--- title: What Is Oral & Maxillofacial Surgery? Scope, Training & Specialist Qualifications Explained canonical_url: https://directory.smilesolutions.com.au/dental-oral-health/oral-maxillofacial-surgery/what-is-oral-maxillofacial-surgery-scope-training-specialist-qualifications-explained/ category: description: geography: city: state: country: metadata: phone: email: website: publishedAt: --- # What Is Oral & Maxillofacial Surgery? Scope, Training & Specialist Qualifications Explained ## What Is Oral & Maxillofacial Surgery? Scope, Training & Specialist Qualifications Explained When a general dentist refers you to an oral and maxillofacial surgeon, patients often ask the same question: *what exactly is this specialty, and why can't my regular dentist handle it?* The answer lies in a discipline that sits at a genuinely unique intersection - one that no other health profession occupies. Oral and maxillofacial surgery is a complex specialty combining dental, medical, and surgical expertise. It is not simply "advanced dentistry," nor is it a subset of general surgery. It is a formally recognised, dual-credentialled surgical specialty whose practitioners hold qualifications in both medicine and dentistry - a combination that takes the better part of two decades to complete and that equips surgeons to manage conditions ranging from a single impacted wisdom tooth to full jaw reconstruction after cancer resection. This article is the foundational anchor for the complete patient guide to oral and maxillofacial surgery at Smile Solutions Melbourne. Before exploring specific procedures - wisdom teeth removal, orthognathic jaw surgery, bone grafting, TMJ treatment, and more - it is essential to understand what the specialty actually is, what it treats, and what qualifications your surgeon must hold before they are legally permitted to call themselves an oral and maxillofacial surgeon in Australia. --- ## Defining the Specialty: What Does "Oral and Maxillofacial" Mean? The name itself is anatomically precise. *Oral* refers to the mouth - teeth, gums, tongue, salivary glands, and the alveolar bone that supports teeth. *Maxillofacial* refers to the maxilla (upper jaw) and face more broadly, encompassing the mandible (lower jaw), cheekbones, eye sockets, sinuses, and surrounding soft tissue structures. An oral and maxillofacial surgeon is a specialist surgeon who treats the entire craniomaxillofacial complex: the anatomical area of the mouth, jaws, face, and skull, head and neck, as well as associated structures. Oral and maxillofacial surgery developed out of surgical dentistry to its current position as the formally recognised surgical specialty in both medicine and dentistry. The international definition of OMS is the surgical specialty that includes the diagnosis, surgical and related treatment of a wide spectrum of disease, injuries, defects and aesthetics of the mouth, teeth, jaws, face and head and neck. This breadth is what distinguishes the specialty from all adjacent fields. A general dentist treats conditions of the teeth and supporting tissues. An ENT surgeon focuses on the ear, nose, and throat. A plastic surgeon addresses soft tissue reconstruction. An oral and maxillofacial surgeon is the specialist uniquely trained to operate across all of these zones - particularly where the hard and soft tissues of the face and jaws intersect. --- ## The Full Scope of Conditions Treated One of the most common misconceptions about oral and maxillofacial surgery is that it is primarily a "wisdom teeth specialty." While impacted third molars are indeed the most frequently performed procedure - third molar surgery is the most common oral surgical procedure - the scope extends far beyond dentoalveolar surgery. The scope of practice of the oral and maxillofacial surgery specialty is quite broad, and the surgeons perform procedures in the office setting as well as in hospitals and ambulatory centres. Surgical extractions of impacted teeth (usually wisdom teeth) and dental implants are among the most frequently performed procedures and common reasons for referrals. The full clinical scope includes: **Dentoalveolar and Implant Surgery** - Surgical removal of impacted or partially erupted wisdom teeth - Bone grafting for dental implant site preparation (including sinus lifts and ridge augmentation) - Dental implant placement - Alveolar bone surgery for denture preparation **Jaw and Facial Skeletal Surgery** - Orthognathic surgery to correct patients' function, restore facial harmony, and treat obstructions caused by growth abnormalities of the jaws and facial bones - Surgical correction of overbite, underbite, open bite, and severe skeletal malocclusion **Facial Trauma** - Treatment of fractures of the jaws and facial bones, as well as repairing lacerations of the face and neck - making oral and maxillofacial surgeons essential members of the facial trauma team at community