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Dental Specialties 7 - Oral and Maxillofacial Surgery

Oral and Maxillofacial Surgery (also known by many as Oral Surgery) is the specialty of dentistry concerned with surgical treatment, and treatment that is adjunctive to surgery, of the lower face and associated structures. 

Oral surgery is possibly the most likely specialty of dentistry for a patient to utilize.  From a time management point of view, a large part of an oral surgeon’s area of concentration is the removal of wisdom teeth.  The young people often ask me why the body has wisdom teeth anyway.  While I can’t offer a definitive answer to this question, I can say that most people do not have sufficient space to allow for proper eruption of wisdom teeth.  Furthermore, of those people who actually have the space to accommodate wisdom teeth, few are able and/or willing to put forth the extra effort required to maintain them without decay or gum problems.  Wisdom teeth, especially the impacted ones, can represent a significant challenge to remove.  Your dentist can help you to decide if they should be removed in your individual case and when that should occur.  An impacted tooth is a tooth that cannot be fully visualized in the mouth.  It can be completely covered in bone, or might only have a soft tissue covering.

Oral surgeons also remove other teeth that are likely to have complications when they are extracted.  What teeth might those be?  Examples might include teeth broken off at or below the gum line, teeth that have many small craze (crack) lines in them, or teeth that have been treated with root canals.  In short, any tooth that has a pretty high chance of breaking when removed would usually be removed with less trauma (and thus a shorter healing period) if an oral surgeon removes it.  You might understand that in the not so distant past, a general dentist removed any tooth that had to be removed.  However, in recent years the standard of care has been enhanced.  For example, it is no longer acceptable to leave broken roots in place or prop a mouth open for an hour and a half to get wisdom teeth out.  Things have changed, and just as your family doctor doesn’t remove tonsils or an appendix any more, a general dentist no longer removes all teeth that have to be removed no matter what the circumstance.

Oral surgeons also are involved in interesting and complicated surgeries like osteotomies.  Have you ever seen someone who appears to not have a chin?  Sometimes, people have such a short mandible (lower jaw) that it looks like there is no chin.  On such a person, the oral surgeon and the orthodontist can work together to lengthen the chin.  This is such an appearance changing procedure that often afterwards the person looks to be someone else.  Of course, this kind of procedure also produces intense self esteem enhancement and all the positive changes that come with it.  As well, oral surgeons are involved in reconstructive surgery of the lower face after accidents.  

An oral surgeon often works as part of a larger team of surgeons and others in a hospital.  For this and other reasons, many universities with oral surgery programs have changed their training to provide combined oral surgery training and an MD when their course is completed.  As you might imagine, this training is quite long.  Twelve or more years of full time university training is not uncommon at all for an oral surgeon.

The work of an oral surgeon is precise and interesting.  There are many areas of the specialty of Oral Surgery, and some oral surgeons practice in only part of the field.  We are fortunate to have an Oral Surgeon who comes to our town from Winnipeg to more conveniently take care of the people of this area.

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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