An oral surgeon is a specialist who diagnoses and treats conditions affecting the teeth, jaws, face, and neck. Their full title is “oral and maxillofacial surgeon,” and their work goes well beyond pulling teeth. They handle everything from impacted wisdom teeth and dental implants to facial fractures, jaw realignment, and tumor removal. If a procedure involves cutting into bone or soft tissue in the mouth and face, an oral surgeon is typically the one performing it.
Training and Qualifications
Oral surgeons complete four years of dental school to earn either a DDS or DMD degree, followed by a minimum of four years in a hospital-based surgical residency. That residency is where they gain hands-on experience with trauma cases, anesthesia, complex extractions, and reconstructive procedures in a hospital setting alongside medical residents and attending physicians.
Some oral surgeons also complete medical school and earn a dual MD degree, though this isn’t required to practice. After residency, surgeons can pursue board certification through the American Board of Oral and Maxillofacial Surgery, which involves a 300-question written exam covering 11 subject areas followed by an oral examination testing clinical judgment across a series of timed cases. Those who pass become Diplomates of the Board. Additional fellowship training can expand a surgeon’s scope into areas like head and neck cancer treatment, cleft and craniofacial surgery, microvascular reconstruction, and facial cosmetic surgery.
Wisdom Tooth Removal
This is the procedure most people associate with oral surgeons, and for good reason. Wisdom teeth that are impacted (stuck beneath the gum or bone) can’t simply be pulled with forceps. The surgeon makes an incision, lifts a flap of gum tissue, and often removes surrounding bone to access the tooth. Sometimes the tooth is sectioned into pieces for easier removal.
When the roots of a wisdom tooth sit dangerously close to the nerve that runs through the lower jaw, some surgeons use a technique called coronectomy. Instead of removing the entire tooth, they cut the crown off a few millimeters below the enamel line and leave the roots in place to avoid nerve damage. After the tooth is out (or the crown removed), the wound may be fully sutured closed or partially closed with a small opening to allow drainage. Recovery from wisdom tooth surgery generally involves a few days of swelling, dietary restrictions, and careful wound care. Proper blood clot formation at the extraction site is the first critical step in healing.
Dental Implants and Bone Grafting
Dental implants are titanium posts surgically placed into the jawbone to serve as artificial tooth roots. An oral surgeon handles the surgical portion: evaluating bone density, placing the implant, and managing any complications. But many patients don’t have enough bone in their jaw to support an implant right away, which is where bone grafting comes in.
Grafting material can come from several sources. The gold standard is bone harvested from another site in the patient’s own body. Alternatives include processed bone from a donor, animal-derived bone (most commonly bovine), and synthetic materials like calcium phosphates or bioactive glass. Each has trade-offs in terms of how well it integrates with existing bone.
For implants in the upper jaw, a common challenge is that the sinus cavity sits too close to the jaw ridge. Oral surgeons address this with a sinus lift, where they gently raise the sinus membrane and pack grafting material underneath to build up the bone floor. This can be done through a small window in the side of the jaw or through the implant site itself using specialized instruments. Once the graft heals and new bone forms (a process that can take several months), the site is ready for implant placement.
Corrective Jaw Surgery
When the upper and lower jaws don’t align properly, braces alone may not fix the problem. Corrective jaw surgery, called orthognathic surgery, repositions one or both jaws to improve bite function, breathing, and facial symmetry. Oral surgeons use this approach to treat severe overbites, underbites, undersized or oversized jaws, obstructive sleep apnea, and temporomandibular joint (TMJ) disorders.
During the procedure, the surgeon makes cuts in the jawbone, moves the jaw into its new position, and secures it with surgical plates, screws, or wires. Most incisions are made inside the mouth, so visible scarring is minimal. A splint is placed over the teeth afterward for stability. This is a major surgery, and recovery takes weeks to months. Patients typically follow a soft or liquid diet during the initial healing period, and orthodontic treatment usually continues after surgery to fine-tune the bite.
Facial Trauma and Fracture Repair
Oral surgeons treat broken jaws, fractured cheekbones, eye socket injuries, and soft tissue lacerations to the face and mouth. The basic principle mirrors any broken bone: the fragments need to be realigned and held in place long enough to heal.
For straightforward jaw fractures, the surgeon may wire the upper and lower teeth together to immobilize the jaw while it heals. Complex or multi-site fractures often require open surgery, where the surgeon exposes the bone through incisions and secures the pieces with titanium plates and screws. Patients who have lost teeth or have very few remaining teeth may need a heavier reconstruction plate to stabilize the fracture, since there aren’t enough teeth to wire together for support.
Pathology and Biopsies
Oral surgeons evaluate and remove abnormal growths in the mouth, jaws, and surrounding structures. This includes cysts (fluid-filled sacs that can develop around impacted teeth or within the jawbone), benign tumors, and suspicious lesions that need biopsy to rule out oral cancer. Managing infections that originate from teeth and spread into deeper tissue planes of the head and neck also falls under their scope, and these cases can be life-threatening if not treated surgically.
Anesthesia and Sedation
One thing that sets oral surgeons apart from general dentists is their extensive training in anesthesia. They’re qualified to administer multiple levels of sedation in their offices, from mild oral sedation to intravenous (IV) sedation, which is the deepest form of conscious sedation available in an outpatient dental setting. For more involved procedures, or for young children, patients with special needs, and those with severe anxiety, oral surgeons can also provide general anesthesia.
This in-office anesthesia capability is a major reason dentists refer patients to oral surgeons. It allows complex, painful, or lengthy procedures to be done comfortably without needing a hospital operating room.
What Recovery Looks Like
Recovery timelines vary widely depending on the procedure. A straightforward extraction might have you back to normal eating within a few days, while corrective jaw surgery or major reconstruction can mean weeks of restricted diet and activity. Across all procedures, the general guidelines are consistent: take prescribed medications as directed, avoid hot or hard foods that could irritate the surgical site, keep the area clean without disturbing it, and attend follow-up appointments so the surgeon can monitor healing.
Healing speed depends on your overall health, how complex the procedure was, and how closely you follow post-operative instructions. The first priority after any oral surgery is allowing a stable blood clot to form at the wound site. Dislodging that clot (through vigorous rinsing, using a straw, or smoking) is one of the most common causes of complications like dry socket.