Prosthodontics is a dental specialty recognized by the American Dental Association that pertains 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.
A prosthodontist is a dentist who has completed dental school plus three additional years of advanced training and education in an ADA-accreded prosthodontic graduate program. They specialize in treating and handling dental and facial problems that involve restoring missing tooth and jaw structures. A prosthodontist is highly trained in cosmetics, dental implants, crowns, bridges, dentures, temporomandibular disorders (TMJ/TMD), and more.
The term “prostho” means replacement and “dontist” means dealing with teeth. Essentially, prosthodontists are THE recognized experts when anything needs to be replaced in your mouth. This can range from a single tooth, multiple teeth, or all teeth and gums in the mouth. While many other dentists can do some of these treatments, prosthodontists are the specialists dedicated to this type of care.
Prosthodontists have advanced training in restoring and replacing teeth. Prosthodontists are considered the leaders of the dental treatment plan. They regularly lead teams of general dentists, specialists, and other health professionals to develop solutions for your dental needs.
Choose a prosthodontist because of their advanced education and training, efficiency, and expertise with advanced technology. Prosthodontists are extensively trained in state-of-the-art techniques and procedures for treating complex dental conditions and restoring optimum function and esthetics.
Rigorous training and experience give prosthodontists a special understanding of the dynamics of a smile and the preservation of a healthy mouth.
Use the ACP's Find a Prosthodontist search to locate a prosthodontist in your area.
A board certified prosthodontist has successfully passed a rigorous examination conducted by the American Board of Prosthodontics. He or she is subjected to re-certification every eight years to insure that he or she is current in practices that affect the specialty.
Learn more about the ABP through their website.
The American Board of Prosthodontics maintains a Locate a Board Certified Prosthodontist search.
A dental laboratory technician is a trained professional that fabricates dental restorations, crowns, bridges, and dentures based on designs and instructions provided by a prosthodontist.
A dental implant by itself is not a tooth! A dental implant is a prosthesis used to replace missing teeth. Essentially, it is a small titanium post/fixture that is inserted into the jawbone, on top of which a single crown (cap), a fixed bridge, a partial denture, or full denture can be attached. Once the implant integrates to your bone, a structure called an abutment is connected to the implant and then the artificial tooth/teeth are attached. Therefore, there are 3 parts to an “implant tooth”: the dental implant itself, the abutment, and the artificial tooth.
Almost anyone who is missing a single tooth, multiple teeth, or all teeth are candidates for dental implants. Talk to your prosthodontist for your specific needs.
Humans are “blessed” with 2 sets of teeth (baby teeth and adult/permanent teeth). When a single permanent tooth or multiple teeth are lost due to dental decay or gum disease, dental implants can now replace them as the 3rd set of fixed teeth! Dental implants can last a lifetime and can improve your appearance, your confidence, and your ability to eat the foods you like, and participate in an active lifestyle, without worry about your teeth. Dental implants are made of titanium and can never get dental decay!
Like any minor oral surgical procedure, there is a risk of infection, inflammation, and pain, but your prosthodontist will discuss how these can be managed for your specific situation. If there is no available bone to place the implant, then bone and gum grafting procedures may be required, which can increase the cost of your treatment. However, the upfront investment can pay off in the long term.
In general, the cost of replacing a single tooth with a dental implant is almost the same as replacing it with a regular fixed bridge. Dental implant treatment may qualify for some insurance coverage, but situations vary. The cost will vary by patient needs, bone quantity, and region. A prosthodontist will make an assessment based on your unique needs.
It varies from individual to individual and with health and habits. For a healthy individual with good oral hygiene and good health, dental implants are predictably successful with reported success rates above 90-95 percent.
Unlike natural teeth dental implants are not susceptible to dental disease such as decay; however, the health of the gums is vital to maintaining lasting implant success. Conscientious home care by the patient and regular professional cleanings and check-ups are essential elements for dental implant sustainability. Each patient is different, and success relies upon diagnosis and planning, medical history, and a variety of other factors.
