Training requirements for today’s Prosthodontists are very strict and are standardized throughout the country by a National Examining Board, the Royal College of Dentists of Canada. Dentists from all over the world compete to get into training programs that are offered in Canada or in the United States. Prosthodontic post-graduate programs are usually very small, (two to six students), expensive to take and are extremely difficult to get accepted into. After graduating in general dentistry, it is a requirement to successfully complete three to four years of Prosthodontic Specialty training.

In Canada, candidates must also pass the scrutiny examinations of the Royal College of Dentist of Canada before provincial regulatory bodies will accept them and license them as Certified Specialists. Presently, there are still some Prosthodontists who had “grandfathered” the qualifications to sit the examination process as they practiced at a specialty level before accredited university graduate programmes were in place. All proven Prosthodontists will have the “Certified Specialist in Prosthodontics” designation.

* Prosthodontics
* Periodontics
* Orthodontics
* Pediatric Dentistry
* Oral and Maxillofacial Surgery
* Endodontics
* Oral Pathology
* Public Health
* Oral and Maxillofacial Radiology

* Cosmetic Dentistry, Implant Dentistry and Holistic Dentistry are not recognized specialties.

Prosthodontics has to do with prosthetic restoration of the teeth including tissues of the mouth and face.
Periodontics has to do with the management of the gums and bony tissues that support the teeth.
Orthodontics has to do with straightening the alignment of the teeth and jaws.
Pediatric Dentistry has to do with the dental treatment and management of children and juveniles.
Oral and Maxillofacial Surgery has to do with surgery and operations of the teeth, face, head and neck.
Endodontics has to do with root canal treatment of the dental pulp in teeth.
Oral Pathology has to do with the diagnosis and treatment of diseases of the mouth, head and neck.
Public Health has to do with community treatment and prevention of dental disease.
Oral and Maxillofacial Radiology has to do with interpretive x-ray and other imaging of the head and neck.

Rigorous training and experience provide Prosthodontists with the special understanding of the dynamics of the smile, the preservation of a healthy mouth, and the creation of tooth replacements. Serving as the prime practioners of dental treatment planning, Prosthodontists collaborate with referring general dentists, other dental specialists and other health professionals to develop solutions for patients dental concerns and dental problems.

A Prosthodontist can provide an extremely high level of care for patients who are missing teeth or have sustained significant damage to their existing teeth. Prosthodontists also deal with congenital defects as well as with problems arising from trauma or neglect. A Prosthodontist can aid in the rehabilitation of a complete dentition or merely in the replacement of one or two teeth. With the advent of dental implants as a viable means of replacing teeth, the Prosthodontist’s role has expanded significantly into this area, providing services such as; evaluating baseline conditions, instituting start to finish treatment planning and making the final delivery of implant-based restorations. Some Prosthodontists have also taken on extra surgical training and additionally are able to perform the surgical aspects of installing dental implants.

A Prosthodontist will usually treat the more difficult dental problems for people who are missing many teeth or have significant functional or esthetic problems. Many general dentist practitioners are quite capable of handling basic crown and bridge procedures or providing dentures to replace missing teeth. However, when it comes to restoring extensive areas or the entire mouth, the Prosthodontist is called on for these more difficult and complex types of dental treatments.

The most unusual aspect of this has to do with quackery. Quackery has long existed in the Medical and Dental arena. People who are chronic sufferers are particularly susceptible to practitioners of pseudo-science who make claims not supported by mainstream science or proven practice. While I am not a closed-minded person I believe in the scientific basis of the burden of proof before I will buy into a proposition and I suggest that you as member of the public be careful and prudent about persons who practice outside of the boundaries of convention. Persons who claim to have unusual or unique powers to heal, particularly those who claim to heal medical conditions or ailments by virtue of the way in which they do their dentistry should be cautiously approached.

Another area of misleading advertising has to do with professing to be a “Dental Implant Specialist” when in fact no such designation actually exists. Currently there is no existing recognized specialty program in Dental Implantology although there are hundreds of private training courses, which are offered for a fee to teach dentists basic surgical skills and basic didactic knowledge. Some of these courses are for a single day and some may last for several weeks but these courses are a far cry from a comprehensive traditional post graduate program of three to four years of specialist training. Worst of all, none of these courses have any standards of governance. Presently there are three specialties which include a component training in Dental Implantology; Oral and Maxillo-facial Surgery, Periodontics and Prosthodontics yet none of these are comprehensive enough to provide a designation as a specialty in Dental Implantology. There are a few organizations that purport to provide accreditation in Dental Implantology. Three of these are the American Academy of Implant Dentistry (AAID) , the American Board of Oral Implantology (ABOI) and the International Congress of Oral Implantologists (ICOI). Credentials in these and other like organizations however are not professionally recognized and are no assurance that you, the public, will have an appropriate level of expertise provided by designates from these organizations.

Basically, to achieve an expertise in Dental Implantology, a dentist will need to undertake as much private training and mentoring as possible and develop a personal program of self-learning and experience derived from many years of practice and collaboration. For example I have been placing Dental Implants for over 25 years but I still cannot call myself a specialist in Dental Implantology. I have however gone through a career-long learning process and have to-date placed well over 3000 implants. As well, I am widely recognized in the community for teaching and providing this service. Presently the best you can do for assurance as a consumer, is to ask around and be discriminating in choosing who should provide dental implant services should you need them.

Depending on the circumstances, this process may take anywhere from a few weeks to many months of treatment. If accessory treatments are required, such as orthodontics, jaw alignment surgery, periodontal regeneration, or bone grafting, the process may take a year or even more.

Before undertaking a treatment of this complexity, a preliminary meeting and discussion should take place with an experienced Restorative Dentist to establish a rapport; to have a preliminary discussion as to what urgent care, if any, is necessary, and to determine what the general objectives goals of treatment should be and what realistic treatment expectations can be achieved.

The next step after the preliminary consultation is to perform a proper case analysis including obtaining a complete medical and dental history, obtaining a comprehensive series of individual X-rays as well as panoramic X-rays, obtaining diagnostic casts (tooth models) mounted to a jaw movement simulator and recording pre-treatment photographs.

Often a diagnostic pretreatment is made to a second set of casts to evaluate if a successful outcome of jaw and tooth alignments is possible. The pretreatment cast diagnosis can also allow for the visualization of the effects of making a realignment of teeth and jaw function position as required. If Dental Implants are required a comprehensive bone volume analysis will need to be made. This thorough Diagnostic Case Analysis is akin to making an engineering and architectural evaluation of a site prior to undertaking the construction of a home or building.

On occasion, consultations with other specialists may be made for treatments that are other than purely restorative.  Also  on an ‘as needs’ basis, three dimensional x-ray imaging may be prescribed (i.e. cone beam volumetric tomograms), to more accurately evaluate jaw structure, jaw-joint structure, airway breathing space, sinus location and conditions and main nerve structure positions.

Once all data is assembled, a detailed treatment plan can be determined and follow-up consultations can be made to review what is possible and what may not be possible, what the treatment sequencing and scheduling may be, and what the costing and expense structure will be.  A review of risks and benefits and as well as possible complications will be made and a discussion on any matters that need further explanation such as dental insurance or health trusts and tax deductibility can also be made.