Oral & Maxillofacial Surgery

What is Oral & Maxillofacial Surgery?​

Oral and maxillofacial surgery is a surgical specialty of dentistry concerned with diagnosing and treating conditions affecting the mouth, jaws, face, and neck — collectively known as the oral and maxillofacial region. It is one of the few surgical fields that bridges both dentistry and medicine, addressing problems involving the hard and soft tissues of this region, whether the cause is disease, injury, a condition present from birth, or purely aesthetic concern.

Oral and maxillofacial surgeons undergo extensive training in both dental and medical disciplines, equipping them to manage conditions that often involve a close interplay between teeth, bone, nerves, and soft tissue. This includes everything from the surgical removal of impacted wisdom teeth to complex reconstruction following facial trauma or cancer, making it a specialty defined as much by the breadth of its training as by the region of the body it treats.

Understanding the Oral and Maxillofacial Region

The oral and maxillofacial region encompasses the mouth, jaws, and face, an area built around a complex framework of bone, muscle, nerves, and soft tissue that must work together for essential functions such as chewing, swallowing, speaking, and breathing. At its centre are the maxilla (upper jaw) and mandible (lower jaw), which meet at the temporomandibular joints just in front of each ear, allowing the jaw to open, close, and move side to side.

This region also contains the teeth and their supporting structures, the salivary glands, and a dense network of facial nerves responsible for sensation and movement across the face. Because these structures are so closely interconnected, a problem in one area, such as a misaligned bite or an impacted tooth, can affect function and comfort well beyond its immediate location, which is part of why oral and maxillofacial surgery requires such a broad and integrated scope of training.

Areas of Focus Within Oral and Maxillofacial Surgery

Oral and maxillofacial surgery covers several distinct areas of treatment:

• Dentoalveolar Surgery: Covers surgical procedures involving the teeth and surrounding bone, including the removal of impacted or problematic teeth and preparation of the jaw for dental implants.
• Orthognathic (Jaw) Surgery: Involves surgically repositioning the upper or lower jaw to correct significant misalignment, improving bite function, facial balance, and in some cases, breathing.
• Temporomandibular Joint (TMJ) Surgery: Addresses conditions affecting the jaw joint, ranging from non-surgical management to surgical intervention for more severe or persistent joint problems.
• Facial Trauma Surgery: Covers the diagnosis and surgical repair of fractures and soft tissue injuries affecting the face and jaw, commonly resulting from accidents or injury.
• Oral and Maxillofacial Pathology: Focuses on diagnosing and treating cysts, tumours, and other abnormal growths of the oral and facial tissues, including benign conditions and oral cancers.
• Reconstructive and Cosmetic Surgery: Covers reconstructive procedures following trauma or disease, as well as surgery aimed at enhancing facial appearance.
• Cleft and Craniofacial Surgery: Addresses congenital conditions such as cleft lip and palate, often requiring staged surgical treatment from infancy through to adolescence.

Common Conditions Treated

• Impacted wisdom teeth: Wisdom teeth that do not have enough room to emerge properly can become impacted, trapped partially or fully beneath the gum, leading to pain, infection, or damage to neighbouring teeth if not removed.
• Temporomandibular joint (TMJ) disorders: A group of conditions affecting the jaw joint and surrounding muscles, causing jaw pain, clicking or locking, and difficulty opening or closing the mouth comfortably.
• Jaw misalignment (malocclusion): A significant mismatch between the upper and lower jaw can affect chewing, speech, and facial appearance, and in more severe cases may require surgical correction alongside orthodontic treatment.
• Facial trauma: Fractures of the jaw, cheekbones, or other facial bones, along with associated soft tissue injuries, often resulting from falls, sports injuries, or road traffic accidents, requiring prompt surgical assessment and repair.
• Oral and facial cysts and tumours: Abnormal growths within the jawbone or soft tissue of the mouth and face, which may be benign or, in some cases, cancerous, and often require surgical removal and further evaluation.
• Oral cancer: Cancer affecting the lips, tongue, cheeks, or other areas of the mouth, often requiring surgical removal of the tumour alongside reconstruction, sometimes in combination with other cancer treatments.
• Salivary gland disorders: Conditions such as salivary gland stones, infections, or tumours can affect saliva production and may require surgical treatment if they do not resolve with more conservative management.
• Cleft lip and palate: A congenital condition in which the lip or roof of the mouth does not fully join together during early development, typically requiring a series of staged surgeries over childhood and adolescence.
• Facial deformities: Structural abnormalities of the jaw or face, whether present from birth or acquired later in life, which can affect both function and appearance and may be corrected through reconstructive surgery.
• Obstructive sleep apnoea (jaw-related): In select cases where the position or size of the jaw contributes to airway obstruction during sleep, orthognathic surgery may be considered as part of a broader treatment approach.

