Prosthodontics

Overview

The American Dental Association officially recognizes nine dental specialties. One of those specialties is prosthodontics. A prosthodontist is a dentist who has received three years of additional training through a hospital or university based program after completing dental school.

When patients suffer from missing or deficient teeth, they can often experience problems with their oral function, comfort and appearance. The role of the prosthodontist is to correct these issues. Using a series of procedures such as dental veneers, crowns, implants and dentures, a skilled prosthodontist can improve a patient's oral health as well as their appearance.

During the additional training that prosthodontists receive beyond dental school, they take on complex cases and see them through to completion. They focus specifically on these cases for their entire post-graduate training. This provides prosthodontists with practical knowledge to take with them into the field and enables them to offer complete oral rehabilitation to their patients and restore optimum function and appearance to their smiles.

Prosthodontic Procedures

In order to service patients, a prosthodontist relies on several procedures, including:

  • Dental Veneers: When teeth are broken, misshaped, permanently stained or out of proportion, veneers can often be the solution. Dental veneers are thin, custom shells that are bonded to the front of the teeth. The result is a more attractive, proportional smile that you can be confident about.
  • Crowns: When a tooth is broken or cracked to a great extent, a crown is often the answer. Aesthetically, a crown can return a tooth to its normal size and shape. More importantly, a crown can hold together a tooth where the structure has been compromised.
  • Dental Implants: When a tooth falls out or has been removed, often the healthiest option is a dental implant. During the procedure, a supportive cylinder is surgically implanted into the jaw. This provides a foundation for sturdy, natural-looking replacement teeth.
  • Dentures: People lose teeth for several reasons, usually due to tooth decay or gum disease. For these patients, dentures are often a welcome solution. A set of dentures is a prosthetic device that allows patients to chew better, speak normally and improve their appearance overall.
  • Bridges: Dental bridges replace missing teeth with a short row of prosthetics that rely on the strength of surrounding teeth and help stabilize the bite. Bridges also help keep nearby teeth from moving into the open space of the missing tooth. Once the surrounding teeth are prepared for the bridge, it is attached to the teeth.

Prosthodontic Specialties

Prosthodontics is a dental specialty that involves restoring injured, damaged or missing teeth with prosthetic replacements, providing patients with aesthetic and practical benefits. Prosthetic replacements help restore a patient's smile and confidence, as well as their ability to eat and speak with ease after tooth loss.

Tooth loss is a common condition that affects most people at some point in their lives. Tooth damage or loss may result from poor dental hygiene, gum disease, infection or trauma. While many people seek prosthetic replacements for cosmetic purposes, prosthetic dentistry also treats medical conditions and promotes oral health.

Laboratory Procedures

Prosthodontists are trained extensively in laboratory procedures in order to ensure that the restorations created will meet all of the technical and esthetic needs of the patient. This involves an education in the creation and preparation of working casts, development and trials of the framework, and application of the restorative device. Prosthodontists have a thorough knowledge of both the fabrication techniques for various dental treatments as well as the handling, function and optimal uses of each specific material.

Treatment Planning

The type of dental restoration that you may require is ultimately determined by your dental professional. Prosthodontists are specialists in treatment planning of the oral cavity, helping you to decide which type of restoration and materials used will be best suited to your particular needs. Dental restorations are available in such a wide range that health, financial and esthetic concerns can all be considered in order to find the restoration that is right for you. The longevity of a dental restoration also depends on many factors, including the patient's health, dental hygiene, type of restoration and its location in the mouth.

Implant Restorations

During three years of post-graduate training, prosthodontists complete many implant restorations. Most dental students, even in their last year of schooling, complete a minimal number of implant restorations and are only briefly exposed to other prosthetic procedures.

Dental implants are titanium cylinders that are surgically implanted into the jawbone to replace the roots of the missing tooth. The replacement structure is supported by the implant, and looks and feels like a natural tooth. Implants offer permanent results and full functionality. Patients can enjoy the same comfort and confidence they experienced before tooth loss.

Dental implants are placed during a series of appointments over several months. During the first procedure, the titanium anchors are placed in the jaw. Over the next three to six months, the anchors heal and fuse to the bone, a period known as osseointegration. Small posts are attached to the implant to help provide stability for the replacement tooth. After the anchors heal, the patient is fitted for replacements, which can be installed during the next appointment. Implant surgery is performed as an outpatient procedure under local or general anesthesia.

Esthetic Restorations and Replacement of Teeth

Prosthodontic training concentrates on both the function and appearance of the teeth. Therefore, prosthodontists have advanced knowledge of esthetic restorations as well as the replacement of missing teeth. Esthetic dentistry improves the look of a smile and may involve reshaping the teeth, bonding, whitening and veneers. When a tooth or teeth are missing, it is essential to have them replaced to prevent bone loss and the other teeth from shifting. Depending upon the extent of tooth and bone loss and several other factors, your prosthodontist may consider a bridge, crown, implant or dentures to use for the dental restoration.

Treating Patients with congenital defects as well as problems arising from trauma

While many people lose teeth as a result of an injury or dental condition, some patients never develop certain teeth due to a congenital defect. These defects most often occur as a result of genetic factors and run in families, although they may also be caused by environmental factors, such as viral infections, toxins or effects of chemotherapy.

Treatment for congenitally missing teeth can vary depending on the location and quantity of missing teeth, as well as the patient's overall health and preference for treatment. Dental implants are commonly used with crowns, bridges or dentures to create a full, beautiful smile that naturally restores the patient's appearance. Implants are just as strong and durable as regular teeth, and allow patients to eat and speak normally.

Patients who experience dental trauma often have pain, loose or missing teeth, socket bleeding and may have additional jaw and soft tissue damage as well. Your prosthodontist will likely perform a series of X-rays in order to evaluate the extent of damage and determine the best treatment option for your individual condition.

Prosthodontists are trained to treat a wide range of dental traumas and provide emergency care for such problems as fractured teeth, avulsed (knocked out) teeth and fractured jaws. Treatment for dental trauma depends on the type and severity of the injury. Dental restorations such as crowns or bridges may be used to repair chipped, cracked or broken teeth. A broken jaw may require surgery to realign the bone and allow for proper healing. Any type of trauma should be treated immediately to prevent further damage from occurring.

Rehabilitation of Occlusion and Treatment of Temporomandibular Joint Disorder

Chronic facial pain may be caused by temporomandibular joint disorders or TMD, painful conditions affecting the jaw and chewing muscles. Common causes of TMD include:

  • Trauma to the head or neck
  • Oral habits such as clenching or grinding of the teeth
  • "Bad" bite or missing teeth
  • Arthritis
  • Mal-alignment of the upper and lower jawbones

Treatments for TMD include arthocentesis, stress-reducing exercises, muscle relaxants, mouth protectors to prevent teeth grinding, soft foods, heat/ice packs and avoidance of extreme jaw movements. More extensive treatments may take the form of correctional surgery or pain-relief injections.

Correct dental prosthetic restorations that have been done incorrectly

If a dental prosthetic restoration is not performed correctly, the result can be painful for the patient. Even a crown that is just a bit too long can cause an uneven bite and result in discomfort. If left unattended, this malocclusion can cause uneven tooth wear or breakage. An experienced prosthodontist can determine what is wrong with the restoration in place and how to improve the situation. Sometimes that requires just a slight change such as shaving down or thinning the restoration. In other cases, it might mean creating an entirely new restoration that will fit properly and eliminate the problem for the long term.