Prosthodontics ( Prosthetic or Restorative Dentistry ) is a branch of dentistry focused on the design, development, and fitting of artificial replacements for teeth and other portions of the mouth. Through prosthodontics, a dentist seeks to preserve or restore dental function, health, appearance, and function through proper diagnosis, treatment planning, rehabilitation, and maintenance.

In the united states, Prosthodontics work is done by your general dentist or by a Prosthodontist specialist. Other specialists like Periodontist and Oral surgery may offer restorative work like teeth in a day or smile makeovers. Patients need to understand that should be avoided, as Periodontist and Oral surgeons’ primary training and expertise are on dentistry’s surgical aspects and not in the Prosthetic (crown, bridge, cosmetic ) work, as this requires daily practice and exclusive dedication. Furthermore, In some states, the legislation protects the consumers by restricting dental professionals’ practices to their specialties.

To be called a Certified Prosthodontist, a licensed dentist needs to complete three years of full-time residency training in the United States and Canada at  CODA-accredited Prosthodontics programs.  During this time, the future Prosthodontist goes to unparalleled advanced daily training in the techniques and technology used for tooth restoration and replacement, such as dental crowns, dental bridges, cosmetic dentistry, and dental implants.

Prosthodontists specialize in complex dental diagnosis and treatment planning where a patient’s teeth or surrounding tissue and bone are missing or severed damaged. After the residency training, Prosthodontists master the unique skills to restore the function, comfort, and appearance of a healthy, beautiful smile.

The fundamental distinction between a prosthodontist and a general dentist is in the level of education and specialization that they’ve acquired. A general dentist goes to dental school for four years, graduating with either a DMD or DDS. Some dentists would enroll in full-time residency training for one or two years in advanced education in General Dentistry ( AEGD ) at a university or hospital. 

 A general dentist can offer unique services, such as orthodontic, periodontics, endodontics,  hygiene check-ups, or same-day crowns. Many General Dentists are experienced in restorative and prosthodontic procedures. 

On the other hand, a Prosthodontist will focus on treating very advanced dental conditions, complete oral rehabilitation, medically compromised patients, or managing traumatic injuries to the oral cavity. Prosthodontists are super-dentists.

The American Academy of Periodontology says that a periodontist specializes in preventing, diagnosing, and treating periodontal – or gum – disease and oral inflammation. Periodontists treat infections with scaling and root planing – a procedure that cleans the infected root of a tooth or removes damaged tissue. They may also use other surgical procedures to treat periodontal disease. In addition to examining the teeth and gums, the Periodontist may take X-rays or probe between the teeth and gums to see whether pockets of infection have formed.

According to the American College of Oral maxillofacial surgeons , oral surgeons are trained to recognize and treat a wide spectrum of diseases, injuries, and defects in the head, neck, face, jaws, and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia and provide care in an office setting. They treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and dental implant surgery. Oral and maxillofacial surgery is a surgical specialty recognized by the American College of Surgeons and is one of nine dental specialties recognized by the American Dental Association,

According to the American College of Prosthodontists, these specialty dentists focus on oral rehabilitation. They make, fit and install crowns, bridges, veneers, inlays, complete and partial dentures. And if you wondered whether you needed a periodontist or Prosthodontist for implants, know that prosthodontists handle them too.

 Periodontists/ Oral Surgeons do not have the training to make crown bridges or fabricate prosthetics appliances or any permanent restorative work. Restorative Dentistry should be performed  by your  general dentists or Prosthodontist. As part of oral–healthcare team,  Periodontists and Oral surgeons should  work with your restorative dentist to provide the best dental  care. 

Placement of dental implants is a procedure, not an American Dental Association (ADA) recognized Dental Specialty. Dental implants, like all dental procedures, require dental education and training.

Implant therapy is a prosthodontic procedure with radiographic and surgical components. Using a dental implant to replace missing teeth is dictated by individual patient needs as determined by their dentist. An implant is a device approved and regulated by the FDA, which can provide support for a single missing tooth, multiple missing teeth, or all teeth in the mouth. The prosthodontic and the surgical part of implant care can range from straightforward to complex.

A General Dentist who is trained to place and restore implants may be the appropriate practitioner to provide care for dental implant procedures. This will vary depending on an individual clinician’s amount of training and experience. However, the General Dentist should know when care should be referred to a specialist (a Prosthodontist, a Periodontist or an Oral and Maxillofacial Surgeon). Practitioners should not try to provide care beyond their level of competence.

General Dentists are experienced in restorative procedures, and many have been trained and know the requirements for the dental implant restorations they provide. However, suppose a patient’s implant surgical procedure is beyond the usual practice of a dentist. In that case, this part of the care should be referred to another dentist that is competent in placement of implants. The referring dentist should effectively communicate and provide specific instructions and any necessary surgical guide(s) for appropriate care.

