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Thinking About Oral and Maxillofacial Surgery? |
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Maxillofacial Surgery is touched upon as part of the Dental Undergraduate curriculum, and by the time you qualify you should have an idea about what this specialty involves. Most dental undergraduates get the opportunity to observe and brush shoulders with the SHO’s, SpR’s and Consultants in this field. So, ever wondered what they do, and how you get there?
The History This specialty goes back to the war years, when injuries to the hard and soft tissues of the face were reconstructed with prosthetic devices. As surgery developed dental surgeons were prominent in reconstructing lost facial tissues with local flaps. Specialists started to emerge and the surgical arm of dentistry became established.
It went on as a dental speciality until 1982 when the British Association of Oral and Maxillofacial Surgeons recognised that in order to provide a competent surgical service and manage patients under its care it was necessary to have both medical knowledge and surgical training. They passed a resolution that within 10 years it would be mandatory for consultants in this field to possess both dental and medical qualifications. In 1994 it became one of the nine surgical specialties recognised by the surgical colleges.
Scope of Surgery The core activity of the specialty is the comprehensive management of:
¨ Facial trauma Injuries ranging from simple cuts and bruises to complex craniofacial trauma. The majority of such injuries are the result of interpersonal violence and road traffic accidents
¨ Head and neck cancer Approximately 80% of mouth and jaw cancer is currently managed by this specialty. Tumour resection and subsequent reconstructive surgery is performed by Oral and Maxillofacial Surgeons. Such surgery is potentially disfiguring and destructive to functions such as speech and swallowing. It requires a multidisciplinary team approach to manage complex cases.
¨ Facial deformity The range of treatment extends from soft tissue surgery, such as removal of moles and hard tissue orthognathic surgery (correction of skeletal disproportion), through to correction of congenital abnormalities, such as cleft lip and palate and craniofacial syndromes.
¨ Surgery of the mouth and related structures Diagnosis and treatment of diseases affected the mouth, jaws, face and neck. This includes disorders of the temporomandibular joints, salivary glands, soft tissues of the oral cavity (mouth ulcers and infections), impacted teeth, cysts and tumours of the jaws. Oral and maxillofacial surgeons frequently work alongside other specialists including orthodontists, oncologists, neurosurgeons, ophthalmologists, radiologists, plastic surgeons, and ENT surgeons. |
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By the time you qualify as a dentist you’ll be pretty familiar with the Oral Surgery Department and the basic techniques of oral surgery – extractions, biopsies, even apicectomies. But, ever wondered what exactly the Maxillofacial part entails, what the Senior House Officers (SHO’s) do? |