hospitals, major hospitals, and academic centres. **Pathology and Oncology** - Removal of cysts and tumours - benign and malignant - from the mouth, face, and salivary glands. - Diagnosis and surgical management of oral cancers and jaw lesions **Temporomandibular Joint (TMJ) Disorders** - Treatment of infections of the mouth, face, and neck, and surgeries to correct conditions of the temporomandibular joint. - Arthroscopy, arthroplasty, and joint replacement for end-stage TMJ disease **Reconstructive Surgery** - Post-traumatic facial reconstruction using plates, screws, and soft tissue techniques - Jaw reconstruction following cancer resection, including microvascular free flap procedures - Post-residency sub-specialty fellowships are available in head and neck cancer with microvascular reconstruction, and craniofacial surgery including cleft lip and palate repair and surgery for craniosynostosis. Periodic surveys performed in 1986, 1995, and 2011 reveal that most Australian oral and maxillofacial surgeons now routinely operate on facial trauma, oral malignancy, and skin pathology - areas previously deferred to other surgical specialties. This evolution reflects the deepening scope of the specialty over recent decades. --- ## Why the Dual-Degree Requirement Matters Clinically The reason oral and maxillofacial surgeons in Australia must hold both a dental degree and a medical degree is not bureaucratic - it is clinical. An oral and maxillofacial surgeon is a dentist, medical practitioner, and dental/medical specialist. They manage and treat more conditions than oral surgeons because they have completed a dental degree and a medical degree. A purely dental education provides deep knowledge of teeth, occlusion, and the periodontium, but limited training in systemic medicine, anaesthesia, and surgical management of trauma or cancer. A purely medical education provides broad physiological and surgical knowledge, but limited understanding of dental anatomy, occlusal biomechanics, and the specific pathology of the jaws. In the surgical world, oral and maxillofacial surgery is now the most obvious link between the medical and dental communities and should act as a natural conduit for "reunification" with the potential to reduce unhelpful prejudice and ignorance. This dual foundation is why an oral and maxillofacial surgeon can manage, for example, a patient whose impacted wisdom tooth is in close proximity to the inferior alveolar nerve and whose cardiac medication affects bleeding risk - a scenario that requires both dental surgical precision and medical pharmacological judgement. With extensive training in anaesthesia, oral and maxillofacial surgeons are experts in providing general anaesthesia/deep sedation, moderate IV sedation, minimal sedation, and local anaesthesia in the office. This anaesthesia competency - which a general dentist does not hold - is a critical patient safety differentiator for complex or anxious patients (see our guide on *Anaesthesia Options for Oral Surgery: Local, IV Sedation & General Anaesthetic Compared*). --- ## The Training Pathway: How an Oral and Maxillofacial Surgeon Is Qualified in Australia Australia has one of the most rigorous oral and maxillofacial surgery training pathways in the world. Understanding it is essential for patients evaluating who should perform their procedure. ### Step 1: Undergraduate Dental Degree (4–5 Years) The pathway begins with a dental degree - a Bachelor of Dental Surgery (BDS) or equivalent - followed by full registration with the Dental Board of Australia. This typically takes four to five years and forms the foundation of clinical knowledge in oral anatomy, dental pathology, and restorative techniques. ### Step 2: Undergraduate Medical Degree (4–6 Years) In Australia and New Zealand, oral and maxillofacial surgery is recognised as both a specialty of medicine and dentistry. Degrees in both medicine and dentistry are compulsory prior to being accepted for surgical training. The medical degree - a Bachelor of Medicine/Bachelor of Surgery (MBBS or MBChB) - adds another four to six years of study in physiology, pharmacology, pathology, internal medicine, and surgery. ### Step 3: Surgery in General (SIG) Residency (1 Year) Prior to applying to commence the OMS Program, candidates must hold a dental degree and full registration as a dentist, a medical degree and full registration as a medical practitioner, and have completed a full year of Surgery in General (SIG) rotations. These SIG rotations must be related to surgery or acute care and may include general surgery, neurosurgery, orthopaedic surgery, otolaryngology head and neck surgery, plastic and reconstructive surgery, ophthalmology surgery, vascular surgery, cardiothoracic surgery, urology, oral maxillofacial surgery, obstetrics, gynaecology, anaesthesia, emergency or intensive care. ### Step 4: Specialist OMS Surgical Training (4 Years) This