There is no such thing as “metal-free” teeth. Almost all materials used for teeth replacements have some sort of metal ions in them. Dental implants are made of titanium alloy (similar to hip implants, shoulder implants, and knee implants), which is highly biocompatible, and an allergy to titanium is extremely rare! Currently, there are no proven alternatives to titanium dental implants.
All-on-4® is a trademarked treatment procedure that essentially involves replacement of all missing teeth in one jaw by using only 4 implants. This procedure is especially beneficial in patients who have lost a lot of bone in the back areas of the mouth.
Dentures cannot be “made into implants”. Implants are metal screws placed into the jawbone to help anchor and support artificial teeth (dentures). It may be possible to have implants placed beneath existing dentures to aid in the stabilization and support for those dentures. This could only be done if the current dentures were otherwise in excellent condition. You should consult with your prosthodontist to have your existing dentures carefully examined.
No, dental implants are fixed solidly in the bone and allow teeth to be replaced in a manner that is closest to natural teeth.
Actually implants are most popularly used in patients who wear full dentures or partial dentures. Dental implants can be used to provide retention and support for a removable implant overdenture, which basically snaps on the implants! Therefore the partial or full denture does not move and reduces the dependency on denture adhesives/denture glue. Or, dental implants can be used for a fixed denture, where a patient’s dentures are fixed/bolted to the implants through titanium components. Only the dentist can remove this from the mouth.
The best starting point to see if dentures are an option for you is to see your general dentist or a prosthodontist. A prosthodontist is a specialist with an additional three years of training after dental school who focuses on the restoration and replacement of teeth, including dentures for even the most complex cases. A prosthodontist also will be able to help determine if another treatment option might be more suited to your particular situation.
Dentures may replace all the teeth or only some of the teeth. The dentures that replace all the teeth are known as complete dentures and they rest on the gums that cover the jawbones. The stability and retention of these dentures can be improved by attaching them to dental implants. Dentures that replace some but not all of the teeth are known as partial dentures. They attach to the teeth that are still present and also cover and rest on the gums and bone where the teeth are missing. Dental implants can also be used to restore and stabilize partial dentures as well.
Denture fees vary widely based on many factors including the complexity of your particular treatment, the time required to accomplish the treatment, and the location of the dental practice. Denture fees can vary depending on your needs and the prevailing fees in your community. Payment terms also vary according to the business requirements of the specific practice. The best way to determine fees for the services you require is to visit with your dentist or prosthodontist and discuss the care you may need.
You may also contact your state or local dental society to find out if the organization has any resources for the public related to the cost of dental services. You may want to seek the care of a prosthodontist, a dentist with three years of training beyond dental school who specializes in the care and maintenance of dentures. You can use the ACP's search to find a prosthodontist near you.
Whitening: It is not possible to whiten dentures like natural teeth because dentures are made of plastic. To minimize staining, properly clean your dentures daily to remove food and plaque bacteria. Brushing with a denture brush or soft toothbrush will prevent dentures from becoming permanently stained and keep your mouth healthy. Moisten the brush and apply a non-abrasive soap or denture paste (regular toothpaste is too abrasive). Brush every surface, inside and out, scrubbing gently. A variety of over-the-counter denture cleanser products may be safely used (by following the manufacturer’s instructions) to remove most stains. Do not use bleach on your dentures unless your dentist or prosthodontist gives you special instructions on using bleach. Dilute household bleach can be used to clean and disinfect your denture, but don’t use bleach until you see your dentist for instructions. More stubborn stains may require removal by your dentist or prosthodontist.
Brushing: Do not brush your dentures with normal toothpaste. Toothpastes are designed to be used on teeth, and they often contain materials and chemicals that help whiten and strengthen teeth, but may harm dentures, which are made of a very durable plastic. Even though the plastic is strong, it is not as strong as the enamel of teeth and may be scratched by using toothpaste to clean your dentures. You should use a dish washing liquid and a special denture brush to clean your dentures by hand every day. After rinsing them thoroughly, soak your dentures in water-based cleaning solution overnight.
