Oral & Maxillofacial Surgery
Oral and maxillofacial dentistry is a specialty that deals with surgical procedures on the following:
- Mouth (interior or exterior)
- Upper and lower jaw
Oral and maxillofacial surgeons perform operations involving all types of tissues including teeth, gums, skin, lymph nodes, tendons and ligaments, nerves and blood vessels. They usually deal with:
- Removal or repair of diseased or dysfunctional tissue (such as oral tumors or impacted wisdom teeth)
- Reconstruction of dental and facial structures that are damaged or abnormal (such as a cleft palate or trauma from an accident)
Training and Certification in Oral and Maxillofacial Surgery
Oral surgeons are first trained and certified as dentists (DDS or DMD). Then, they go on to further study and gain clinical experience at a graduate level to achieve certification as an OMS by the American Board of Oral and Maxillofacial Surgery (ABOMS). This advanced education includes training in fields such as cosmetic and reconstructive surgery, anesthesia and pathology. Oral surgeons may also be members of professional organizations such as the American Association of Oral and Maxillofacial Surgeons (AAOMS). Unlike many other dentists, an OMS will have hospital privileges and substantial experience in operating using general anesthesia. Some medically necessary procedures commonly performed by oral surgeons are at least partially covered by medical insurance, dental insurance or both.
Common Oral and Maxillofacial Surgery Procedures
Here are some of the treatments that oral surgeons perform:
Wisdom Tooth Extraction
Patients with wisdom teeth that pose a risk of complication during extraction are referred to an OMS for tooth removal. This is often advisable when the lower wisdom teeth are impacted (have not emerged from the bone or gum). A cyst sometimes forms around an impacted wisdom tooth. Upper wisdom teeth can perforate the sinus cavity if the tooth roots extend too far upward. All of these issues require advanced surgical skill for extraction without damaging surrounding structures.
Missing or Damaged Tooth
Dentists who specialize in oral and maxillofacial surgery are trained in the replacement of teeth that are lost due to trauma or disease. The surgical placement of dental implants can restore a single tooth or support a bridge or dentures to replace several teeth. You can actually see an OMS, a prosthodontist or a periodontist for this type of procedure. Oral and maxillofacial surgeons may have particular expertise in restoring lost gum or bone tissue in addition to installing an implant.
Failed Root Canal
A standard root canal can be performed by a dentist. However, if infection persists or spreads, the tip of the tooth root may need to be surgically removed. This procedure requires greater surgical experience. Endodontists and oral and maxillofacial surgeons are the two types of dentists qualified to perform this treatment.
TMJ (Jaw Pain or Dysfunction)
Disorders of the temporomandibular joint (where the jaw fits into the skull) are most commonly treated without surgery. However, an OMS may be called in to reposition the disk of cartilage in the joint, reshape the jaw joint or perform other advanced surgical procedures to reduce chronic and/or severe jaw dysfunction. The most likely indications for surgery in TMJ are to repair broken or dislocated jaw bones or to address the effects of advanced osteoarthritis or rheumatoid arthritis. An OMS may also perform jaw surgery to address significant facial asymmetry.
Medical Procedures Performed in Oral and Maxillofacial Surgery
An OMS is trained to provide treatment for medical conditions or defects such as:
Cleft Palate or Cleft Lip: Surgery to repair these congenital abnormalities of the lip and mouth are usually recommended during infancy or early childhood to help ensure normal growth and function. Early intervention can help a baby eat and breathe more easily.
Sleep Apnea : An oral surgeon may reduce vibration in the throat and help keep the airway open by removing tonsils and adenoids, restructuring soft tissues or repositioning the jaw.
Tumor or Cyst: An OMS may remove malignant oral or facial tumors or benign cysts. This procedure may involve reconstructing the site after the operation.
Your dentist may recommend an oral and maxillofacial specialist to treat the issues above if your condition is diagnosed during a dental exam. If your condition is diagnosed by your general physician, you might get a referral to a plastic surgeon, otolaryngologist or surgical oncologist. In either case, you should verify the credentials of the surgeon and feel comfortable with their level of expertise before having an oral or maxillofacial operation of any kind.