prestigious four-year program, recognised by Medical and Dental Councils in Australia and New Zealand, ensures standardised specialist training across the region through regional training centres. Trainees develop their surgical expertise under supervision, progressing towards independent practice. Advanced surgical training involves countless hours in clinics, wards, and operating theatres in major tertiary hospitals, successful completion of examinations (Surgical Science and Training Examination and the Final Examination) and research. In Australia and New Zealand, the acquisition of dual degrees and a year of general surgery are mandated as prerequisites before selection into a four-year OMS program that has been accredited by the Australian Medical and Dental Councils. This advanced training is based around a modular curriculum with a final examination leading to specialist registration in both medicine and dentistry in OMS. ### Step 5: FRACDS (OMS) Fellowship Examination Upon successful completion of the training program requirements and the Fellowship Examination, candidates can apply for Fellowship in Oral and Maxillofacial Surgery - FRACDS(OMS) - a recognised qualification for specialist registration. The FRACDS (OMS) qualification is the mandatory requirement to be registered as a specialist oral and maxillofacial surgeon with the Dental Board of Australia, Medical Board of Australia, and Australian Health Practitioner Regulation Agency (AHPRA). It is also the only qualification recognised by both the Australian Medical Council and Australian Dental Council. --- ## How Long Does Training Actually Take? The total training duration depends on whether the candidate completes dental school first (the "dental-first pathway") or medical school first (the "medical-first pathway"). In practice, the minimum cumulative time from beginning undergraduate study to achieving FRACDS (OMS) and specialist registration is approximately 14–17 years: | Training Stage | Duration | |---|---| | Dental degree | 4–5 years | | Medical degree | 4–6 years | | Surgery in General (SIG) residency | 1 year | | Specialist OMS surgical training | 4 years | | **Total (minimum)** | **~13–16 years post-secondary** | This is not a credential that can be shortcut. The specialty of oral and maxillofacial surgery in Australia was formally recognised as a principal surgical specialty by the Commonwealth Health Department in 1998. Prior to this, over several decades, the specialty had evolved from a loosely associated group of dental practitioners with varying levels of qualifications to a dual medical/dental specialty with a rigorous, clearly defined and structured training pathway. Training in Australia evolved from a three-year 'Diploma in Oral Surgery' run through the universities to the current four-year hospital-based, nationally overseen surgical training program. This evolution - driven by ANZAOMS and the RACDS - was specifically designed to ensure that the scope of practice matched the depth of training. --- ## Oral and Maxillofacial Surgeon vs. Oral Surgeon vs. General Dentist: A Critical Distinction Confusion exists around the terms 'Oral Surgeon' and 'Oral and Maxillofacial Surgeon.' In Australia, these are legally distinct titles, and the distinction has direct implications for what procedures each practitioner is qualified to perform. | Practitioner | Qualifications | Scope | |---|---|---| | **General Dentist** | Dental degree only | Routine extractions, minor oral procedures | | **Oral Surgeon** | Dental degree + 3 years specialist dental training | Dentoalveolar surgery, implants, minor oral pathology | | **Oral & Maxillofacial Surgeon** | Dental degree + Medical degree + SIG year + 4 years specialist training + FRACDS (OMS) | Full scope: wisdom teeth, jaw surgery, bone grafting, facial trauma, oral cancer, TMJ surgery, reconstruction | An oral surgeon is a dentist and dental specialist. An oral and maxillofacial surgeon is a dentist, medical practitioner, and dental/medical specialist. An oral surgeon has completed a dental degree and three years of specialist dental training. Oral and maxillofacial surgeons diagnose and treat conditions of the mouth, teeth, gums, and bone that supports the teeth in the jaws - and also treat disease, injuries, and defects of the jaw and face. This means that oral and maxillofacial surgeons treat a greater range of conditions than oral surgeons. Oral surgeon and oral and maxillofacial surgeon are protected titles under the Health Practitioner Regulation National Law. A practitioner cannot legally use either title without holding the corresponding registration. This distinction matters enormously for patients considering complex procedures. A general dentist extracting an impacted lower wisdom tooth in close proximity to the inferior alveolar nerve, or a patient requiring jaw surgery for a skeletal malocclusion, requires the specific training