The surgeon for the mouth, jaws and face. Dental school first, then four to six more years, and the highest pay of any dental specialty.
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What you earn and what it costs to get there.
Median
$352,220
Bottom tenth
$86,250
Top tenth
$622,640
The national median is $352,220 a year, and the top tenth reach $622,640. The bottom tenth near $86,250 are mostly new graduates and part-time academic surgeons. This is the best paid of the dental specialties, and the survey only counts surgeons paid a wage, so practice owners are largely missing from it.
About $60,000 to $80,000 a year
Resident salary, rising each year, for four to six years
Surgical residents are paid hospital employees. It is a real salary for very long hours, and the interest on your dental school loans is compounding the entire time.
$600,000 and above
Partners in established oral surgery groups
Most oral surgeons end up in private practice, where the office has its own operating suites, imaging and anesthesia. Owning a share of that is what separates the top of the range from the middle, and it comes with a large business loan on top of the student loans.
Tuition, fees, exams and kit. Not rent, food or travel
The low end is a community college start into a public university in your own state for the bachelor's degree, then a dental school in your own state at the cheaper end of about 50,000 dollars a year. The high end is four full years of undergraduate study at 16,000 dollars a year plus a private dental school near 100,000 dollars a year all in, with 2,000 to 5,000 dollars for the dental admission test and applications and several thousand more across the licensing and specialty board exams. Dental school is among the most expensive education in the country and 300,000 to 500,000 dollars of federal loans is common for oral surgeons. The six year residency is paid and, at a nonprofit hospital, counts toward the ten years of payments needed for federal loan forgiveness, which matters a great deal over a residency that long.
Dental school is among the most expensive education in the country and graduating with $300,000 to $500,000 of federal student loans is common for oral surgeons. Fill out the FAFSA (Free Application for Federal Student Aid) every year. Residency at a nonprofit hospital counts toward the Public Service Loan Forgiveness program, which matters a great deal when the residency is six years long.
Third molar removal
Taking out wisdom teeth is the volume procedure of the specialty and the financial base of most practices.
Dental implants
Placing titanium implants in the jaw. Elective, largely paid out of pocket, and a large share of practice income.
Corrective jaw surgery
Moving the upper or lower jaw to fix a bite. Big hospital cases, planned for months, usually done with an orthodontist.
Facial trauma
Broken jaws and cheekbones from crashes, assaults and sport. Emergency work, often through a hospital call rota.
Pathology and reconstruction
Removing cysts and tumors from the mouth and jaws and rebuilding what is left.
The exact path from high school to qualified.
Dental school first, not medical school. Then a surgical residency that some programs stretch to six years so you finish with a medical degree too.
High school
Grades 9 to 12
Biology, chemistry, physics and calculus. Grades matter from the start because dental school admissions read your whole college record.
Bachelor's degree
4 years
Any major that covers the science prerequisites. Keep a high GPA and take the dental admission test in your third year.
Dental school
4 years
Four years for a doctor of dental surgery or doctor of dental medicine degree. The two are the same qualification under different names.
Oral and maxillofacial surgery residency
4 to 6 years
Four to six years, accredited by CODA (the Commission on Dental Accreditation). The six-year programs include medical school coursework and a medical degree, plus general surgery and anesthesia rotations.
Board certification
1 to 2 years after residency
A written qualifying examination and then an oral certifying examination from the American Board of Oral and Maxillofacial Surgery, taken after residency.
Biology and chemistry
Prerequisites for dental school everywhere, and the basis of the admission test.
Physics
On the dental admission test, and behind imaging and the mechanics of the jaw.
Art, sculpture or anything with your hands
Dental school admissions genuinely value manual dexterity, and some programs test it.
English
You will explain anesthesia and surgical risk to frightened teenagers and their parents.
You practice on a state dental license, issued by your state's board of dentistry after a dental degree from a program accredited by CODA (the Commission on Dental Accreditation), a national written dental examination and a clinical examination. On top of that sits specialty certification from ABOMS (the American Board of Oral and Maxillofacial Surgery), which is the qualification hospitals and insurers actually look for. Surgeons in six-year programs also sit steps of the USMLE (United States Medical Licensing Examination) for the medical degree. Administering general anesthesia in your own office needs a separate state permit.
In-state public dental schools
Far cheaper for residents of that state, and most reserve the majority of their places for them.
Four-year residency programs
Surgical training without the medical degree. Shorter, and the graduates practice the same scope in most settings.
Six-year residency programs
Include medical school coursework and a medical degree. Preferred if you want hospital-based reconstruction, trauma or academic work.
Hospital trauma centers
Residencies attached to a busy trauma center give you far more facial fracture experience, which is hard to get any other way.
Things you don't need, but that help.
Head and neck cancer
A fellowship in removing oral and facial tumors and rebuilding with bone and tissue from elsewhere in the body.
Craniofacial and cleft surgery
Working with children born with cleft lip and palate or skull deformities, usually in a hospital team.
Cosmetic facial surgery
Some oral surgeons add facial cosmetic work. Elective, cash-pay and competitive with plastic surgery.
Dental implant reconstruction
Complex cases where the jaw bone has to be rebuilt before implants can go in.
Academic surgery
Teaching residents and running a program at a dental school, at a much lower salary.
Research during dental school
Oral surgery residencies are among the most competitive in dentistry and published research helps.
A high score on the dental board examination
Residency programs screen on it heavily, and some require a medical licensing exam score too.
Hospital experience as a student
Rotating through an emergency department shows you what facial trauma actually looks like.
Physical stamina
A jaw reconstruction can run eight hours on your feet. This is not a desk specialty.
Day to day, pros and cons, where you'd work.
Office days are a surgical production line: eight to twelve cases, mostly wisdom teeth and implants, each with the patient sedated or fully asleep under anesthesia you are giving yourself with your own trained team. Consultations between cases, reviewing scans and explaining what is going to happen. Hospital days are the other extreme, one long corrective jaw operation or a facial fracture repair with plates and screws. Plus a call rota: broken jaws arrive in the emergency department at night and on weekends.
The good
The hard parts
Things people don't tell you.
Six-year oral and maxillofacial surgery residencies include medical school coursework, so graduates hold both a dental degree and a doctor of medicine degree. No other dental specialty offers that, and it is why these surgeons operate in hospitals alongside other surgical teams.
Oral surgeons are trained to administer general anesthesia and deep sedation in their own offices using a team they trained themselves, which requires a separate state permit. Almost no other outpatient surgical specialty in the country does this.
Removing third molars is the single most common procedure in the specialty and the financial base of most private practices. The complex jaw reconstruction and cleft work that surgeons train hardest for is usually the smaller part of the schedule.
Modern facial surgery was built in the military hospitals of the First World War, where dentists and surgeons worked together to rebuild the shattered jaws and faces of soldiers. The techniques for plating a fractured jaw come directly from that work.
Last checked September 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise.