From DAVinci Plastic Surgery; Georgetown University Hospital Center; and the Carey School of Business, Johns Hopkins University.
Plast Reconstr Surg. 2019 Apr;143(4):872e-879e. doi: 10.1097/PRS.0000000000005447.
In recent years, the practice of cosmetic surgery has expanded to include oral and maxillofacial surgeons. The groundwork for this scope-of-practice expansion was laid in part by the American Dental Association's definition change of the practice of dentistry. This change modified the scope of dentistry from the earlier "teeth and surrounding and supporting structures" to the maxillofacial area and beyond. A number of states adopted this new definition into legislation, giving practitioners the premise on which to perform cosmetic and other medical procedures on the face and potentially other parts of the body. This expansion has created legal and regulatory issues over scope and truth in advertising. The authors hypothesize that this is confused by a lack of federal guidelines and state-by-state variations in scope-of-practice laws for oral and maxillofacial surgeons.
This article provides a brief overview of the key legal issues and their impact on legislation in some of the battleground states. The authors review the national distribution of scope of practice for oral and maxillofacial surgeons.
The most successful path to expanded scope for dentistry has been through control of certification and credentialing. This has marginalized medicine boards from contributory oversight, thus circumventing any arguments over practice parameters. The scope-of-practice dispute is further complicated by the existence of dual-degree oral and maxillofacial surgeons.
With increasing demand for cosmetic surgical interventions, establishing scope-of-practice standards for single-degreed oral and maxillofacial surgeons is critically important. As physicians, the oral and maxillofacial surgery graduates of the dual M.D./D.D.S. degree programs have no such scope-of-practice restrictions. Furthermore, if plastic surgery is to effectively argue against expanded scope of practice for oral and maxillofacial surgeons, more objective data will be necessary.
近年来，美容外科的实践范围已经扩大到包括口腔颌面外科医生。这一实践范围的扩展部分是由美国牙科协会对牙科实践的定义改变奠定的。这一改变将牙科的范围从早期的“牙齿及其周围和支持结构”修改为颌面区域及更远的区域。许多州将这一新定义纳入立法，为从业者在面部和潜在的身体其他部位进行美容和其他医疗程序提供了前提。这种扩张在范围和广告真实性方面引发了法律和监管问题。作者假设，这是由于缺乏联邦指导方针以及口腔颌面外科医生的实践范围法律在各州之间的差异而造成的混淆。
本文简要概述了一些关键的法律问题及其对一些战场州立法的影响。作者回顾了口腔颌面外科医生实践范围的国家分布情况。
扩大牙科范围最成功的途径是通过控制认证和证书。这使得医学委员会边缘化，从而避免了任何关于实践参数的争论。实践范围的争议进一步复杂化，因为存在双重学位的口腔颌面外科医生。
随着对美容手术干预需求的增加，为单一学位的口腔颌面外科医生建立实践范围标准至关重要。作为医生，双重 MD/DDS 学位课程的口腔颌面外科毕业生没有这样的实践范围限制。此外，如果整形外科学要有效地反对口腔颌面外科医生扩大实践范围，就需要更多的客观数据。
