Becoming an oral surgeon requires 12 to 14 years of education and training after high school, making it one of the longest paths in all of healthcare. The journey moves through four stages: an undergraduate degree, dental school, a surgical residency, and licensing and board certification. Each stage is competitive, but the payoff is significant, with oral and maxillofacial surgeons earning an average of $360,240 per year.
Undergraduate Degree: Building the Foundation
The first step is a four-year bachelor’s degree. There’s no required major, but most aspiring oral surgeons study biology, chemistry, or a related science because the prerequisite courses for dental school overlap heavily with those fields. You’ll need coursework in general chemistry, organic chemistry, biology, biochemistry, physics, and English at a minimum.
Your GPA matters more than your major. Average GPAs for students accepted to dental school hover between 3.4 and 3.7 depending on the program, with top schools expecting even higher. This is also when you’ll prepare for and take the Dental Admission Test (DAT). The average DAT academic average score for students accepted in the fall 2024 entering class was 21 on the old 30-point scale (440 on the newer 600-point scale), with accepted scores ranging from 17 to 25. Scoring at or above average gives you a realistic shot at most programs, though the most selective schools like UCLA routinely see averages above 22.
Dental School: Earning Your DDS or DMD
Dental school is a four-year doctoral program that awards either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD). The two degrees are functionally identical. The first two years focus on classroom and lab instruction in anatomy, pathology, pharmacology, and other foundational sciences. The final two years shift heavily toward clinical rotations where you treat patients under supervision.
During dental school, you should seek out as much surgical experience as possible. Elective rotations in oral surgery, research with faculty in the department, and strong letters of recommendation from oral surgeons all strengthen your residency application. Programs are extremely selective: NYU, for example, accepts just two applicants per year into its six-year track and one into its four-year track.
The 4-Year vs. 6-Year Residency
After dental school, you enter an oral and maxillofacial surgery (OMFS) residency accredited by the Commission on Dental Accreditation (CODA). This is where the path splits into two tracks.
Four-Year Certificate Track
The four-year program focuses entirely on surgical training. A typical structure, based on Emory’s program, looks like this: the first year is spent on the oral surgery service, the second year rotates through medicine, general surgery, and anesthesia (roughly 11 months of off-service rotations), the third year mixes oral surgery months with rotations in ENT, plastic surgery, and electives, and the fourth year is a full chief year on the oral surgery service. You graduate with a certificate in oral and maxillofacial surgery.
Six-Year MD-Integrated Track
The six-year program weaves a full medical degree (MD) into the residency. At UCSF, for instance, residents spend about 25 months in medical school coursework and 33 months in oral surgery rotations over six years, plus time in anesthesia, general surgery, plastics, and ENT. You take the USMLE medical licensing exams during this track and graduate as both a dentist and a physician.
The six-year track opens doors to a broader surgical scope, hospital privileges, and fellowship opportunities. It’s increasingly popular: many academic medical centers only offer the six-year path. That said, the four-year track produces fully qualified oral surgeons who perform the same core procedures. Your choice depends on whether you want the additional medical credential and the broader scope that comes with it, weighed against two extra years of training.
What Oral Surgeons Actually Do
Oral and maxillofacial surgery covers a wide range of procedures involving the teeth, jaws, face, and neck. The most common include wisdom tooth removal, extraction of damaged or decayed teeth, dental implant placement, bone grafting to rebuild the jawbone, and gum grafts for receding gums. On the more complex end, oral surgeons perform orthognathic (jaw) surgery to correct misalignment, reconstruct facial injuries from trauma, and repair congenital conditions like cleft lip and palate.
Most oral surgeons also administer general anesthesia and IV sedation in their own offices, a scope of practice that sets them apart from other dental specialists. The anesthesia training during residency, typically five months of dedicated rotations, prepares you for this responsibility.
Licensing and Board Certification
Before practicing, you need a state dental license. Requirements vary by state, but most follow the same general framework. You must pass Parts I and II of the National Board Dental Examinations, complete a CODA-accredited residency of at least two years, and pass a clinical or specialty examination approved by your state board. Many states also require a jurisprudence exam covering that state’s specific dental laws. Some states offer licensure without a separate clinical exam if you can document at least 3,500 hours of specialty clinical practice and 40 hours of continuing education in the preceding years.
Board certification through the American Board of Oral and Maxillofacial Surgery (ABOMS) is optional but widely expected, especially in academic and hospital settings. It involves two exams. The Qualifying Examination is a 300-question computer-based test covering 11 subject areas. After passing, you have three consecutive years to complete the Oral Certifying Examination, which is a case-based oral exam lasting 144 minutes across three sections. Passing both earns you the title of Diplomate of ABOMS.
Total Timeline at a Glance
- Undergraduate degree: 4 years
- Dental school (DDS/DMD): 4 years
- OMFS residency: 4 or 6 years
- Total: 12 to 14 years after high school
Salary and Job Outlook
Oral and maxillofacial surgeons earn an average of $360,240 per year, according to 2024 Bureau of Labor Statistics data. The mean hourly wage is $173.19. Those working in private dental offices earn the most on average at $375,120, while positions in physician offices average $347,480. Academic roles at universities pay considerably less, averaging around $81,910.
Geography plays a role too. North Carolina leads the states at $400,440 on average, followed by Alabama at $393,490 and Pennsylvania at $325,160. Among metro areas, San Diego tops the list at $317,960, with Detroit and Los Angeles close behind. Most oral surgeons work in private practice, either solo or in a group, though hospital employment and academic positions are also common paths.