What Is a Prosthodontist?

Architects of Oral Restoration

When we hear the word “prosthetics” we may think of artificial limbs used to restore missing arms or legs. Yet missing teeth can also be a major issue requiring their own type of precision-engineered prosthetics. Teeth routinely withstand intense forces (up to 275 pounds) during chewing; they are also the main feature of a beautiful smile. When teeth are broken or missing, replacing them requires high-tech materials, expert care and an eye for aesthetics.

A prosthodontist (“prostho” – replacement, “dont” – tooth) is a dental specialist who has advanced training in restoring missing or damaged teeth along with other oral structures. Sometimes called “the architects of oral restoration,” prosthodontists provide tooth-replacement solutions that are both cosmetic and functional—from restoring a single crown to performing a full smile makeover.

What Do Prosthodontists Do?

Among their other skills, general dentists are trained to replace and repair teeth. Prosthodontists, however, are specialists in this area, and their expertise is often utilized in more complex tooth restoration cases. One of nine dental specialties recognized by the American Dental Association (ADA), prosthodontics is concerned with constructing and installing oral prostheses, such as:

• Dental implants: Small titanium posts which are surgically inserted into the bone to replace the tooth root and then covered with a crown. As the most natural-looking and durable solution for missing teeth, dental implants have become a mainstay of the specialty.
• Crowns (or caps) are replacements for the visible part of the tooth, often needed after a root canal or when teeth are broken or badly decayed.
• Bridges are structures in which multiple crowns are linked together to fill spaces where one or more teeth are missing. The bridge may be attached to healthy natural teeth on each end, or to dental implants.
• Removable dentures can replace some or all teeth. They usually consist of gum-colored acrylic bases fitted with replacement teeth, and can be supported by surrounding oral tissue or dental implants.
• Bonding and veneers: To improve cracked, misshapen or discolored teeth, a prosthodontist can apply bonding or very thin shells called veneers or laminates to the tooth’s surface.

Fewer than 2% of practicing dentists are prosthodontists. Like other dental specialists, prosthodontists must first graduate from a recognized dental school. Then they must complete an additional three years in an accredited graduate program in prosthodontics, where they receive advanced training in all aspects of restorative dentistry. Prosthodontists can become board certified by passing a rigorous multi-part exam administered by the American Board of Prosthodontics. Every eight years they must be recertified to demonstrate that they are keeping current in this rapidly advancing field.

Why See a Specialist?

All graduates of accredited dental schools may place crowns, bridges, implants, veneers and dentures. But prosthodontists have extensive clinical experience in restorative treatments—not only from their education, but also from the daily practice of their specialty. That’s why general dentists sometimes refer challenging cases to these specialists.

Prosthodontics has evolved though advances in technology, and many prosthodontists are adept at using state-of-the-art equipment and techniques including digital imaging, computer-aided design and manufacturing (CAD/CAM) and laser surgery. They work closely with laboratory technicians to ensure an optimal fit for each custom-made prosthesis. In addition, prosthodontists treat disorders of the jaw joint (temporomandibular joint disorders), snoring and sleep disorders, and oral defects present at birth or resulting from oral cancer, advanced periodontal (gum) disease or trauma. Many times their work involves whole-mouth reconstruction.

Prosthodontists can often be found at the helm of a team of experts whose goal is to solve multifaceted oral health problems. In these situations, the prosthodontist may devise an overall treatment plan that includes sequencing the various aspects of treatment. He or she may also coordinate a care team that involves general and specialty dentists, medical doctors, laboratory technicians and dental hygienists.

Oral Function Meets Cosmetic Dentistry

With restorative dental work, any artificial structure must not only function well but also be aesthetically pleasing. Cosmetic dentistry is not a recognized dental specialty, but a broad term that refers to any dental work done primarily to improve appearance. Prosthodontics fits squarely in this area, as it requires in-depth knowledge of aesthetics and cosmetic dental procedures. Restoring oral function in the most cosmetically pleasing way is a prosthodontist’s business.

In addition to improving oral function, prosthodontists help rebuild patients’ confidence. They understand the relationship between appearance and self-image, and are skilled in restoring facial harmony. As people live longer and age better, appearance has become an ongoing concern for many. That’s why people often turn to prosthodontists for dental reconstruction. These caring specialists offer customized treatment options that can help preserve oral health and bring back an attractive smile, restoring function, comfort and aesthetics through dental prosthetics.