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What is an Oral and Maxillofacial Surgeon?

  April 02, 2015

By Alexander Germanis

Functionality and aesthetics. Whether it is in regard to a car, a watch, or even a cell phone, it is not enough to most people that something performs its function properly, it is also important that it looks good while doing it. How much more do those concerns of function and aesthetics translate to that which we display to the world more often that any vehicle or gadget: our own faces.

Achieving that facial meld of functionality and aesthetics is the very essence of what oral and maxillofacial surgeons do. David Efaw, MD, DDS of Doran, Capodice, Efaw and Ocheltree, LLC explains: “Any time you manipulate anything on the face, by definition, [it must be] both functional and cosmetic.”

In order to acquire the knowhow to confidently balance form and function, oral and maxillofacial surgeons spend a significant number of years in study and practice. Dr. Efaw outlines the rigors at the start of one’s career. “Just to give the scope of the training,” he says, “most of us have gone through college, four years of dental school, an option to do medical school as well, a year of general surgery, an oral and maxillofacial residency, and then a fellowship. I grew up here. When I came back to town, I was 31 years old.”

When one considers the complexities of the human face and mouth — both what is on the surface and what is hidden beneath — it comes as no surprise there are many complex procedures to repair, restore, and beautify those structures.

"There are several components to it,” Dr. Efaw explains. “Like a pie. What are the pieces? The first one is extractions and wisdom teeth. The second would be reconstructive surgery including jaw surgery. The third one would be facial trauma, facial injuries — specifically bony facial injuries. The next one would be pathology: cysts and tumors and things like that of the face and jaws. And then there’s cosmetic and reconstructive surgery of the face. So either post-traumatic cosmetic surgery or elective cosmetic surgery.”

Of the different types, Dr. Efaw cites orthognathic surgery as being “the most complex surgery that we do.” Orthognathic stems from the Greek orthos and gnathos, meaning ‘straight jaws.’ In such a surgery, either one or both the maxilla (upper jaw bone) and mandible (lower jaw bone) are repositioned in order to bring them into alignment.

Just one of the problems such a procedure is meant to solve is to correct a patient’s bite. When the jaws are misaligned, the teeth do not perform the functions of chewing and biting properly.

Function is again of great import, but the resulting profile of the patient is also brought into proper alignment, thus satisfying the second criterion of aesthetics.

The pie has yet one more piece, Dr. Efaw continues, and that “would be pre-prosthetic and implant surgery, or dental implants.” This leap forward in oral rehabilitation has many oral surgeons excited. Single or multiple tooth loss can be combated with artificial teeth that are affixed through permanent titanium implants in the jaw bone.

One of Dr. Efaw’s colleagues, Jack Capodice Jr., MD, DMD, points out how delicate even the most basic-sounding of these procedures and surgeries can be. “When you’re drilling into somebody’s jaw, there are blood vessels, there are nerves, there’s the sinus, there’s the floor of the nose. If you perforate outside the bone, if you don’t drill at the right angle you could hit muscles and blood vessels,” he explains. “Everybody thinks: ‘Oh, it’s just drilling a hole and screwing something in. It’s not that big a deal, is it?’ Well, it’s not a big deal even 99 out of 100 times, depending on your experience level. But getting to that experience level comes with years of additional training and hundreds and thousands of additional cases.”

In other words, entrusting the functionality and aesthetic quality of one’s face is clearly not something to be taken lightly. “If you’re entrusting your care to someone, know their qualifications,” Dr. Capodice urges. “Are they a specialist? How many cases have they done? Are they board certified in their specialty? These are important questions to ask. If this was your child or your [sibling] or your [spouse], what would you do?”

Future issues of Healthy Cells will delve deeper into the procedures performed by oral and maxillofacial surgeons.

Drs. Doran, Capodice, Efaw and Ocheltree provide a full scope of oral and maxillofacial surgery with expertise ranging from wisdom tooth removal and dental implants to bone grafting procedures and corrective jaw surgery. They can also perform facial cosmetic surgery. Their office is located at 109 N. Regency Dr. in Bloomington with satellite offices in Watseka and Lincoln. For more information, you may call 309-663-2526 or visit them online at

Photo credit: OJO_Images/iStock Back to Top

April 02, 2015

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