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Oral and Maxillofacial Surgery: Definition and Overview

Definition and Overview

Oral and maxillofacial surgery refers to various surgical techniques performed on the mouth (oral) and maxillofacial regions (jaw, neck, and face) either for aesthetic or medical purposes or both. Although this is a branch of medicine, it is treated as a specialty in dentistry in the United States and other countries such as Australia and Canada.

A specialist who performs this type of surgery is called an oral and maxillofacial surgeon. The training of these medical professionals begins with four years of undergraduate studies followed by another four years of either dental or medical degree. After graduation, they proceed to being a resident doctor in a hospital or dental health care setting where the training can take as much as five years. The doctor eventually obtains a certification by passing a board exam.

The field, nevertheless, is vast, giving a specialist different areas in which to specialize. These areas include:

  • Correction of facial deformity – Congenital defects, diseases, and traumatic injuries can leave the face, including the jaws, disfigured. To restore the normal appearance of the face, or make it look as normal as possible, surgery is needed. The surgery sometimes helps the patient regain the function of the affected body part.

  • Oncology – A surgeon can also specialize in ncology, which focuses on the treatment of cancer. Under this specialty, the doctor deals primarily with tumors that appear in the neck and head, salivary glands and the jaw. Throat cancer, meanwhile, is handled by another specialist, usually an ENT (ears, nose, throat) surgeon.

  • Oral medicine – Also referred to as dental medicine or stomatology, this is a dental specialty that deals with the mouth and the parts of the face that are close to it, especially those found on the lower section of the face.

  • Trauma surgery – Under this specialty, the surgeon focuses on surgical procedures performed on both the hard and soft tissues of the facial region that have been damaged due to traumatic events such as a vehicular accident, fall, or even violence.

  • Cosmetic surgery – Under this specialty, the surgeon performs surgical procedures primarily to enhance the appearance of the mouth, jaw, and face. While the job can be handled by a cosmetic surgeon, an oral maxillofacial surgeon has more in-depth training when it comes to surgeries that affect the mouth, lips, upper and lower part of the face, and jaw.

When to see an Oral Maxillofacial surgeon

Patients may need to see an oral maxillofacial surgeon if:

  • They have been referred to by their general doctor and other specialists – Patients who suffer from facial deformity or TMJ condition for example, are typically referred by their general physicians or general dentist to oral maxillofacial surgeons.

  • They have been diagnosed with head and neck cancer – Oral and maxillofacial surgeons can perform surgical procedures to cut off the tumor. If there are cancer cells left, the patients then proceed to other treatment plans such as chemotherapy and radiotherapy.

  • There are deformities in the mouth and maxillofacial region – Not all types of deformities are harmful or reduce the quality of life, but many do, especially if they are left untreated over time. For instance, an injury or a dislocated jaw may prevent proper biting and chewing, which then affects a person's digestion. Oral and maxillofacial surgery can restore the appearance and function of the body part as well as boost the patient's self-confidence.

  • The patients suffer from pain – One of the most common causes of pain that is handled by an oral and maxillofacial surgeon is temporomandibular joint disorder, which typically leads to pain in the face that can travel toward the shoulder. It can also cause ear problems, such as tinnitus (ringing in the ears) and even hearing loss.

  • There's a need to create the right support for the mouth – It's important for people to have a nice bite, among others. Diseases affecting the mouth, however, can damage that. To correct it, oral surgery may have to be performed where devices such as implants are attached. Further, to serve as a good support for the entire structure of the mouth, bone grafting can also be carried out. The kind of bone and the complexity of the operation depends on how much of the existing bone is damaged or has been lost.

    References:

  • Mayersak RJ. Facial trauma. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Mosby Elsevier; 2013:chap 42.

  • Hill JD, Hamilton III GS. Facial trauma. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 22.