Oral and Maxillofacial Surgery - Research Paper Example

Oral and Maxillofacial Surgery Introduction The scope of oral and maxillofacial surgery is considered to be relatively large and it includes the treatment and correction of facial disproportion and facial injuries, facial pain, neck and head cancers, the management of diseases affecting the oral mucosa, the removal of teeth, salivary gland diseases, temporomandibular joint disorders, tumors and cysts of the jaws. The dual medical and dental surgical training and qualifications help the give oral and maxillofacial surgeons the unique combination of surgical skills and anatomical basis that is necessary for ensuing that they are able to provide comprehensive services. Oral and maxillofacial surgeons are able to provide a course of treatment that had previously been widely fragmented between general surgery, ear, nose and throat surgery, dermatology and plastic surgery. The adoption of a multi-disciplinary approach is found to be quite essential in the effective management of most complex conditions and due to their unique skill set, oral and maxillofacial surgeons are now considered as being established members of the cleft lip and palate, head and neck cancer and craniofacial teams (Gibbons, Baden and Williams 205). History of Oral and Maxillofacial Surgery As opposed to other branches of medicine and science such as obstetrics and gynecology that have been practiced by doctors for hundreds of years, the history of oral and maxillofacial surgery is rather short as it is traced as originating from the events of the American Civil War. During the course of this war, numerous revolutionary advancements were made in the treatment of both Confederacy and Union soldiers suffering from a myriad of facial fractures. The developments made during this war saw oral and maxillofacial surgeons begin pioneering cleft palette and other facial reconstructive surgery (omsfoundation.org 2014). The innovations made by these oral and maxillofacial surgeons continued through the 1920’s when they were able to pioneer most of the procedures that serve as the basic foundations of the modern day cosmetic surgery. World War II saw a relatively large number of young men return from active combat while sporting a number of severe facial injuries. In various countries around the world, plastic surgery and jaw surgery units were established and consultant dental surgeons were able to tirelessly work with plastic surgeons so as to reconstruct the damaged faces of the returning solders. This war saw a number of great improvements in the effective management of maxillofacial injuries. A number of reconstructive techniques were further developed to now involve the use of tubed pedicles and bone grafts. Other advancements saw antibiotics become available and stainless steel wires become used to directly fix shattered bone fragments. Since then, dental surgeons have found themselves increasingly becoming involved in the rehabilitation and reconstruction of neck and head injuries. As the 20th century continued to progress, oral and maxillofacial surgeons in the United States were able to develop and refine a large number of the current trauma techniques through the experience they were able to gain when treating the dire injuries that happened to have been inflicted on soldiers during the Viet Nam war, World War II, the Korean War and the Gulf War (omsfoundation.org 2014). In recent times, there have been a number of developments in oral and maxillofacial surgical techniques, antibiotics, equipment, anesthetics and imaging. Other advances have seen developments in improved techniques for the internal fixation of maxillofacial fractures with bone plates, as well as the use of free tissue transfer by using a number of microvascular techniques that have greatly improved the possibilities for soft tissue reconstruction. Until the 1960s, most of the oral and maxillofacial surgeons were seen to have only obtained dental surgery qualifications. However, the numerous changes witnessed in surgical technology and techniques have made it to be more desirable that oral and maxillofacial clinicians be also medically qualified. Surgeons are now required to be dually qualified so as to practice oral and maxillofacial surgery. Oral and maxillofacial surgery has now been able to establish itself as a leader in a number of fields including the treatment and reconstruction of craniofacial and facial trauma, lip, cleft palate repair, neck oncology and its reconstruction, craniofacial surgery and oral surgery. Oral and maxillofacial surgery is widely recognized as having one of the longest surgical training pathways, however this pathway help to develop more mature surgeons that have an unparalleled ability to repair, maintain and reconstruct both the soft and hard facial tissues. When undertaking this course, most trainees tend to first obtain a dental degree before applying for and taking a course in oral and maxillofacial surgery. Why I chose Oral and Maxillofacial Surgery Growing up, I always knew that I would eventually become a doctor when I grew up. With this in mind, I took a keen interest in my studies and particularly so in subjects pertaining to the human biology. However, I was not really sure as to which kind of doctor I wanted to be. Despite my having numerous discussions with my teachers who were careful to explain to me the differences between the different branches of medicine, I was still unsure as to exactly which field of medicine I was most interested in. I later one joined the army and was sent on a number of tours where I came face to face with the often very grim realities of war. I made a lot of new friends and lost a few close ones. The number of doctors willing to join the military is quite low and the military constantly encourages and supports soldiers who wish to be doctors to take-up courses in medicine. Due to my interest in medicine, I was quick to take-up this opportunity and embark on taking courses in dentistry before I was eventually sent on a tour of Afghanistan. During this tour, I was often selected to accompany a team of field medics as I showed a keen aptitude for the treatment of injured soldiers on the battle field. Although my experience of treating patients at the time was rather