Oral and maxillofacial surgery: when might you need it?

A referral for a surgical opinion does not necessarily mean you need an operation. It means a clinician with relevant expertise should assess the problem and explain the options. The referral may concern a difficult tooth extraction, a jaw injury or a change in the tissues of the mouth.

In the UK, oral surgery and oral and maxillofacial surgery are related but distinct specialties. Oral surgery focuses on surgical conditions affecting the mouth and jaws. Oral and maxillofacial surgeons have medical and dental qualifications and treat a wider range of conditions involving the mouth, jaws, face and neck, often in hospital.

Why you might be referred

Your dentist may arrange a surgical assessment for an impacted tooth, a cyst, a persistent mouth lesion or an extraction that needs additional expertise. An impacted tooth has not emerged into its expected position; it does not always hurt or need to be removed. Wisdom teeth that are healthy and causing no problems can often be monitored.

Major jaw injuries, some tumours and complex jaw reconstruction need hospital specialist care. These are different from procedures carried out in a dental practice. The examples here describe the wider specialty, rather than a list of operations available at Medical Dent.

Jaw surgery to change the position of the jaws is called orthognathic surgery. It may be considered for selected jaw alignment problems, usually alongside orthodontic treatment. Having a crossbite, an open bite or crowded teeth does not by itself mean surgery is necessary. Assessment considers the jaws, teeth, function and your own concerns.

What happens at the assessment?

Bring details of your medicines, allergies, previous treatment and any relevant medical conditions. Explain when the problem began, what makes it worse and whether your bite or ability to open your mouth has changed. The clinician may examine your mouth and arrange imaging if it will help make a treatment decision.

Before agreeing to a procedure, ask what it is intended to achieve, what the alternatives are and what could happen if you wait. Discuss the likely benefits, risks, costs and who will provide follow-up care. Treatment cannot be guaranteed to remove every symptom.

Anaesthetic and recovery

Some procedures use local anaesthetic; others may involve sedation or a general anaesthetic. The choice depends on the operation, your health and the treatment setting. Follow your team’s specific instructions about eating beforehand, transport, driving and whether someone needs to stay with you afterwards.

Recovery also varies. An assessment alone does not automatically require a day off work, while a more complex operation may need a longer recovery period. After extraction, possible complications include bleeding, infection and dry socket; nerve injury is a consideration for some teeth. Your surgeon should explain the risks relevant to you and how to get help afterwards.

When to seek help promptly

Arrange a dental or GP assessment for a mouth ulcer lasting more than three weeks, an unexplained lump or a persistent red or white patch. These changes have several possible causes and should be checked.

Seek urgent care after a significant facial injury, especially if your bite has changed or you cannot open or close your mouth normally. Call 999 or go to A&E for breathing or swallowing difficulty, or heavy bleeding that will not stop.

For a planned assessment, contact the practice to discuss the appropriate route. Ask for a written estimate before private treatment. If you are considering finance, check the current terms and eligibility information; availability depends on the treatment and application.

Read more from BAOMS about the specialty and the NHS about wisdom tooth removal.