Your general dentist is extraordinary at what they do. Preventive care, restorations, cosmetic work, referrals when something requires more — family dental practices are the front line of oral health, and the ones that do it well are essential. But when your dentist says "you need an oral surgeon," that's not a vague referral. It's a very specific recommendation — and understanding what actually separates an oral and maxillofacial surgeon from every other dental professional helps you choose the right care with confidence.

At Davary & Smith Oral & Maxillofacial Surgery in Sterling, Virginia, Dr. Ashkan Davary and Dr. Christopher Smith represent the most rigorously trained category of surgical specialist in the oral and maxillofacial field. Both hold dual degrees — DDS and MD — meaning they completed both dental school and medical school before entering a hospital-based oral surgery residency. That training path, and what it produces, is what this blog is about.

The Credential Behind the Title

Most people have a rough sense that an oral surgeon does more complex procedures than a general dentist. What's less widely understood is the specific training that earns the title.

Oral and maxillofacial surgeons complete:

• Dental school: Four years of dental education, typically resulting in a DDS (Doctor of Dental Surgery) or DMD.
• Medical school: Some oral surgeons — including Dr. Davary and Dr. Smith — complete a full MD degree during their training, earning a medical doctorate alongside their dental credentials.
• Hospital-based surgical residency: A multi-year residency (Dr. Davary's NYU residency was six years) in a hospital setting, training alongside medical surgical residents in anesthesia, trauma, medicine, and complex surgical care.
• Board certification: Dr. Davary is board-certified by the American Board of Oral and Maxillofacial Surgery (ABOMS) — the highest specialty credential in the field, requiring examination following completion of residency.

Dr. Davary graduated magna cum laude from UC Irvine with a degree in Biomedical Engineering, earned his DDS from Columbia University College of Dental Medicine, and his MD from NYU School of Medicine. Dr. Smith graduated from the University of Pennsylvania, completed both dental school and his OMS residency at Temple University's Kornberg School of Dentistry — where he served as chief resident — with rotations at Hahnemann University Hospital and the University of Illinois at Chicago.

That is a great deal of hospital-based training in medicine, surgery, and anesthesia. And that training produces specific capabilities.

Anesthesia: The Biggest Clinical Difference Most Patients Don't Know About

General dentists and many dental specialists can offer sedation — typically oral sedation (a pill that produces drowsiness) or nitrous oxide. These work well for mild to moderate anxiety and straightforward procedures.

What they are not is the full spectrum of anesthetic techniques that oral and maxillofacial surgeons can administer. OMS-trained surgeons can deliver IV sedation and general anesthesia with the same level of precision and monitoring protocols used in hospital surgical settings — because their residency training happened in hospitals where they managed surgical anesthesia alongside anesthesiology teams.

Davary & Smith's facility in Sterling operates as an NFPA 99 Category 1 certified anesthesia facility — the same standard required of hospital operating rooms and accredited ambulatory surgery centers. This is one of the few oral surgery practices in Northern Virginia to hold this certification, which involves rigorous inspection of the facility's anesthesia equipment, monitoring systems, gas delivery infrastructure, emergency protocols, and staff training.

For patients who need more than a pill and a little gas — because they have significant anxiety, because they need a complex procedure, or because they simply prefer to be genuinely unconscious during oral surgery — this level of anesthetic capability is not universally available. It's specifically available here.

Complex Extractions: What "Impacted" Actually Means Surgically

When a wisdom tooth is described as "impacted," the range of what that means is wider than most patients realize. A wisdom tooth that's nearly emerged and slightly tilted is a very different surgical challenge from one fully buried in the jawbone, curved around the inferior alveolar nerve, or positioned against the root of the adjacent molar.

The most complex impacted wisdom tooth cases involve proximity to the inferior alveolar nerve — the nerve running through a canal in the lower jawbone that provides sensation to the lower teeth, gums, and lip. Managing an extraction near this nerve requires detailed preoperative imaging (typically a cone beam CT scan), specific surgical technique, and the anatomical knowledge that comes from hospital-based training in facial and jaw anatomy.

Dr. Davary and Dr. Smith perform the full spectrum of impacted wisdom tooth cases — including the complex ones that general dentists and some oral surgeons refer to specialists. When a general dentist refers a patient to an oral surgeon for a wisdom tooth case, it's often because the complexity warrants exactly the training Dr. Davary and Dr. Smith bring to every procedure.

Implants: Why Placement Matters as Much as the Implant Itself

The dental implant market has expanded dramatically over the past decade, and so has the number of provider types offering implant placement. General dentists, periodontists, prosthodontists, and oral surgeons all perform implant procedures — and the variation in training relevant to implant success is significant.

Implant success depends on surgical precision in placement: the angle, the depth, the relationship to adjacent anatomy, and the management of the bone at the site. When bone grafting is needed before implant placement — which happens whenever the available bone at the site isn't sufficient to support the implant — that's an additional surgical procedure requiring the same level of training as the implant itself.

Dr. Davary and Dr. Smith perform implants at every level of complexity, including All-on-X full-arch restoration cases that involve multiple implants, bone grafting, and comprehensive surgical planning — cases that simply require the full-scope surgical training that dual-degree oral surgeons complete.

Get the Care You Need at Davary & Smith

Dr. Ashkan Davary and Dr. Christopher Smith welcome patients from throughout Loudoun County and Northern Virginia at their practice at 21351 Gentry Drive, Suite 115, in Sterling. Whether you've been referred by your dentist or are seeking an evaluation directly, the first step is a consultation. Call (703) 972-7773 or request an appointment online at davarysmith.com. The dual-degree difference isn't a marketing claim — it's a training standard that shows up in every procedure we perform.

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