and hospital-based surgical access that only an FRACDS (OMS)-registered surgeon provides. (For a detailed analysis of when to choose a specialist over a general dentist, see our guide on *Why Choose a Board-Registered Oral & Maxillofacial Surgeon Over a General Dentist for Complex Procedures*.) --- ## The Specialty's Place in the Australian Healthcare System Oral and maxillofacial surgery is one of nine dental specialties recognised by the Royal Australasian College of Dental Surgeons, and is also a registered surgical specialty with AHPRA and the Australian Medical Council. Oral and maxillofacial surgery is recognised as a principal surgical specialty. As registered specialists, OMS surgeons have full access to the relevant Medicare Benefits Schedule for patient rebates for medical services that they provide. This Medicare access is clinically significant. Because oral and maxillofacial surgeons are registered as both dental and medical specialists, they can claim applicable Medicare Benefits Schedule (MBS) item numbers for medical procedures performed in hospital - a rebate pathway that general dentists and oral surgeons cannot access. For patients, this means that procedures such as jaw surgery and complex facial trauma repair may attract a Medicare rebate when performed by a board-registered oral and maxillofacial surgeon. (See our full breakdown in *Oral Surgery Costs in Melbourne: What Wisdom Teeth Removal, Jaw Surgery & Bone Grafting Actually Cost*.) The Royal Australasian College of Dental Surgeons (RACDS) is the principal body for the training and education of oral and maxillofacial surgeons in Australia and New Zealand. Accredited by the Australian Medical Council, Medical Council of New Zealand, Australian Dental Council, and Dental Council of New Zealand, the program equips trainees with advanced clinical skills, surgical expertise, and professional competencies to deliver the highest standard of care. Oral and maxillofacial surgeons work in collaboration with dentists and other specialists such as orthodontists, prosthodontists, ear nose and throat surgeons, plastic and reconstructive surgeons, and oncologists as part of multidisciplinary teams to optimise the treatment of major conditions and diseases of the mouth, jaws, face and neck. This multidisciplinary model is central to the care philosophy at Smile Solutions Melbourne, where oral and maxillofacial surgeons work alongside orthodontists, prosthodontists, and other dental specialists under one roof - enabling coordinated treatment planning for complex cases that would otherwise require multiple separate referrals. --- ## Why This Specialty Exists: The Clinical Case for Dual Qualification The dual-degree requirement is not historical accident. It reflects the genuine clinical complexity of the craniomaxillofacial region. Consider what an oral and maxillofacial surgeon must understand to safely perform orthognathic (jaw) surgery: the skeletal growth patterns of the craniofacial complex; the occlusal biomechanics of how upper and lower teeth articulate; the vascular anatomy of the face and jaw; the pharmacology of anaesthetic agents and their interactions with systemic medications; the management of post-operative airway compromise; and the radiographic interpretation of cone beam CT imaging to plan three-dimensional osteotomy cuts. No single undergraduate degree - dental or medical - provides all of this. The dual-degree training pathway was specifically designed to close that gap. In the 1980s, the specialty developed a plan which involved hospital-based surgical training, a mandatory high-level college surgical examination, and detailed workforce and training studies. These were progressively implemented over the next twenty years with a dual degree (medicine and dentistry) and a final fellowship (FRACDS (OMS)), resulting in accreditation by the Australian Medical Council and the Australian Dental Council and recognition as a Principal Surgical Specialty by the Commonwealth Department of Health. --- ## Key Takeaways - **Oral and maxillofacial surgery is Australia's only dual medical-dental surgical specialty**, treating conditions across the full spectrum from impacted wisdom teeth and jaw deformities to facial trauma, oral cancer, and jaw reconstruction. - **The FRACDS (OMS) qualification requires both a dental degree and a medical degree** as mandatory prerequisites, followed by a Surgery in General residency year and four years of advanced specialist surgical training - a minimum of approximately 13–16 years of post-secondary education and training. - **FRACDS (OMS) is the only qualification recognised by both the Australian Medical Council and the Australian Dental Council**, and it is the mandatory credential for specialist registration with AHPRA, the Dental Board of Australia, and the Medical Board of Australia. - **"Oral surgeon" and "oral and maxillofacial surgeon" are