Oral and Maxillofacial Surgeon

What oral surgeons make

Job Bank has no page for oral and maxillofacial surgeons. Its closest page, surgeons, shows a median of about $419,000 a year in gross billings (low $144,000, high $767,000), but that covers medical surgeons paid by the province. Oral surgeons mostly run private offices paid by patients and dental insurance, with hospital work billed to the province. This range is an estimate: new associates around $200,000, established surgeons roughly $400,000, busy owners well above that. Solid Canadian pay data for this specialty is thin.

During residency

Oral surgery residents are on the same hospital pay grid as medical residents. Some university programs also charge graduate tuition at the same time, which eats into it.

Mostly private pay

Hospital trauma and reconstruction bill the province. Owning the office is where the top incomes come from, and setting one up with an operating suite and sedation equipment costs a lot.

What it costs to get there

Undergrad (2 to 4 years)

$7,000 to $10,000 a year

Dental school, the DDS (Doctor of Dental Surgery) or DMD (Doctor of Dental Medicine), 4 years

$20,000 to $55,000 a year, among the priciest degrees in Canada

DAT (Dental Aptitude Test), applications, interviews

$1,000 to $3,000

Residency (4 to 6 years)

Paid, but some programs also charge graduate tuition

NDSE (National Dental Specialty Examination)

Set by the Royal College of Dentists of Canada; budget a few thousand dollars

Roughly, all in

$98,000 to $290,000

Tuition, fees, exams and kit. Not rent, food or travel

The low end is two years of undergraduate study, a four year dental degree at the cheapest Canadian schools, the DAT (Dental Aptitude Test) and application costs, and the NDSE (National Dental Specialty Examination). The high end is a full four year undergraduate degree and dental school at the priciest schools, which are among the most expensive degrees in Canada, plus the graduate tuition some surgical residencies still charge on top of the residency salary. The four to six residency years are paid, which is the main thing that keeps this below the orthodontics figure. Dental school debt of $150,000 to $250,000 is common, and many oral surgeons are in their early thirties before they start paying it down properly.

Dental school debt often reaches $150,000 to $250,000. The residency salary helps, but many oral surgeons finish training in their early thirties still owing a lot.

What comes with the job

• No employer pension

  Almost all oral surgeons are self-employed and save through a professional corporation.

• Set your own schedule

  Office owners choose their days. Hospital call is the exception.

• Malpractice coverage

  Through a dental liability plan. Fees are higher than for a general dentist because you do surgery and sedation.

• Hospital privileges

  Most keep an appointment at a hospital for trauma and bigger cases, which comes with call duties.

The path

Dental school first, then a hospital residency alongside medical residents.

1. 1

   High school

   Grades 11 and 12

   Top marks in biology, chemistry, math and English. Dental school admission is roughly as hard as medical school.

2. 2

   University

   2 to 4 years

   Most dental schools want 2 to 4 years of science courses with a high GPA (grade point average). Write the DAT (Dental Aptitude Test).

3. 3

   Dental school

   4 years

   The DDS (Doctor of Dental Surgery) or DMD (Doctor of Dental Medicine). Classes, then years of treating patients in the school clinic. Get to know the oral surgery department early.

4. 4

   Oral and maxillofacial surgery residency

   4 to 6 years

   Hospital-based, 4 to 6 years. You rotate through general surgery, anesthesia and internal medicine with the medical residents, then spend years in oral surgery. Some Canadian programs run 6 years and include a medical degree.

5. 5

   Specialty exam and licence

   End of residency

   Pass the NDSE (National Dental Specialty Examination) run by the Royal College of Dentists of Canada, then register as a specialist with your provincial dental regulator.

High school courses that help

• Biology and chemistry

  Required for dental school.

• Physics

  On the DAT (Dental Aptitude Test) at some schools, and useful for implants and forces on bone.

• Visual arts or shop

  Fine hand skills and a good eye for shape. Dental schools test hand skills at admission.

• English

  You will explain scary surgery to nervous people every day.

Time and money, at a glance

Years after high school

10 to 14

Dental school acceptance rate

Low, similar to medicine

Residency spots

Only a few programs in Canada, including Western and UBC (University of British Columbia)

Total tuition

$100,000 to $250,000, mostly dental school

Paid while training?

Only during residency

Heavily regulated

You need a dental licence from your provincial dental regulator to practise, and specialist registration to call yourself an oral and maxillofacial surgeon. The NDSE (National Dental Specialty Examination) from the Royal College of Dentists of Canada is the national gate, so moving provinces is paperwork. Sedation and general anesthesia in the office need a separate permit in most provinces, with inspections. Hospitals grant operating privileges on their own terms.

Fellowships that shape the practice

Optional 1 to 2 year add-ons after residency.

• Head and neck cancer and reconstruction

  Rebuilding jaws with bone from the leg after cancer. Hospital-based, long operations.

• Cleft and craniofacial surgery

  Children born with cleft lip and palate or skull differences, alongside plastic surgeons.

• Cosmetic facial surgery

  Chin, cheek and jaw reshaping. Private pay.

• Implants and bone grafting

  Rebuilding jawbone so implants can hold. A big part of many private practices.

Nice-to-haves

• Fine motor hobbies

  Drawing, sculpture, instrument playing, model building. Dental schools look for it and surgery demands it.

• Time in a dental or surgical office

  Shadowing an oral surgeon shows you the sedation, the blood and the pace before you commit a decade.

• Research in dental school

  Residency programs are small and weigh publications.

• Comfort with emergencies

  You will run sedation in your own office. Calm under pressure is not optional.

A typical day

Morning in the office: three or four wisdom teeth cases under sedation, a dental implant, a biopsy of a mouth lesion. Oral surgeons train in anesthesia during residency and many give sedation in their own office. Afternoon at the hospital: a jaw broken in a hockey game, plated back together. Once a week, a long jaw-realignment operation for a bite that braces alone cannot fix. Some nights on trauma call for the emergency department.

The honest trade-offs

Work life

Typical hours

40 to 55 a week, plus hospital call if you take it

Remote work

None

Physical demand

Moderate to high, bent over patients for hours

Unionized

Residents yes, practising surgeons no

Similar paths

• DentistFix teeth, run a clinic, earn well. Eight years of school and a lot of debt first.
• OrthodontistA dentist who went back to school to straighten teeth. One of the best-paid jobs in Canada, and one of the longest roads.
• Plastic SurgeonRebuild what injury, cancer and birth defects take away, and reshape what patients pay to change. Far more reconstruction than Hollywood.

Wisdom teeth pay the bills

Removing impacted wisdom teeth, usually four at a time under sedation, is the most common operation an oral surgeon does. Some offices do a dozen cases in a morning.

Some are dentist and doctor

A few Canadian oral surgery residencies run 6 years and include a medical degree, so the graduate holds both a dental and a medical doctorate. The 4-year programs skip the medical degree and reach the same specialty exam.

Born in the trenches

The specialty grew out of the First World War, when dentists were the ones who knew how to rebuild shattered jaws. Facial trauma is still a core part of the job.

Hockey keeps them busy

Sticks, pucks and boards break jaws and cheekbones every winter. Oral surgeons in hospital trauma rotations see a steady stream of them from rinks across the country.