In particular, if you have temporomandibular joint dysfunction (TMD), your dentist will likely refer you to a maxillofacial specialist for treatment.
Common TMJ surgeries include:
- Arthrocentesis is a surgical procedure that uses sterile fluid to wash out the TMJ. The goal of this surgery is to return the cartilage disc to its correct position. The surgeon also removes any debris inside the joint.
- Arthroscopies (“keyhole surgeries”) use a small telescope/camera to diagnose and treat TMD. During the procedure, an arthroscope is inserted into a small incision the surgeon makes in front of the ear. Then the surgeon removes any scar tissue around the joint to relieve pain and discomfort.
Maxillofacial Surgery FAQs
What is the difference between an oral surgeon and a maxillofacial surgeon?
These two terms are used interchangeably, however the technical term is "oral and maxillofacial surgeon." They are different from dental surgeons, who are general dentists. Oral and maxillofacial surgeons have undergone additional training.
What does a maxillofacial surgeon do?
Oral and maxillofacial surgeons perform surgeries of the mouth, jaws, and face. This includes dental implant surgery, bone grafting, wisdom tooth removal, corrective jaw surgery (orthognathic surgery), maxillofacial trauma, TMJ surgery, pathology & reconstruction, and facial cosmetic surgery.
Why is it called maxillofacial?
Maxillofacial refers to the jaws and face. Oral refers to the mouth. Therefore oral and maxillofacial surgeons treat the jaws, face, and mouth.
What is a maxillofacial procedure?
A maxillofacial procedure focuses on the jaw, face, or mouth.
What is the maxillofacial area?
The maxillofacial area refers to your mouth and all its connecting regions including your teeth, jawbone, face, head, and neck.