The Path to Becoming an Oral Surgeon

Becoming an oral surgeon takes 10 to 12 years after high school: four years of undergraduate study, four years of dental school, and a residency program that lasts 4 to 6 years depending on the specialty track you choose. You must pass the Dental Admission Test (DAT) before dental school, earn your Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree, complete a residency in oral and maxillofacial surgery, and pass licensing exams in your state. The field requires strong science grades, manual dexterity, and the ability to work under pressure in a surgical setting.

Oral surgeons perform tooth extractions, place dental implants, correct jaw problems, remove tumors, and handle facial trauma. The work is surgical rather than purely dental — you will spend time in an operating room, often under general anesthesia, rather than in a traditional dental chair. The income is higher than general dentistry, but the training is longer and more specialized.

Key Takeaways

  • You must complete four years of undergraduate education with strong grades in biology, chemistry, and organic chemistry before you can take the DAT and explore to dental school.
  • Dental school takes four years and results in a DDS or DMD degree; you will take the National Board Dental Examination (NBDE) during this time.
  • After dental school, you must complete a 4 to 6 year residency in oral and maxillofacial surgery at an accredited program, which is competitive and requires strong board scores.
  • You must pass your state's licensing exam and obtain a state dental license before you can practice, even during residency in some states.
  • The entire process from high school to independent practice typically takes 10 to 12 years and costs between $200,000 and $400,000 in education expenses.

Undergraduate Education and the DAT

Your first step is a four-year bachelor's degree from an accredited college or university. You do not need to major in biology or chemistry, but you must complete specific prerequisite courses: biology (with lab), general chemistry (with lab), organic chemistry (with lab), biochemistry, physics, and mathematics through calculus. Many students major in biology, chemistry, or health sciences because these programs include most or all of the prerequisites.

Dental schools look at your overall GPA and your science GPA separately. A competitive science GPA is 3.5 or higher, though some schools accept lower scores if your overall profile is strong. During your undergraduate years, gain experience in a dental setting — volunteer at a dental clinic, shadow a dentist or oral surgeon, or work as a dental assistant. This experience shows dental schools that you understand what the profession involves and that you are serious about it.

In your junior or senior year, register for and take the Dental Admission Test (DAT). The DAT is a computer-based exam administered by the American Dental Association (ADA) and covers biology, general chemistry, organic chemistry, biochemistry, reading comprehension, and perceptual ability. A competitive DAT score is 18 or higher on a scale of 1 to 30. You can take the test multiple times, but most dental schools see all your scores, so a strong first attempt is preferable.

Dental School and Your DDS or DMD Degree

Dental school takes four years and leads to either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree — the titles are equivalent and vary by school. The first two years focus on classroom and laboratory work: oral anatomy, dental materials, pharmacology, pathology, and the basic sciences of dentistry. The last two years include clinical work where you treat patients under supervision, learning restorative dentistry, periodontics, and oral surgery basics.

During dental school, you will take the National Board Dental Examination (NBDE) in two parts. Part I covers basic sciences and is usually taken after your second year. Part II covers clinical sciences and patient management and is usually taken in your fourth year. Both parts must be passed before you can obtain a state dental license. Some states also require a clinical exam administered by a regional testing organization.

Dental school costs vary widely. Private dental schools typically charge $60,000 to $80,000 per year, while public schools may charge $20,000 to $40,000 per year for in-state students. Most students graduate with significant debt. During dental school, begin thinking about oral surgery residencies and research programs that interest you, because residency programs review your dental school performance, board scores, and letters of recommendation.

Obtaining Your State Dental License

Before or shortly after graduating from dental school, you must obtain a state dental license. Requirements vary by state but typically include passing the NBDE Parts I and II, passing a clinical exam (in most states), and submitting an process with your dental school diploma and background check. Some states allow you to obtain a temporary license while you complete the clinical exam or while you are in residency.

A few states require you to have a state license before you begin a residency program, while others allow you to practice under a residency license during your training. Check the requirements in the state where you plan to do your residency early in dental school so you can plan accordingly. If you plan to practice in multiple states, you will need a license in each state, though some states have reciprocity agreements that simplify the process.

