Why Consult An Oral Surgeon?

Their training and expertise are unique in dentistry

Dear Doctor,
My dentist sent me for a consultation with an oral surgeon. What exactly do they do?

Dear George,
Oral and maxillofacial surgeons (“oral” – mouth; “maxillo” – jaws; “facial” – face), to use the full title, are dentists who take additional post-graduate education and training to complete surgical residencies specifically in the diagnosis and treatment of diseases, disorders, defects, and injuries of the mouth, teeth, jaws, and face. Residency enables them to perform a wide variety of procedures in both an office setting and in a hospital environment.

The ability to provide patients with safe, effective, outpatient anesthesia has distinguished the specialty since its earliest days. It includes local anesthesia (numbing shots), nitrous oxide (inhalation) anesthesia, intravenous (“intra” – within, “venous” – vein) conscious sedation, and general anesthesia, rendering patients unconscious with medication. With this training, an oral surgeon may appropriately, competently, and safely administer anesthesia in the oral and maxillo-facial surgery office to meet the special requirements of patients and procedures. Anesthesia training also allows oral surgeons to expertly manage and control pain and anxiety.

Office-based surgery is often the most efficient and cost effective way to perform many procedures while maintaining maximum patient comfort and safety. Oral and maxillofacial surgical diagnosis and treatment includes:

• Simple and complex tooth extraction such as impacted teeth and dento-alveolar surgery (“dento” – tooth; “alveolar” – tooth supporting bone) of the jaw bones that includes issues arising from long-term denture wear.
• Pediatric dental problems including the administration of anesthesia specific to their needs, removal of teeth such as supernumerary (extra) teeth, and exposure of impacted teeth in preparation for orthodontics.
• Facial pain management that also includes TMD (Temporo-Mandibular Disorders), a group of conditions, often painful, that affect the jaw joint (TMJ) and the muscles that control chewing.
• Pathologies (“path” – disease; “ology” – study of), diseases in the jaws and facial region that include biopsies (cell or tissue removal for study), and other tests required to determine, diagnose, and develop appropriate treatment for diseases and disorders.
• Infections affecting the jaws, head, and neck region, which can develop into life-threatening emergencies if not treated promptly and effectively.
• Recognition and management of oral cancers, in which an oral surgeon is an integral part of a team in the treatment of advanced disease.
• Reconstructive surgery of the hard (bony) tissues, soft tissues (lips, cheeks, tongue), and other injuries to the upper and/or lower jaws resulting from injury, trauma, and/or disease.

Office-based surgery is often the most efficient and cost effective way to perform many procedures while maintaining maximum patient comfort and safety.

• Surgical placement of dental implants to replace a single tooth, several teeth, or all of the teeth. Dental implants are state-of-the-art "stand alone" tooth replacement systems. They do not attach to other teeth and do not decay. They are the best alternative to bridgework or dentures.
• Repair of injuries to the face, jaws, mouth, and teeth caused by trauma. Oral and maxillofacial surgeons are specialists in trauma management of fractures of the upper and lower jaws, cheekbones, nasal bones, eye orbits (the bones encasing the eye), and of facial lacerations (cuts).
• Orthognathic surgery (“ortho” – to straighten; “gnathic” – jaw) — the correction of discrepancies in the sizes of the jaws leading to malocclusion (“mal” – bad; “occlusion” – bite) and poor facial aesthetics. These problems are caused by differences in skeletal growth between the upper and lower jaws.
• The correction of congenital deformities (abnormal growth and development from birth), like cleft lip and palate that occur when all or a portion of the oral-nasal complex (mouth, palate, and nose) do not grow together properly.
• Increasingly, oral surgeons are receiving training in the diagnosis and treatment of Obstructive Sleep Apnea, OSA (“a” – without; “pnea” – breath), a condition in which breathing ceases for a brief period of time and affecting increasing numbers of the U.S. population. Often characterized by loud and frequent snoring, OSA can lead to excessive daytime sleepiness, poor work performance, and cardiovascular disorders (“cardio” – heart; “vascular” – blood vessels) such as high blood pressure, heart attacks, and strokes.

With both a dental and surgical background along with their ability to reconstruct facial structures damaged through trauma, oral and maxillofacial surgeons perform facial cosmetic procedures both on an outpatient basis as well as in a hospital setting. Most frequently, general dentists are the first dental health professionals to be consulted regarding oral health problems and thus they often have relationships with oral surgeons to whom they will refer patients when they need specialty help as outlined above.