Recognising When You May Need an Oral and Maxillofacial Consultation

• Persistent jaw pain or clicking: Ongoing discomfort, clicking, or difficulty fully opening or closing the mouth can indicate a problem with the temporomandibular joint that may benefit from specialist assessment.
• Pain or swelling around a wisdom tooth: Recurrent pain, swelling, or infection around the back of the jaw often signals an impacted wisdom tooth that may need to be removed.
• Visible jaw or facial asymmetry: A noticeable mismatch between the upper and lower jaw, or asymmetry in facial appearance, may warrant evaluation for a possible underlying skeletal cause.
• Facial injury: Any suspected fracture or significant soft tissue injury to the face or jaw following an accident or trauma should be assessed promptly to prevent complications and guide appropriate healing.
• A persistent mouth ulcer or lump: A sore, lump, or patch in the mouth that does not heal within a few weeks should be evaluated, as persistent lesions occasionally indicate a more significant underlying condition.
• Difficulty chewing, speaking, or breathing: Functional difficulties linked to the position or structure of the jaw may benefit from a specialist opinion on whether surgical correction could help.

Risk Factors for Oral and Maxillofacial Conditions

• Tobacco and betel nut use: Both are significant, well-established risk factors for oral cancer and other diseases affecting the lining of the mouth.
• Participation in contact sports or high-risk activities: Activities with a higher risk of facial impact increase the likelihood of facial trauma and associated fractures.
• Insufficient jaw space: A jaw that is naturally too small to accommodate all teeth comfortably increases the likelihood of impacted wisdom teeth and dental crowding.
• Family history and genetics: Certain jaw growth patterns, malocclusions, and congenital conditions such as cleft lip and palate have a recognised genetic component.
• Teeth grinding or jaw clenching: Chronic grinding or clenching places repeated strain on the temporomandibular joint and surrounding muscles, increasing the risk of TMJ-related problems.
• Poor oral hygiene: Inadequate oral care increases the risk of infections that can, in more severe or neglected cases, extend beyond the teeth into the surrounding jawbone and soft tissue.

How Oral and Maxillofacial Surgeons Diagnose Conditions

• Clinical examination: A thorough examination of the mouth, jaw, and face forms the foundation of diagnosis, assessing bite alignment, jaw movement, and any visible abnormalities.
• Panoramic and dental X-rays: Provide a broad view of the teeth, jawbone, and surrounding structures, useful for assessing impacted teeth, cysts, and the position of the jaw.
• Cone-beam computed tomography (CBCT): A specialised 3D imaging technique that provides highly detailed images of the jaw and facial bones, particularly valuable for planning complex surgeries such as implant placement or jaw repositioning.
• CT and MRI scans: Used for more detailed evaluation of complex trauma, tumours, or soft tissue conditions, providing additional information beyond what standard dental imaging can offer.
• Biopsy: A small tissue sample may be taken from a suspicious lesion or growth and examined under a microscope to confirm a diagnosis, particularly important when oral cancer is suspected.

The Link Between Oral Health and Overall Health

The health of the mouth and jaw is closely connected to overall health in ways that are often underappreciated. Chronic oral infections and gum disease have been linked to an increased risk of cardiovascular disease, believed to be related to the way oral bacteria and the resulting inflammation can affect blood vessels elsewhere in the body.

Beyond this connection, conditions affecting the jaw and bite can also impact nutrition and general wellbeing, as difficulty chewing effectively may lead some patients to avoid certain foods altogether. This broader connection between oral and systemic health is part of why oral and maxillofacial surgeons often coordinate closely with dentists, physicians, and other specialists as part of a patient's overall care.

Preparing for Oral and Maxillofacial Surgery

• Pre-operative imaging and assessment: Detailed imaging, such as a CBCT scan, is often required ahead of more complex procedures to allow precise surgical planning.
• Medical history review: Disclosing existing medical conditions, medications, and allergies allows the surgical team to plan safely, particularly for procedures involving general anaesthesia.
• Fasting instructions: For procedures requiring sedation or general anaesthesia, patients are generally required to fast for a specified period beforehand to reduce anaesthesia-related risks.
• Arranging support for recovery: Because many procedures involve sedation or anaesthesia, and swelling or discomfort is common afterward, arranging for someone to assist with transport and initial recovery at home is generally recommended.

Recovery After Oral and Maxillofacial Surgery

• Managing swelling and discomfort: Swelling and mild discomfort are common in the days following surgery, generally managed with prescribed pain relief and the use of cold compresses.
• Dietary adjustments: A soft or liquid diet is often recommended in the initial recovery period, particularly following jaw surgery or extensive dental procedures, gradually progressing back to normal foods as healing allows.
• Oral hygiene care: Gentle, careful oral care following surgery helps prevent infection while allowing the surgical site to heal without disruption.
• Activity restrictions: Patients are generally advised to avoid strenuous activity for a period following surgery, particularly after more extensive procedures such as jaw surgery.
• Follow-up appointments: Scheduled reviews allow the surgical team to monitor healing, remove any sutures if needed, and address any concerns that arise during recovery.

The Long-Term Benefits of Oral and Maxillofacial Surgery

For many patients, oral and maxillofacial surgery addresses problems that extend well beyond the immediate area treated, improving chewing function, speech, breathing, and facial appearance in ways that can meaningfully improve day-to-day quality of life and self-confidence.

Because conditions such as TMJ disorders, jaw misalignment, and the long-term effects of facial trauma can continue to evolve over time, many patients benefit from ongoing follow-up with their oral and maxillofacial surgeon, particularly where orthodontic treatment, dental restoration, or further reconstructive work forms part of a longer-term treatment plan.

Our dedicated teams of experienced multidisciplinary specialists and healthcare professionals work together to provide treatment plans tailored to the needs of our patients on their recovery journey.

Speak to our Specialists today.