The ADA recognizes oral surgery as a dental specialty that requires advanced post-graduate training. An oral and maxillofacial surgeon performs procedures to treat injuries, defects or disease in a patient's mouth, jaw, face, head and neck. Significant overlap exists between oral surgery and other specialties because of the wide range of surgical procedures many dentists perform. For example, a periodontist and an oral surgeon may both perform grafts and dental implant procedures. Patients should determine the best specialist to perform their treatment based on a dentist's certification and experience with the specific surgical procedure the patient needs.
Types of Treatment That Involve Oral Surgery
Tooth Extractions: Oral surgeons specialize in extracting impacted wisdom teeth. Bone or gum tissue partially or completely covers these impacted third molars making them difficult to remove. Patients with upper wisdom teeth located very close to their sinuses may choose to have an oral surgeon perform their extraction as well to minimize complications.
Root Canals: Oral surgeons may perform endodontic surgeries such as root canals. Patients may develop an abscess (infection) near the root of their tooth because of bacterial infection in the pulp chamber inside the tooth. A basic root canal surgery involves draining the infected area, removing the infected pulp and decayed nerve tissue and inserting a dental filling in the tooth.
Dental Implants: Patients may see an oral surgeon to have a permanent dental implant placed. Patients with bone loss may require several surgeries to graft new bone in the treatment area to receive the implant. Oral surgeons also provide implant-supported prosthetics such as bridges and dentures.
Tumor Removal: Oral surgeons may remove benign tumors, cysts and malignancies in the gums, lips, tongue, jaw and other areas of a patient's face. Oral surgeons collaborate with oncologists to treat patients who have malignant tumors since these patients usually need follow up chemotherapy and radiation.
Cleft Palate: Pediatric oral surgery includes cleft palate repair. Babies with a severe cleft palate may be unable to eat. The child may have missing, abnormally shaped or misaligned teeth. Children with cleft palate often suffer from gum and jaw bone defects as well. An oral surgeon can repair some of these problems. The child may need to undergo multiple surgical procedures to provide the maximum amount of correction possible.
TMJ Treatment: Oral surgeons may treat patients who experience chronic jaw pain. The most commonly used and least invasive version of TMJ surgery involves flushing out excessive fluid buildup in the jaw joint. More complex TMJ procedures include surgery to reposition, re-contour or remove various components in the jaw joint. These treatments may ease movement, relieve pressure on a nerve or reduce inflammation.
Bite Correction: Patients with a crooked jaw or an asymmetrical face may have serious problems with bite misalignment. When orthodontics cannot correct a bite problem, an oral surgeon may perform corrective jaw surgery to relieve pain, restore function and reduce uneven or excessive wear on the affected teeth.
Reconstructive Surgery: Patients who have congenital defects, serious injuries or disease may require restorative dental surgery. Oral surgeons replace missing teeth and graft in new bone, gum, connective tissue or skin to repair the mouth.
Oral Surgery Costs
The costs of oral surgery vary from several hundred dollars for extraction of an impacted tooth to potentially hundreds of thousands of dollars for extensive reconstructive surgery. Costs may include hospital fees, surgeon fees, anesthesiologist fees, medications and more. Patients should review the details of their dental and medical insurance to identify covered procedures. Sometimes, patients may combine benefits from both a dental and medical plan to pay for different aspects of the procedure.
Pros and Cons of Having Oral Surgery
The benefits of oral surgery often include restored oral function, cosmetic improvement, decreased discomfort and better dental health over the long term. Surgical repair of damage or defects may allow patients to eat, speak and smile normally after injury or disease. Some oral surgeries such as cleft palate repair and tumor removal may help save a patient's life.
All surgical procedures carry some risks including excessive bleeding and infection. Patients typically experience some level of pain or discomfort after oral surgery. Not all surgeries result in a successful or satisfactory outcome. Patients may experience temporary or permanent nerve injury causing numbness, tingling or pain. Extensive surgeries that require the use of full anesthesia carry additional risks of serious complications. Patients should weigh the potential benefits of an ideal result, the outcome of leaving a condition untreated and the potential for complications in determining if oral surgery is the right solution.