Prosthodontics

Prosthodontists are dental specialists who use dental prostheses to treat oral health problems. For this reason, the field of prosthodontics can also be referred to as prosthetic dentistry. Prosthodontists are qualified to diagnose and treat any conditions that may derive from teeth and oral tissues that are missing or diminished, using biocompatible dental prostheses to restore the oral health, function, and appearance of their patients. Prosthetic dentistry was introduced in the late 17th and early 18th century, when a French doctor named Pierre Fauchard began using carved bone and ivory to replace missing or severely damaged teeth. Contemporary prosthodontists no longer use ivory or bone, instead relying on technical innovation to select from a variety of natural and synthetic materials to replace and repair teeth.

Prosthodontists are skilled at the cosmetic restoration of damaged teeth and replacement of missing teeth. While the results of dental prostheses invariably provide aesthetic benefit, prosthodontists are also trained to ensure that the function of the teeth is maintained and enhanced through the placement of dental prosthesis. Prosthodontists are responsible for diagnosing, planning, surgically placing, and repairing dental implants and other prostheses, and they receive an additional three to four years of training after completing dental school. Prosthodontists must also demonstrate competency in the surgical placement of dental implants in order to maintain their accreditation with the American Dental Association. Prosthodontists are trained in the anatomy of the head and neck, general biomedical science, treatment planning, surgical techniques, the function of the bite, and aesthetics. Because of the depth and breadth of their training, prosthodontists are qualified to treat many different types of mechanical and congenital disorders, including sleep apnea, through the construction and placement of a wide variety of types of prostheses. Also based on the extent of their training and expertise, prosthodontists consistently rank in the top 10 for the highest paying and most competitive careers in the United States. Board-certified prosthodontists are required to limit their practices to only prosthodontics, which also adds to their high level of specialization and expertise.

Because prosthodontics provides therapeutic benefits, and cosmetic dentistry itself is not recognized as a specialty by the American Dental Association, prosthodontics is the only recognized specialty that has highly specialized aesthetic or cosmetic aspects. While dentists may perform some procedures that have cosmetic benefits, prosthodontists are vastly more qualified to address complex cosmetic restorations or full-mouth reconstructions. They are also the only dental specialty that is highly trained in dental implant procedures.

Prosthodontists who want to advance in their field may seek additional training in maxillofacial prosthodontics. This specialty requires experience practicing as a prosthodontist and a one-year fellowship that focuses exclusively on maxillofacial prosthetics; during this fellowship, prosthodontists receive extensive hands-on training in hospitals and clinics as well as laboratories. This training prepares maxillofacial prosthodontists to treat patients who have defects of the head and neck, either due to genetics, disease, or trauma. The prostheses crafted and placed by maxillofacial prosthodontists may include prostheses that will be used in the mouth, such as prosthetics that assist with speech by manipulating the pharynx or soft palate, and they may include facial prostheses, including artificial eyes, noses, and ears, usually in concert with a team of medical specialists.

Prosthodontists treat a variety of conditions, using an even wider variety of techniques and materials. Certain medications used to treat cancer and other diseases may cause the bones in the jaw to die off or be reabsorbed into the body, in a condition called bisphosphonate-associated osteonecrosis of the jaw, which usually requires surgery; this is a rare but destructive side effect of these medications. A more common condition that prosthodontists treat is bruxism, which is more widely known as grinding the teeth. Prosthodontists also treat temporomandibular joint disorder, or TMJ. Most commonly, prosthodontists treat people with few or no teeth, placing implants, bridges, and crowns to help restore the function and appearance of the mouth and teeth. These treatments depend on the severity of the patient’s tooth loss, and they can range from removable partial dentures, to bridges, to full-mouth restoration with implants and crowns.