What is Oral Surgery?
The specialty of Oral Surgery deals with the diagnosis and management of pathology of the mouth and jaws that requires surgical intervention. Oral Surgery involves the treatment of children, adolescents and adults, and the management of dentally anxious and medically complex patients.
Primary care-based General Dental Practitioners (GDPs) are expected to undertake routine Oral Surgery care, such as dental extractions, as part of their general dental services contracts. More complex Oral Surgery care is provided by specialists in Oral Surgery and by Oral Surgery and Oral & Maxillofacial Surgery consultants (including academics) who may work in primary care or secondary care settings1 . Secondary care-based Oral Surgery consultants would not normally be found in stand-alone units; rather, they would be integrated with OMFS units with the opportunity for skill mix and multi-disciplinary team working. Postgraduate dental trainees working under consultants may also provide Oral Surgery care.
Oral Surgery care is provided by Oral Surgeons and by Oral & Maxillofacial Surgeons as the clinical competencies of these two specialties overlap. The UK General Medical Council recognises ‘Oral & Maxillofacial Surgery’ as a medical specialty.
Given the overlap between Oral Surgery, Oral & Maxillofacial Surgery and Oral Medicine, the workforce within local areas may comprise a variety of performers from ( Kendall N. Improving access to Oral Surgery services in primary care. Primary Dental Care 2009; 16(4): 137-142. 12) different specialties.
Depending on the decisions and information provided by the referring clinician, patients with similar Oral Surgery/ Oral Medicine conditions may be seen by a specialist in Oral Surgery, Oral & Maxillofacial Surgery or Oral Medicine. It is important that commissioners can identify which specialists are providing which services locally. A significant proportion of referrals made to Oral Surgery specialists include dentoalveolar surgery and this less complex work has caused increasing pressure on hospital consultant service waiting lists since the dental contract reforms in 2006.
The recent Medical Education England Dental Programme Board Review of Oral Surgery Services and Training recommended that much of the minor Oral Surgery care could be delivered by specialists; some specialists have established primary care-based Oral Surgery services which are commissioned locally. Forceps extraction and some minor Oral Surgery is undertaken in primary care by GDPs. Some dentists, who are not on the GDC specialist list for Oral Surgery, have enhanced skills and experience in Oral Surgery (and have previously been called, ‘Dentists with extended skills’ DES). These individuals may perform some Level 2 procedures within an Managed Clinical Network. Information regarding activity is presented in Section 8 of this document. It is important to note that data are not consistently collected across all areas of England. However, general trends in activity may be identified when comparing different data sources.
Text above taken from Oral Surgery Commissioning Guide https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/09/guid-comms-oral.pdf