Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecoveryFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

What It Is

Purpose

How to Prepare

What to Expect

Recovery

Frequently Asked Questions

Oral and maxillofacial surgery is used to treat complex dental problems and medical conditions related to the mouth, teeth, jaws, and face. Much of the practice is focused on facial reconstructive surgery, facial trauma surgery, and dental procedures involving the jawbone (likewisdom tooth extractionsanddental implants).

What Is Oral and Maxillofacial Surgery?

Oral and maxillofacial surgery encompasses a variety of procedures that involve surgery of the mouth (oral), jaw (maxilla), and face (facial). Some people regard oral and maxillofacial surgery as an “upgraded” form of dental surgery, but the practice extends far beyond what a dentist can perform.

Oral and maxillofacial surgeons (OMSs) train as dentists but undergo six additional years of education, including two to attain amedical degree(MD).

Some oral and maxillofacial surgeons embark on further training to performfacial cosmetic surgery, treat conditions related to cancer, perform microvascular surgery of the head or neck, or correct congenital face and skull abnormalities in children (such ascleft lip and palate).

Depending on the condition, oral and maxillofacial surgery may be performed as aninpatient,outpatient, scheduled, elective, or emergency procedure. OMSs often work alongside other surgeons (likeorthopedic surgeons,surgical oncologists, or otolaryngologists) to treat complex conditions or in cases involving severe head or facial trauma.

Contraindications

There are few absolute contraindications to oral and maxillofacial surgery other than the inability to tolerategeneral anesthesia. In such cases, other forms of anesthesia—likeregional blocksorlocal anesthesiawithintravenous sedation—may be used.

There are relative contraindications that may exclude certain elective procedures. Cases like these are evaluated on an individual basis, weighing the benefits against the risks. Among the conditions of concern are:

Potential Risks

As with all surgeries, oral and maxillofacial surgery has risks. Even relatively common procedures liketooth extractionspose a risk of potentially serious complications.

In addition to thegeneral risks of surgery(such as excessive bleeding,unfavorable scarring,post-operative infection, and anadverse reaction to anesthesia), oral and maxillofacial surgery poses specific risks, especially with regards to reconstructive surgery or in cases of facial trauma.

These include:

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Purpose of Oral and Maxillofacial Surgery

Oral and maxillofacial surgery is used to treat a wide range of conditions affecting the craniomaxillofacial complex comprised of the mouth, jaws, face, neck, and skull.

The procedures can be broadly defined as being diagnostic/therapeutic, dentoalveolar (involving the teeth, gum, jawbone, and mouth), reconstructive, or cosmetic.

Diagnostic and therapeutic procedures include:

Dentoalveolar procedures include:

Reconstructive procedures include:

Cosmetic procedures include:

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Pre-Operative Evaluation

If oral and maxillofacial surgery is indicated, the surgeon may order a series of tests to map out the surgical plan. These may include:

To fully comprehend what’s involved, do not hesitate to ask as many questions about not only the procedure but what to expect during recovery.

Important Questions to Ask Before You Have Surgery

Location

Many oral and maxillofacial surgeries are performed in-office, including tooth extractions and other dental procedures. Those that involve reconstruction or require open surgery need to be performed in an operating room of a hospital or specialized surgical facility.

Depending on the surgery, ananesthesiologistmay or may not be needed. All OMSs are qualified to administer anesthesia, but complex procedures like microvascular reconstruction need a dedicated anesthesiologist to monitor the health of the patient during surgery.

What to Wear

You may be asked to wear a hospital gown and surgical bib over your clothes when undergoing dental surgery. Wear something that is machine washable on the odd chance you get a spot of blood on your clothing.

Other surgical procedures, particularly those involving general anesthesia, will require you to undress and put on a hospital gown. The day of your procedure, wear something comfortable that you can easily take off/put back on.

Food and Drink

If undergoing general anesthesia or any form of sedation, you will need to adhere to certain food and drink restrictions prior to surgery.

In most cases, you will be advised to stop eating at midnight on the night before your surgery. The next morning, you will be allowed a few small sips of water to take any morning pills, but nothing further.

If local or regional anesthesia is to be used, there may be no such restrictions. The only exception is if intravenous sedation is used alongside local or regional anesthesia. In such cases, the same food and drink restrictions apply.

Why You Can’t Eat or Drink Before Surgery

Medications

As a general rule,nonsteroidal anti-inflammatory drugs (NSAIDs)andanticoagulants(blood thinners) are avoided in the days the preceding surgery. Both of these classes of drugs can promote bleeding and affect the proper healing of wounds.

To avoid complications, advise your surgeon about any and all drugs you take, whether they are prescription, over-the-counter, nutritional, herbal, or recreational.

What to Bring

You will need to bring your driver’s license or another form of government photo ID to check in to your appointment. If you have insurance, bring your insurance card.

You may also need a credit card or other approved form of payment if the facility requires upfront payment ofcoinsurance or copaycosts. Call in advance to be sure that they accept your form of insurance, if you are enrolled in a plan.

Leave any valuables at home.

It is best to bring someone with you to drive you home. Even if only local anesthesia is used, you may experience significant pain after surgery, which can impair your ability to drive. If general anesthesia and any form of sedation is used, under no circumstance should you get behind the wheel of a car.

