About OMFS

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The Specialty of OMFS

The human face, in most cultures, is the visible manifestation of the individual. Judgments are made based on the appearance of the face and so diseases of the face impact on individuals much more than similar diseases of internal organs or limbs.

The two surgical specialties which include “facial surgery” within Annex V are Dental-Oral-Maxillo-Facial surgery (DOMFS) and Maxillo-Facial Surgery (MFS). Within UEMS these specialties fall under the Section of Oral and Maxillo-Facial Surgery. Specialists in DOMFS have both medical and dental qualifications. That the majority of nations within the EAA have a specialty which includes two professions – dentists and doctors – highlights the complex nature of delivering the highest quality of care for patients with facial problems.

Oral – The Mouth, and Dental - The Teeth

Mouths are sensory organs, communication instruments, food processors and sit at the centre of facial function and aesthetics. A thorough understanding of dentistry is essential for surgery in and around the mouth.

Teeth are a complex organ in themselves. Covered with enamel, the hardest substance in nature, and held in place with the periodontal ligament which is so sensitive that a hair can be felt between upper and lower teeth. Repositioning and repairing the jaws is an exact science for this reason.

Maxillo – Jaws

The lower jaw or mandible and the upper jaw which is called the maxilla from the same derivation, make up two thirds of the face. The upper jaw sits below the eyes and supports the nose. The bones of the face sit below the skull. This is why the specialty of OMFS works with other specialties to provide the best patient care (neurosurgery, ENT, ophthalmology to mention just 3).

Facial – Face

The face sits below, above and in front of critical anatomical and functional structures. Above it is the brain, behind the spinal cord and below all the major vessels and organs of the neck. Facial operations require complex skills in hard and soft tissue surgery. In addition to surgical skills, much facial surgery is inter-disciplinary. Surgeons in this field must be able to work with colleagues across medical and dental disciplines. Allied professionals also have a key role in patient care. A facial surgeon must be an empathetic physician and team leader. A critical reviewer of scientific information, an innovator and a self-driven professional. All patients who have had facial surgery understand and appreciate this.

So Much More

Dental and Oral are words that the public understand to mean teeth and mouths. Maxillo originates from the Latin for jaw. Over the last 30 years the surgery undertaken by specialists trained in these two Annex V specialties has been much wider than just teeth, mouth, jaws and face. This is because reconstructing the complex bones of the face may require bone grafts taken as living transfers from the leg, shoulder or arm. Removing cancer of the face may require removal of lymph nodes from the neck where hidden cancer may be present.

Many specialists from DOMFS and MF undertake these resections/reconstructions within a single specialty team but others work in a multi-specialty team with the elements of the surgery being undertaken by the specialists most current in the sub-specialty competency. This is why designing a European Training Requirement is complex and why we have involved all UEMS Sections representing the medical teams with whom we work. We would like to thank them all for their contributions and advice. These are listed in Appendix