Likewise, the patient should be referred to a Prosthodontic specialist (a Prosthodontist) if the restorative procedure is complex and beyond the General Dentist’s usual practice. Prosthodontists may place implants as part of their patients’ reconstruction, but they may also refer to instructions and surgical guides when the implant placement is beyond their competence level. An example would be a referral to an Oral and Maxillofacial Surgeon for more complicated surgical procedures or for patients with serious medical conditions. Referral to a Periodontist would be indicated when a patient exhibits significant periodontal disease that needs to be treated in combination with the implant restorations.

As a licensed dentist, Periodontist and Oral Surgeons can legally offer and perform prosthodontic services like crown and bridge over implants. However, patients need to fully understand that putting a crown/ bridge over an implant is not Periodontist and Oral Surgeons’ expertise regardless of your dental specialits’ background. The appropriate dental professional to restore ( put a crown or a bridge ) an implant is either a General Dentist or a Prosthodontist.

Placement ( and restoring ) of implants without prosthodontic expertise to diagnosis and treatment planning should be avoided. The more complex and extensive the care, the more critical it is to obtain a satisfactory patient outcome. Implants placed without proper prosthodontic ( prosthetic ) planning can result in an implant being placed with improper position, orientation, or adequate restoration space. This can result in compromise of function, durability, esthetics, or any combination of these problems. Implants may even need to be removed to get anticipated results for the patient. In addition to producing a compromised outcome, restoration of improperly placed implants can be expensive and burdensome.

Prosthodontics is just one of nine dental specialties authorized by the American Dental Association. Prosthodontists often coordinate various services to give their patients the best treatment for complex cases. For example, to treat a patient who has missing teeth due to advanced gum disease, a prosthodontist may work with a periodontist to treat the underlying cause of lost teeth and halt deteriorating gums’ progression. To treat a patient with severe TMD issues, a prosthodontist may pair with an oral maxillofacial surgeon and/or an orthodontist to correctly align the jaw and teeth.

Prosthodontists are sometimes known as the “quarterback or cornerstone of dentistry” because they head up treatment plans and coordinate other dental team members’ efforts. Under the care and management of a prosthodontist, patients can be confident that their final results will be perfectly balanced, comfortable, beautiful, and functional.

A prosthodontist is highly qualified to provide the most advanced treatment available to support oral health when one or more tooth is missing. This therapeutic work can include any or several of the following:

•  Cosmetic dentistry: Cosmetic dentistry1 is much more than plastering on a one-size-fits-all Hollywood smile. An accredited prosthodontist will evaluate your natural teeth to plan prosthetics that will seamlessly blend with your natural beauty and give you a realistic, healthily-functioning, and adequately balanced smile.
•  Dental implants and permanent dentures: Dental implants are among the most significant advances in dentistry in the past century. By implanting an anchor directly in the gums, prosthodontists can halt bone deterioration in the jaw and give you replacement teeth that perfectly imitate the function and appearance of your original smile. Prosthodontists help guide cases of dental implants, whether the anchor is meant to support just one missing tooth, a bridge spanning several teeth, or a full permanent denture.
•  Reconstruction for congenital disabilities such as missing teeth or cleft palate: Sometimes, the challenge at hand isn’t that a tooth or vital oral tissue has been lost, but that it was never there in the first place. Prosthodontists help create treatment plans that fuse prosthetics, surgical intervention, and natural oral dentition to give patients all the advantages of natural, healthy teeth, gums, and jaw.
•  Treatment for geriatric patients and gum disease: The most common cause of lost teeth is gum disease, which becomes more common as we age. Dental care for senior patients can become more complicated, as immune system functioning and healing time can change. Prosthodontists are specialists in handling senior patients’ needs to help them restore health and balance to their smiles.
• Restorative dentistry and prosthodontics: Although many general dentists offer restorative dentistry services, a prosthodontist is a specialist in creating, fitting, and maintaining replacement dentition to give you the best, most long-lasting results.
• Temporomandibular joint syndrome/disorder (TMD/TMJ): Many patients experience misaligned bites. This can lead to teeth grinding, chronic pain, and even sleep disorders, among other challenges. TMD can be ubiquitous with mismanaged dental prosthetics, as the replacement teeth don’t fit properly, leading to an imbalance in the bite. A prosthodontist ensures that all restorative work is in balance with a healthy bite.
• Complex case management: Many extreme dental challenges will involve more than one specialist to give the patient the best results. When this is the case, a prosthodontist manages a multi-faceted treatment plan and coordinates with various specialists.
• Restoration after traumatic injuries or oral cancer: Accidents and/or surgery may necessitate removing a portion of the mouth–this might include part of the jaw, multiple teeth, portions of the hard or soft palate, or important gum tissue. Utilizing state-of-the-art tools and techniques, prosthodontists restore the function and appearance of a healthy mouth and smile.

Look for Board Certification. To become a Board-accredited prosthodontist, individuals must successfully pass intensive testing conducted by the American Board of Prosthodontists. Furthermore, prosthodontists must re-certify every eight years to confirm they’re up-to-date on the ever-changing landscape of technology and tools that assist in dental restoration and the mechanics of the smile. Learn more and find a board-certified prosthodontist on the website of the American Board of Prosthodontists.