Combining medicine and dentistry

Professor Andrew Heggie’s (BDSc 1977, MDSc 1981, MBBS 1991) work in oral and maxillofacial surgery (OMS) straddles the worlds of both medicine and dentistry. His academic journey began with a dental degree at the University of Melbourne, during which time the father of a fellow student, a surgical specialist, recommended that he observe Mr Robert Cook undertaking surgery. What he witnessed dramatically altered his career aspirations.

“I went and watched Mr Cook totally change a face, by essentially moving the jaw back, and I just couldn’t believe my eyes. I didn’t know this sort of surgery was possible,” Professor Heggie said.

From that point on, Professor Heggie committed himself to acquiring the specialised training that is required for OMS - a dentist’s unique anatomical understanding of jaw function and pathology and the medical knowledge and skills related to surgical principles. This training involved almost a decade and a half of studying and training to complete both a dental and a medical degree, the latter of which he undertook whilst running an oral surgical practice with a young family.

OMS has changed dramatically since Professor Heggie entered the specialty. Bridging the worlds of medicine and dentistry provided major challenges for the discipline, as he and his fellow practitioners established their place alongside related specialties, particularly plastic surgery and ear, nose and throat surgery.

“We are registered as both dental and medical specialists, and dentistry is pivotal to our surgical specialty as this is the unique background that delivers our specialists superior skills in managing conditions affecting the maxillofacial skeleton,” he said.

Advances in technology have also had a significant impact on Professor Heggie’s work since his surgical career began.

“Using computers to help make alloplasts, which are materials that can be implanted to replace the shape and form of normal structure, has had a dramatic effect on our profession, together with software that enables virtual surgical planning of corrective and reconstructive surgery.”

The specialty of OMS has also now evolved sufficiently for sub-specialties to develop. Professor Heggie’s interests in the correction of facial skeletal deformities and infant airway obstruction in the cleft and craniofacial spectrum has led to the development of the sub-specialty of paediatric maxillofacial surgery. He has held the position of Head of Oral and Maxillofacial Surgery in the Department of Plastic and Maxillofacial Surgery at the Royal Children’s Hospital since 1994, and was recently appointed as Clinical Professor in the Department of Paediatrics at the Melbourne Medical School.

Despite the lengthy and rigorous training involved to become an oral and maxillofacial surgeon, Professor Heggie says there are still many young students aspiring to this career pathway.

“You can tell those that are riveted by it. You can just see this in their eyes.”

Professor Heggie has dedicated his career to the development and recognition of maxillofacial surgery, including helping to found the Melbourne Research Unit for Facial Disorders in 2000, and advancing the techniques and management of facial deformities.

As with all specialties, there is still much more to be explored and perfected by the new guard of aspiring OMS surgeons at the University of Melbourne, who are lucky enough to have many inspirational leaders, such as Professor Heggie and the Training Centre team.