Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. It is one of nine dental specialties recognized by the American Dental Association (ADA), The ADA defines it as “the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using bio-compatible substitutes.”
According to the American College of Prosthodontists, a prosthodontist is a dentist who:
- Specializes in the aesthetic (cosmetic) restoration and replacement of teeth.
- Receives three to four years of additional training after dental school.
- Restores optimum appearance and function to your smile. The planning and restoration of implants, treatment of temporomandibular joint disorder (TMJ), and rehabilitation of occlusion with prostheses all fall under the field of prosthodontics.
The American College of Prosthodontists (ACP) ensures standards are maintained in the field. Becoming a prosthodontist requires an additional three years of postgraduate specialty training after obtaining a dental degree. Recently, the ADA’s Commission on Dental Accreditation (CODA) passed the updated educational standards for all prosthodontics programs in the United States that now mandates surgical placement of dental implants at an in-depth competency level (on par with other surgical dental specialties) Training consists of rigorous clinical and didactic preparation in the basic sciences, head and neck anatomy, biomedical sciences, biomaterial sciences, implant surgery, function of occlusion (bite), TMJ, and treatment planning and experience treating full-mouth reconstruction cases, and esthetics. Due to this extensive training, prosthodontists are required to treat complex cases, full-mouth rehabilitation, TMJ-related disorders, congenital disorders, and sleep apnea by planning and fabricating various prostheses. There are only 3,200 prosthodontists in comparison to 170,000 general dentists in the United States Prosthodontists have been consistently ranked at 6th or 7th positions by Forbes among America’s most competitive and highest salaried jobs.
Board certification is awarded through the American Board of Prosthodontics (ABP) and requires successful completion of written examination and oral examinations. The written and one oral examination may be taken during the 3rd year of specialty training and the remaining two oral examinations taken following completion of specialty training. Board eligibility starts when an application is approved by the ABP and lasts for six years. Diplomates of the ABP are ethically required to have a practice limited to prosthodontics. Fellows of the American College of Prosthodontists (FACP) are required to have a dental degree, have completed three years of prosthodontic specialty training, and be board certified by the ABP.
According to the ADA, specialties are recognized in those areas where advanced knowledge and skills are essential to maintain or restore oral health (Principles of Ethics and Code of Professional Conduct). Not all areas in dentistry will satisfy the requirements for specialty recognition. Acknowledged by the profession, the contributions of such and their endeavors are encouraged.
The American Dental Association does not recognize Cosmetic dentistry as a specialty. Prosthodontics is the only dental specialty under which the concentration of cosmetic/esthetic dentistry falls. General dentists may perform some simple cosmetic procedures. Consequently, there are questions regarding whether it is ethical for general dentists to treat “smile makeovers” or complex cosmetic and full-mouth reconstruction cases, as they are not qualified to address the complex needs of the patient. Likewise, there is no specialty recognized by the ADA for dental implants.
Maxillofacial prosthetics (Oral and Maxillofacial Prosthodontics) is a sub-specialty (or super-specialty) of Prosthodontics. All Maxillofacial prosthodontists are prosthodontists first and then attain a fellowship training (1 year) exclusively in Maxillofacial prosthetics that includes oral surgical and prosthodontic treatments. Maxillofacial prosthodontists treat patients who have acquired and congenital defects of the head and neck (maxillofacial) region due to cancer, surgery, trauma, and/or birth defects. Maxillary obturators, speech-aid prosthesis (formerly called as Pharyngeal/soft palate obturators) and mandibular-resection prostheses are the most common prostheses planned and fabricated by Maxillofacial prosthodontists. .Other types of prostheses include artificial eyes, nose and other facial prostheses fabricated in conjunction with an Anaplastologist.
Treatment is multidisciplinary, involving oral and maxillofacial surgeons, plastic surgeons, head and neck surgeons, ENT doctors, oncologists, speech therapists, occupational therapists, physiotherapists, and other healthcare professionals.