Oral Surgery: Your Complete Guide
Oral and maxillofacial surgery is the dental specialty that focuses on surgical procedures involving the mouth, jaw, and face. Oral surgeons handle everything from wisdom tooth extractions to complex jaw reconstruction. They are the only dental specialists trained to administer all levels of anesthesia, including general anesthesia, in an office setting. Their training is the longest of any dental specialty, often lasting 4 to 6 years beyond dental school.
What Does a Oral Surgeon Do?
A oral surgeon is a dentist with advanced training in oral and maxillofacial surgery. Here is what they handle:
- Extract wisdom teeth and other teeth that are impacted or difficult to remove.
- Place dental implants, including complex cases requiring bone grafting.
- Perform corrective jaw surgery (orthognathic surgery) to fix jaw alignment problems.
- Treat facial trauma including fractured jaws, cheekbones, and eye sockets.
- Remove tumors, cysts, and other pathological growths from the jaws and mouth.
- Perform biopsies of suspicious oral lesions.
- Administer all levels of sedation and general anesthesia.
- Perform cleft lip and cleft palate surgery.
- Treat obstructive sleep apnea with surgical procedures when other treatments fail.
When to See a Oral Surgeon
Your dentist will refer you to an oral surgeon for procedures that go beyond what a general dental office can handle. Common reasons include:
- Your wisdom teeth need to be removed, especially if they are impacted (stuck under bone or gum).
- You need a tooth extraction that is complicated by the tooth being broken, angled, or fused to bone.
- You are getting dental implants and need bone grafting or sinus lift procedures.
- Your jaws are significantly misaligned and orthodontic treatment alone cannot fix the problem.
- You have a cyst, tumor, or suspicious growth in your mouth or jaw.
- You suffered a facial injury such as a broken jaw or knocked-out teeth.
- You need a biopsy of an unusual sore or lump in your mouth.
- You require sedation or general anesthesia for dental procedures due to anxiety, medical conditions, or the complexity of the surgery.
Oral Surgeon vs. General Dentist
General dentists perform routine extractions and minor oral procedures. Oral surgeons handle cases that require advanced surgical skills, sedation, or hospital-level care.
General Dentist
- Simple tooth extractions where the tooth is fully visible and accessible.
- Basic oral examinations and referrals.
- Minor soft tissue procedures.
- General dental care and preventive treatment.
Oral Surgeon
- Impacted wisdom tooth removal requiring bone removal and surgical exposure.
- Full-arch dental implant placement with bone grafting.
- Corrective jaw surgery (orthognathic surgery).
- Repair of facial fractures and trauma.
- Removal of tumors and cysts from the jaws.
- Administration of IV sedation and general anesthesia.
- Treatment of oral pathology including biopsies.
- Cleft lip and palate repair.
Oral and maxillofacial surgeons complete 4 to 6 years of hospital-based surgical residency training after dental school. Many also earn a medical degree (MD) during their training. Their residency includes rotations in general surgery, anesthesiology, internal medicine, and emergency medicine, giving them the broadest surgical training of any dental specialist.
Common Oral Surgery Procedures
Wisdom Tooth Extraction
The most common oral surgery procedure. Wisdom teeth often lack room to grow in properly and can become impacted, causing pain, infection, or damage to nearby teeth. The oral surgeon numbs the area or uses sedation, then removes the tooth by making an incision in the gum and sometimes removing a small amount of bone. Recovery typically takes 3 to 5 days.
Corrective Jaw Surgery
Also called orthognathic surgery. This procedure repositions the upper jaw, lower jaw, or both to correct significant misalignment. The surgeon makes cuts in the jawbone, moves it into the proper position, and secures it with small plates and screws. Jaw surgery is done in a hospital under general anesthesia and is typically combined with orthodontic treatment before and after surgery.
Dental Implant Surgery
Oral surgeons place titanium implant posts into the jawbone to replace missing teeth. Complex cases may require bone grafting, sinus lifts, or nerve repositioning before implant placement. Oral surgeons are especially well-suited for full-arch implant cases and patients who need significant bone reconstruction.
Oral Biopsy
When a suspicious sore, lump, or discolored area is found in the mouth, the oral surgeon removes a sample of tissue for laboratory analysis. This helps diagnose or rule out conditions like oral cancer, infections, and autoimmune diseases. The procedure is usually quick and done with local anesthesia.
Conditions Treated by Oral Surgeons
Oral Surgeons diagnose and treat a range of conditions. Here are some of the most common:
Oral Surgeon Education and Training
Oral and maxillofacial surgeons complete the longest training of any dental specialist: 4 years of dental school plus 4 to 6 years of hospital-based surgical residency. Many programs include a medical degree (MD), meaning some oral surgeons hold both DDS/DMD and MD degrees. Residency includes rotations in general surgery, anesthesiology, trauma, and intensive care. Board certification by the American Board of Oral and Maxillofacial Surgery requires passing comprehensive examinations.
Frequently Asked Questions About Oral Surgery
How long is wisdom teeth recovery?
Most people recover from wisdom tooth extraction in 3 to 5 days. Swelling peaks on days 2 to 3 and then starts to go down. You can usually return to normal activities within a week. Your surgeon will give you instructions on managing pain, swelling, and diet during recovery.
Will I be asleep during oral surgery?
It depends on the procedure and your preference. Options range from local anesthesia (numbing only), to IV sedation (you are deeply relaxed and may not remember the procedure), to general anesthesia (you are fully asleep). Your oral surgeon will discuss the best option based on your procedure and comfort level.
Is jaw surgery worth it?
For patients with significant jaw misalignment, jaw surgery can dramatically improve chewing ability, breathing, speech, facial appearance, and overall quality of life. It is a major procedure with a recovery period of several weeks, but patients with properly indicated cases typically report high satisfaction.
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