The American Dental Association recognizes oral and maxillofacial surgery – commonly referred to as oral surgery – as one of dentistry’s nine specialty areas. This dental specialty focuses on the diagnosis and surgical and adjunctive treatment of diseases, injuries and defects related to the functional and esthetic aspects of the face, mouth, teeth and jaws (maxillofacial area).
Conditions Treated With Oral Surgery
An oral surgeon is an important link in your referral network of primary care providers. When functional dental concerns – such as keeping teeth, overcoming congenital growth issues, controlling serious oral disease and treating trauma-related damage – supersede esthetics, oral surgeons are the appropriate dental specialists with whom to seek a referral.
General dentists, orthodontists, pediatric dentists and medical physicians usually serve as the referrers. Prosthodontists often work hand-in-hand with oral surgeons to develop orthotics and prosthetic appliances to treat a number of functional issues. However, it’s important to note that whenever surgery involves the face, a cosmetic dentist should also be consulted as part of the dental team. Some patients also may wish to consult with a plastic surgeon.
An oral surgeon is skilled in the following:
Removing diseased and impacted teeth and administering anesthesia. An oral surgeon can remove impacted and damaged teeth and provide in-office anesthesia services, including intravenous (IV) sedation and general anesthesia.
Placing dental implants. In collaboration with a cosmetic or restorative dentist who designs your new smile or restorations, your oral surgeon can help with the planning and subsequent placement of your tooth implants. Oral surgeons can reconstruct bone in areas requiring it for implant placement and, when necessary or desired, modify gum tissue around the implants to produce a more natural and attractive appearance.
Treating facial trauma. Oral surgeons can repair minor-to-complex facial skin lacerations, set fractured jaw and facial bones, reconnect severed nerves and treat other facial injuries involving the oral tissues, jaws, cheek and nasal bones, eye sockets, and the forehead.
Evaluating pathologic conditions. Oral surgeons treat patients with benign cysts and tumors of the mouth and face, as well as people with malignant oral, head and neck cancer, and severe infections of the oral cavity, salivary glands, jaws and neck.
Alleviating facial pain. An oral surgeon can diagnose and treat facial pain disorders, including those caused by temporomandibular joint (TMJ) problems. Your oral surgeon can order imaging studies of the joints and make appropriate referrals to other dental and medical specialists, or a physical therapist. When non-surgical treatment is insufficient or there is definite joint damage, your oral surgeon may suggest surgery.
Performing reconstructive and cosmetic surgery. Oral surgeons can correct jaw, facial bone and facial soft tissue problems that result from trauma or the removal of cysts and tumors. Such corrective surgeries restore form and function to the maxillofacial area and often involve using skin, bone, nerves and different tissues from other parts of the body to reconstruct the jaws and face.
Performing corrective jaw (orthognathic) surgery. Oral surgeons correct minor and major skeletal and dental jaw irregularities to improve chewing, speaking and breathing. Usually in collaboration with an orthodontist (a dental specialist who treats improper bites or malocclusions), an oral surgeon surgically reconstructs and realigns the upper and lower jaws into proper dental and facial relationships in order to improve biting function and facial appearance. Oral surgeons also surgically correct birth (congenital) defects of the face and skull, such as cleft lip and cleft palate.
Your dentist, orthodontist and oral surgeon all must collaborate to determine whether orthognathic surgery is right for you or your child. However, it is the oral surgeon who decides which procedure is appropriate. As part of the dental team, the oral surgeon often provides surgical consultation and educational and emotional support for the family over the course of long-term treatment.
Providing surgical treatment for obstructive sleep apnea (OSA). If your dentist suspects that you have a sleep disorder, you will likely be referred to a sleep clinic for a polysomnography, an overnight clinic test that monitors your sleep patterns. Your dentist then will help select the best treatment for you based on whether your OSA is mild, moderate or severe. If non-surgical treatments such as behavior modification or oral appliances do not work, your dentist may refer you to an oral surgeon for a surgical procedure. Surgical procedures to correct sleep apnea include:
- Uvulopalatopharyngoplasty, which shortens and stiffens the soft palate by partially removing the uvula and the edge of the soft palate to correct airway collapses
- Genioglossus advancement, which opens the upper breathing passage by tightening the front tongue tendon, reducing tongue displacement into the throat
- Maxillomandibular advancement, which surgically moves both jaws forward to open the upper airway