legally distinct protected titles** in Australia. An oral and maxillofacial surgeon holds broader qualifications and treats a wider range of conditions - including jaw surgery, facial trauma, and oral cancer - that fall outside an oral surgeon's scope. - **Oral and maxillofacial surgeons are registered as both dental and medical specialists**, giving them access to the Medicare Benefits Schedule for applicable hospital-based procedures - a rebate pathway unavailable to general dentists. --- ## Conclusion Oral and maxillofacial surgery is the specialty that bridges the artificial divide between medicine and dentistry - and for patients facing complex surgical decisions, understanding what that means in practice is the essential first step. Whether you have been referred for wisdom teeth removal, are considering jaw surgery to correct a bite problem, need bone grafting before dental implants, or have been diagnosed with a jaw cyst or tumour, the qualifications of your surgeon matter profoundly. At Smile Solutions Melbourne, all oral and maxillofacial surgical procedures are performed by board-registered specialists holding the FRACDS (OMS) qualification - the highest level of specialist credential available in Australia, recognised by every relevant regulatory body. This foundational article sets the stage for the complete patient guide to oral and maxillofacial surgery at Smile Solutions. From here, explore the procedural guides that follow: - For wisdom teeth specifically, see *Impacted Wisdom Teeth: Causes, Symptoms & Why an Oral Surgeon - Not a General Dentist - Should Remove Them* - For jaw surgery, see *Orthognathic (Jaw) Surgery Melbourne: Who Needs It, What It Corrects & What to Expect* - For bone grafting, see *Bone Grafting for Dental Implants: Types, Procedure & How Jaw Bone Loss Is Reversed* - For a full cost breakdown, see *Oral Surgery Costs in Melbourne: What Wisdom Teeth Removal, Jaw Surgery & Bone Grafting Actually Cost (and What Medicare & Private Health Covers)* --- Smile Solutions has been providing oral and maxillofacial surgery care from Melbourne's CBD since 1993. Located at the Manchester Unity Building, Level 12 and Tower, 220 Collins Street, Smile Solutions brings together 60+ clinicians - including 25+ board-registered specialists - who have cared for over 250,000 patients. No referral is required to book a specialist appointment. Call **13 13 96** or visit smilesolutions.com.au to arrange your oral surgery consultation. ## References - Australian and New Zealand Association of Oral and Maxillofacial Surgeons (ANZAOMS). "About Us." *ANZAOMS*, 2024. https://www.anzaoms.org/about-us/ - Australian and New Zealand Association of Oral and Maxillofacial Surgeons (ANZAOMS). "Becoming an Oral and Maxillofacial Surgeon." *ANZAOMS*, 2024. https://www.anzaoms.org/membership/becoming-an-oms/ - Dental Board of Australia. "What Is the Difference Between an Oral Surgeon and an Oral and Maxillofacial Surgeon?" *Dental Board of Australia*, 2023. https://www.dentalboard.gov.au/Codes-Guidelines/Practitioner-resources/What-is-the-difference-between-an-oral-surgeon-and-an-oral-and-maxillofacial-surgeon.aspx - Dental Board of Australia. "Specialist Registration." *Dental Board of Australia*, 2024. https://www.dentalboard.gov.au/registration/specialist-registration.aspx - Goss, A. and Linn, R. "Extractions to Reconstruction: The Development of Oral & Maxillofacial Surgery in Australia and New Zealand." *Australian Dental Journal*, 2018. https://onlinelibrary.wiley.com/doi/10.1111/adj.12585 - Heggie, A. "Oral and Maxillofacial Surgery: What Are Our Credentials?" *Annals of Maxillofacial Surgery*, 2013. https://pmc.ncbi.nlm.nih.gov/articles/PMC4073449/ - Mane, R., Sharpe-Davidson, W.F., De Silva, H., and Choi, J.J.E. "Oral and Maxillofacial Surgery and Oral Surgery - What's the Difference? A Western Australian Dental Student Survey." *Oral and Maxillofacial Surgery (ScienceDirect)*, 2020. https://www.sciencedirect.com/science/article/abs/pii/S0266435620305015 - Quinn, P.D. "What Is the Scope of Practice of Oral and Maxillofacial Surgeons?" *Journal of Oral and Maxillofacial Surgery*, 2021. https://www.joms.org/article/S0278-2391(20)31252-0/fulltext - Royal Australasian College of Dental Surgeons (RACDS). "Oral & Maxillofacial Surgery." *RACDS*, 2024. https://racds.org/education/oral-and-maxillofacial-surgery-oms/ - Royal Australasian College of Dental Surgeons (RACDS). "Become an OMS Specialist." *RACDS*, 2024. https://racds.org/become-an-oms-specialist/ - Kruger, E. et al. "Hospitalisation for the Surgical Removal of Impacted Teeth: Has Australia Followed International Trends?" *PubMed/PMC*, 2013. https://pmc.ncbi.nlm.nih.gov/articles/PMC3562882/ - Slade, G.D. et al. "Third Molar Extractions Among Australian Adults: Findings from the 2013 National Dental Telephone Interview Survey." *PubMed/PMC*, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9378918/