minimal, I read a large number of books on the subject in addition to gaining first-hand experience as we offered treatment to wounded patients on the battle field. I was greatly elated when my best friend Todd, who joined the army a short while after me, was able to finish his military training and luckily enough, was assigned to join our unit. Despite his now being a soldier, Todd was still quite squeamish around blood. He was however a brave soldier who constantly put his life on the line and quickly became a favorite around the camp as he gained the enviable reputation of being a soldier you would want to be next to you during combat. One day while our unit was on a routine patrol, we came under a sudden attack as the vehicle we were travelling in was shot at by Taliban rebels. The vehicle was partially armored and could take on a lot of gun fire without incurring any critical damage, however one of the Taliban insurgents launched a rocket propelled grenade at our vehicle and I lost consciousness in the ensuing blast. When I regained consciousness after a few minutes, I found myself surrounded by soldiers from our barracks who had been patrolling a nearby location and had come to our rescue when they heard the gunshots. These soldiers were able to push back the attacking Taliban insurgents and whisked us to the safety of the camp. I enquired about the other soldiers that I had been travelling with and was informed that we had lost two of the soldiers while three others were in critical condition. I was also made aware of the fact that I was the only one to emerge from the experience relatively unscathed. I went in to check on my friends and was shocked at the injuries to the face and jaws that had been inflicted on Todd after our vehicle was blown up. I grew frantic wanting to help him but my limited surgical skills were of no use. Upon inquiry, the Army doctor on duty informed me that a general surgeon would have to operate on Todd and stitch him up as there was currently no Oral and maxillofacial surgeons in our military base. I later on came to learn that the number of qualified and maxillofacial surgeons in the military is very small and that the military was looking into ways of trying to increase the number of these professionals within its ranks. Although the army general surgeon did his best, Todd was nevertheless left with a number of physical scars around his face that he would have to nurse for life. While sitting at Todd’s bedside watching him trying to come to terms with his new appearance, I immediately knew exactly which branch of medicine I would specialize in. I resolved there and then that I would choose to study oral and maxillofacial so as to provide the brave members of our forces the very best medical attention possible; and in my own special way, make a contribution that will greatly improve the quality of medical service that our soldiers are able to receive while in the line of fire. After having served in the military for a considerable time period, I am not squeamish around blood as military service has exposed me to situations whereby I have had to help and attend to wounded soldiers who often had some very gory and disturbing injuries after experiencing heavy physical trauma. Oral and maxillofacial surgery is of great interest to me as unlike most of the other surgical specialties that often tend to primarily focus on only one aspect, oral and maxillofacial surgery involves both medical and dental surgical treatments. Oral and maxillofacial surgeons not only diagnose and treat diseases; they are also able to correct deformities, cosmetic defect and injuries affecting the oral and facial regions. Generally, oral and maxillofacial surgeons (OMFS) have been given the distinction of being considered to be the plastic, orthopedic and reconstructive surgery specialists of the human maxillofacial regions. Of note is that maxillofacial is a medical term that literally means jaws and face. Every year, the United States sends thousands of soldiers on tours in different regions around the world. These tours range from peace-keeping missions to active military conflicts and while wounded soldiers are able to receive basic medical and surgical treatment while out in the field, they are however unable to receive oral and maxillofacial surgery due to a critical lack of surgeons and doctors who are specialized in this field. This forces these dedicated members of our armed forces to have to make do with the limited quality services they are able to receive from the military field medics. I am greatly interested in Oral and maxillofacial surgery as I strongly believe that it has the capability of changing lives. Although in some circles it might not be considered to be important as compared to other specialties such as cardiology and neurosurgery, I strongly believe that the skills I will gain by studying oral and maxillofacial surgery will be appreciated and will make all the difference to the numerous people that I will be able to help out both within the military service an within the civilian population. Conclusion The value of oral and maxillofacial surgeons cannot be under estimated. This branch of surgery offers surgeons a unique combination of skill sets that has caused oral and maxillofacial surgeons to become an integral part of head and neck cancer, cleft lip, and craniofacial teams. Oral and maxillofacial surgeons are able to comfortably combine the previously heavily segmented functions of ear, nose and throat surgery, plastic surgery, dermatology and general surgery. According to Gibbons, Baden and Williams (207), an estimated 16% of all the injuries that affecting soldiers in war are seen to require oral and maxillofacial surgeons and as such, I believe that a career in this field will help me in not only offering improved medical services to the men and women serving in the military, but also to the general population at large. Despite its long surgical training pathway, oral and maxillofacial surgery promises the benefit of a greatly fulfilling career. Works Cited Gibbons, A. J., J. M. Baden, and M. D. Williams. "Oral and maxillofacial surgery." Journal of the Royal Army Medical Corps 150.3 (2004): 205-207. omsfoundation.org. History of Oral and Maxillofacial Surgery. Accessed at . Web. 2014. Read More