Driving After Surgery or Anesthesia

Pre-Op Lifestyle Changes

Every effort should be made tostop smokingat least two weeks beforeandafter surgery. Cigarette smoke causes the profound constriction of blood vessels, reducing the amount of blood and oxygen that reaches the surgical wound. This not only impedes healing butincreases the risk of treatment failure, such as loss of a skin graft or improper bonding of bones.

If you find it difficult to quit, ask your healthcare provider for prescriptionsmoking cessation aidsthat can reduce cravings. Many of these aids are available free of charge under theEssential Health Benefits (EHB) mandateof theAffordable Care Act.

Oral Surgery: What to Expect

What to Expect on the Day of Surgery

The expectations for oral and maxillofacial surgery are as diverse as the procedures used. With that said, there are some common elements involved in all of these procedures, and knowing more about them can help you prepare.

Before the Surgery

What You Should Know Before Undergoing Surgery

During the Surgery

Once you are prepped and the appropriate anesthesia has been administered, the surgery can begin. It may beopen surgery(an invasive procedure involving a large incision),endoscopic surgery(also known as “keyhole surgery”), or minimally invasive open surgery (involving a small incision and minimal tissue damage).

The surgery may also be classified as being reconstructive (to repair or correct structural abnormalities) or aesthetic (used for cosmetic purposes).

Upon completion of the surgery, sutures, staples, or tape may be used to close your incisions. A sterile bandage is then applied.

Splints, spacers, and various braces (including headgear, mouthguards, and jaw wiring) may be used to immobilize the skull, jaw, or nose so that it heals properly and in the correct position.

After the Surgery

Once the surgery is complete, you are taken to a recovery room or thepost-anesthesia care unit (PACU), where you will be monitored until you are fully awakened from the anesthesia. With local anesthesia, this usually takes 10 to 15 minutes or so. With general anesthesia, it generally takes around 45 minutes.

In addition to wound care instructions, you may be givenpain medicationsto help ease post-operative pain as well asoral antibioticsto help preventpost-operative infection.

In the same way that oral and maxillofacial surgeries can vary, so too can recovery times. While most people can return to work and normal activity within a few days of a wisdom tooth extraction, for example, those who undergo orthognathic surgery may take months before they are fully recovered.

Certain factors can increase or decrease recovery times, including your general health before surgery, how well youcare for your surgical wound, and whether you or not you smoke.

Some oral and maxillofacial surgeries will require your jaw to be wired. Because you’ll be limited to a liquid diet, you will need to rinse your mouth thoroughly after brushing, as well as rinse with salt water several times a day to remove bacteria from the gums and prevent plaque buildup.

People who undergo soft palate surgery may experience changes in speech articulation that requirespeech therapyto correct.In fact, any surgery of the jaw, tongue, or soft or hard palate can affect speech, either temporarily or permanently. A speech pathologist can help determine what, if any, treatment is needed.

Damage to branches of the trigeminal nerve is common following maxillofacial surgery, most cases of which resolve on their own over time. Severe cases may require medications and other treatments to block the nerve pain.

Some oral and maxillofacial surgeries require extensive rehabilitation to restore nerve sensations or the function of facial muscles. Similarly, some scars can take months of ongoing care tominimize their appearanceor prevent the development of thick, raised patches (hypertrophic scarring).

To ensure that you heal completely, work closely with your healthcare provider. Keep all scheduled appointments and have realistic expectations about what it will take to recover. Rushing this period is never a good idea.

A Word From Verywell

If you are referred to an oral and maxillofacial surgeon, it is likely because a specific procedure is beyond the scope of the healthcare provider or dentist you are seeing. It doesn’t necessarily mean that the condition is inherently more serious, but rather that the procedure would benefit from a specialist trained to work on the complex structures of the face, jaw, mouth, and skull.

Frequently Asked QuestionsYour surgeon may recommend either a liquid or soft-food diet, depending on the type of surgery. When possible, choose nutrient-rich foods to give your body the fuel it needs to heal. Some good options may include:SmoothiesYogurtOatmealApplesauceScrambled eggsMeatloafTofuMashed bananasFrozen yogurt or sorbetLearn MoreWhat Is a Soft Diet?Swelling in your face may continue to increase for two to three days after surgery. It should start to lessen after three days. If the pain or swelling gets worse after that time, check with your surgeon.

Your surgeon may recommend either a liquid or soft-food diet, depending on the type of surgery. When possible, choose nutrient-rich foods to give your body the fuel it needs to heal. Some good options may include:SmoothiesYogurtOatmealApplesauceScrambled eggsMeatloafTofuMashed bananasFrozen yogurt or sorbetLearn MoreWhat Is a Soft Diet?

Your surgeon may recommend either a liquid or soft-food diet, depending on the type of surgery. When possible, choose nutrient-rich foods to give your body the fuel it needs to heal. Some good options may include:SmoothiesYogurtOatmealApplesauceScrambled eggsMeatloafTofuMashed bananasFrozen yogurt or sorbet

Your surgeon may recommend either a liquid or soft-food diet, depending on the type of surgery. When possible, choose nutrient-rich foods to give your body the fuel it needs to heal. Some good options may include:

Learn MoreWhat Is a Soft Diet?

Swelling in your face may continue to increase for two to three days after surgery. It should start to lessen after three days. If the pain or swelling gets worse after that time, check with your surgeon.

18 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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