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Why Oral Surgery Should Only be Left In the Hands of Oral Surgeons

Oral surgery without an oral surgeon...yikes!Last month, we saw three patients referred for complications from failed oral surgery procedures done at general dentistry offices.  The first patient suffered chronic infection and numbness of her tongue following removal of her wisdom teeth.  The second patient had root fragments from a wisdom tooth that were left in place because the dentist could not remove them.  Furthermore, one of the roots was pushed through the bone into the throat area.  The third patient had an infected dental implant that had been watched inappropriately over a couple of months only to result in bone loss and a more severe infection.  In all three cases, patients and parents did not know anything about the qualifications of the dentist doing the oral surgery procedure.  They simply trusted the recommendations of their dentist to have an oral surgery procedure done at their office.

Such incidents are not rare. On the average, we see four to five patients a week with complications that could have been easily avoided if a trained specialist in a more appropriate environment had seen the patient. If you need an oral surgery procedure such as wisdom teeth extraction or dental implants, your general dentist should refer you to an oral surgeon for the proper treatment.  These types of oral surgery procedures are best performed by an oral surgeon at his or her office, not only because of their experience, but also to ensure that the facilities of the office are properly equipped and staffed to manage such treatments efficiently and safely.

Some general dentists may choose to perform oral surgery procedures in their office in order to increase practice production and profits. The general dentist may elect to do the procedure or may bring in a periodontist or an oral surgeon to do the procedures at their general dentistry office. The dentist may tell his patients that there is no need to see an oral surgeon; they take advantage of the trust of their patient and lead them to believe they are capable of doing the procedure.  They may also tell their patients, “don’t worry, you don’t have to go anywhere, we have a specialist who comes in to do these procedures here at our office for your convenience.”  They try to emphasize that it will be easier and faster to have it done at their office.  Either way, be aware of the complications that may result from such dangerous recommendations:

General dentist doing the surgery: Patients should be aware that general dentists are not trained for surgical procedures. While a general dentist may have taken a course or two, an oral surgeon has years of oral surgery training and can deliver predictable results with teeth extractions, wisdom teeth surgery, or dental implants.

General dentist hiring another general dentist with “experience” in oral surgery: In group practices, another general dentist may be designated to perform surgeries since they may have some experience or just choose to dive into the surgical world and try it. Yet, a general dentist doesn’t have the experience an oral surgeon acquires by doing surgeries every day.

General dentist hiring a periodontist to do oral surgery procedures: While some periodontists may do simple extractions or dental implants, they are not experienced in the extraction of impacted wisdom teeth and complex bone grafting and dental implant procedures. Just because they are proficient in management of gum diseases and related surgical procedures, it does not qualify them for oral surgery procedures.

General dentist hiring an oral surgeon to do oral surgery procedures: “I actually did this for a few months during my first year of practice about 16 years ago” said Dr. Kazemi. However, he quickly realized that a general dentistry office is poorly designed for such intricate procedures. Lack of proper instrumentation, equipment, staff knowledge, and support makes a general dentistry office risky and even dangerous in spite of the surgeon’s training and experience.  A general dentistry office has an entirely different focus and is set up differently than an oral surgery office. It simply cannot meet the criteria for surgical procedures.

IV sedation (being asleep for the procedure) is not an option: Whether it is an oral surgeon, periodontist, or the general dentist doing the surgery at a general dentistry office, you won’t be able to receive proper IV sedation. Your dentist may say you don’t need it, but it is the most comfortable and recommended way to have surgical procedures done. A general dentist can only offer local anesthesia, which means you will be awake for the procedure.

So, when you are making decisions about oral surgery procedures, remember you always have the option of requesting a board-certified oral and maxillofacial surgeon that will have a well-equipped office with specialized personnel designed to provide the best oral surgery treatment for patients.