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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), Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons. 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 biocompatible substitutes."
Australian programs are accredited by the Australian Dental Council (ADC) and are 3 years in length and culminate with either a Master degree (MDS), a Master of Dental Science (MDSc) or a Doctor of Clinical Dentistry degree (DClinDent). Fellowship can then be obtained with the Royal Australasian College of Dental Surgeons, FRACDS (Pros).
Canadian programs are accredited by the (CDAC) and are a minimum of three years in length and usually culminate with a master (MSc or MDent) degree. Graduates are then eligible to sit for the Fellowship exams with the Royal College of Dentists of Canada (FRCD (C)).
In Canada, prosthodontics speciality programs are available at University of Toronto and University of British Columbia.
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. Training consists of rigorous clinical and didactic preparation in the basic sciences, head and neck anatomy, biomedical sciences, biomaterial sciences, 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 the Part I written examination and Part 2, 3 and 4 oral examinations. The written and one oral examination may be taken during the 3rd year of speciality training and the remaining two oral examinations taken following completion of speciality 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 speciality 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 speciality. Prosthodontics is the only dental speciality 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. It is the only recognized sub-specialty of all dental specialties by the American Dental Association. 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.
Due to their extensive training in prosthetic reconstruction, breadth of knowledge and capability of handling most types of complex cases, Maxillofacial prosthodontists have been referred to as "bullet-proof" dentists.
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