Oral Surgery Residency Programs

After dental school, you must complete a residency in oral and maxillofacial surgery. These programs are 4 to 6 years long and are highly competitive. You explore during your final year of dental school through the National Resident Matching Program (NRMP), which matches applicants to residency positions. Residency programs look at your dental school GPA, NBDE scores, letters of recommendation from dental school faculty, and your personal statement.

During residency, you work in a hospital or surgical center setting, performing extractions, placing implants, removing impacted teeth, correcting jaw deformities, removing tumors and cysts, and managing facial trauma. You will work alongside other surgical specialists and learn to manage patients under general anesthesia. Residencies are structured with rotations through different surgical areas and increasing responsibility as you progress.

Residency is paid, though the salary is lower than what you would earn as a general dentist — typically $30,000 to $50,000 per year depending on the program and your year of training. However, residency covers your tuition and many of your expenses. The competitive nature of these programs means that strong board scores and clinical performance during dental school are essential.

Board Certification and Specialty Recognition

After you complete your residency, you are may be able to access to take the written and oral exams administered by the American Board of Oral and Maxillofacial Surgeons (ABOMS). Board certification is not legally required to practice oral surgery in most states, but it is widely expected and demonstrates that you have met national standards. The written exam covers surgical principles, anatomy, pharmacology, and clinical decision-making. The oral exam involves case presentations and discussion with board-certified examiners.

Some oral surgeons pursue additional fellowship training in subspecialties such as dental implants, orthognathic surgery (jaw surgery), or head and neck oncology. These fellowships typically last one to two years and are pursued after residency. Fellowship training is optional but can lead to a more specialized practice or academic career.

Licensing and Practice Setup

Once you complete your residency and pass your state licensing exam (if required), you can practice as an oral surgeon. You may join an existing practice, start your own practice, or work in a hospital or academic setting. If you start your own practice, you will need to obtain a business license, arrange malpractice insurance, set up a surgical facility that meets state and federal regulations, and hire staff.

Malpractice insurance for oral surgeons is more expensive than for general dentists because surgical procedures carry higher risk. Annual premiums typically range from $3,000 to $8,000 depending on your location and the scope of your practice. Setting up a surgical practice requires significant capital investment in equipment, facility renovation, and working capital — often $200,000 to $500,000 or more.

Time and Cost Summary

The total time from high school to independent practice is 10 to 12 years. The total cost of education is typically $200,000 to $400,000, including undergraduate tuition, dental school tuition, and exam fees. Many students borrow money to cover these costs and spend years paying back loans after graduation. However, oral surgeons earn significantly more than general dentists — median income is around $230,000 to $280,000 annually, depending on location and practice type.

The investment is substantial, but the field offers job security, high income, and the satisfaction of performing complex surgical procedures that improve patients' quality of life. If you are considering this path, start by shadowing an oral surgeon or working in a dental office to confirm that the work aligns with your interests and strengths.

Frequently Asked Questions

Do I need to work as a general dentist before becoming an oral surgeon?

No. You can go directly from dental school into an oral surgery residency program. Many oral surgeons never practice general dentistry. However, some people choose to work as a general dentist for a few years to gain experience and pay down student loans before pursuing a residency.

What if I don't get into an oral surgery residency on my first try?

If you do not match to a residency program, you can reapply the following year. Many people strengthen their process by working as a general dentist, taking additional courses, or gaining more clinical experience. You can also pursue a general practice dentistry career if you decide that oral surgery is not the right fit.

Can I become an oral surgeon with a DDS instead of a DMD?

Yes. DDS and DMD degrees are equivalent and both lead to the same career paths. The difference is in the school's naming convention, not in the training or credentials. Residency programs and licensing boards recognize both equally.

How competitive are oral surgery residency programs?

Very competitive. Spots are limited and programs receive many more applications than they have positions. A strong dental school GPA (3.5 or higher), high NBDE scores (above 22), and excellent letters of recommendation are typically needed to be competitive. Some applicants explore multiple times before matching.

What is the difference between an oral surgeon and a periodontist?

Oral surgeons perform surgical procedures including extractions, implants, jaw surgery, and tumor removal. Periodontists specialize in treating gum disease and placing dental implants but do not perform the same level of surgical procedures. Oral surgery residencies are longer and more surgical in nature than periodontal residencies.