Repairing broken dentures: The best solution is to return to the dentist or prosthodontist who made your dentures and have the cracked denture repaired professionally. It may seem easy to fix, but it is important that the repair is done correctly to prevent problems with chewing and to avoid any sore spots. The dentist also needs to check the denture and adjust it after it is repaired. The denture may be too old and may no longer fit closely to your gums, and you may need a new denture.
Yes, you can wear your dentures at night but it is preferred that they be removed. You should remove your dentures at night and this will give your gums and bone a chance to relax from the pressure of the denture during the day. If you need to wear your dentures for social reasons or to prevent your jaws from over closing, you should find time during the day to properly clean your mouth and your prostheses. You should never wear your dentures 24 hours a day without preforming proper oral hygiene. Dentures should be cleaned at night and stored in water during the night.
Most patients need to learn how to use dentures properly and as a result, it takes a little time to get used to them. After a while, you should be able to eat fairly normally, but it may take more time to get comfortable with harder foods or sticky foods. Using a small amount of denture adhesive (no more than three or four pea-sized dabs on each denture) may help stabilize the dentures and help hold them in place while you learn how to get comfortable with them and may make the learning process easier.
Chewing gum: Dentures and chewing gum do not usually work well together, no matter which brand of chewing gum you decide to try. The gum typically sticks to the acrylic plastic in the denture and may break a seal on the dentures, which will loosen them as a result. Gum may remain stuck to the denture and eventually harden and discolor. Ultimately, if you wear dentures, you should avoid chewing gum.
When you’re first fitted for new dentures, it’s normal to experience minor irritation, which should fade as your mouth becomes accustomed to them. The period of pain varies. If you’ve previously worn dentures and now have a new set it may take longer. Similarly, if you had some natural teeth present that were removed at the time of the new dentures, the areas where the extractions were performed may be painful or uncomfortable for up to several weeks after the removal of the teeth. Regular visits to your dentist or prosthodontist to adjust the dentures as you go through the normal healing process are recommended.
If the dentures no longer fit as well as they once did, you may need to have a procedure done to refit the base of the denture, called a “reline". Check with your dentist or prosthodontist to see if your dentures can be relined. It is best not to reline your dentures with over the counter reline kits. This procedure, which can be done by your dentist or prosthodontist, will enable your dentures to fit better and tighter than they have previously.
You may consider having the upper denture checked to see if it positioned properly. Sometimes dentures can be made in a position that does not allow the lips to close resulting in excess saliva. If swallowing is not impaired, you should be able to clear your mouth and the amount of saliva will generally decrease. If this does not happen, you should see your dentist or prosthodontist to correct the problem.
The term “permanent dentures” is deceptive and misleading. As we know, most things in life are not permanent, teeth and dentures alike. “Permanent dentures” are retained by screws or dental cement onto dental implants and cannot be removed by a patient; they can only be removed by your dentist or prosthodontist. Eventually even these “permanent dentures” may wear or break or become stained and discolored and will require replacement. Typically, soreness should be resolved within two weeks; if it persists, likely something in the denture needs to be adjusted. You should see your prosthodontist as soon as possible.
Yes, it is possible to have your teeth removed and dentures put in the same day. These dentures are called immediate dentures and you should talk to your dentist or prosthodontist to see if that treatment is the best for your mouth.
If the implants had been placed a long time ago and you have not returned for folllow-up/maintenance visits, such problems can occur. Unfortunately, in time the bone shrinks beneath dentures causing the dentures to slip and slide resulting in painful ulcers. Additionally, the attachment parts get worn down with use or damaged and require replacement. Regular visits to your prosthodontist is recommended.
In most cases, the lower denture is much less stable than the upper denture. This is due to the shape of the gums on the lower ridge and movement of the denture caused by the tongue. Ask your dentist or prosthodontist about supporting your lower denture with dental implants. Implants can be used to stabilize and retain the lower denture allowing you to chew more efficiently and feel the confidence of knowing that your denture will stay in place.
Prosthodontists and their teams are highly trained in the art of color and shade matching. Assuming it is a new partial denture, they can work to produce a match to your remaining natural teeth. If it is an existing partial denture, we would recommend having a new one made, as the expense would be about the same to recolor the old one.
If you had implants inserted, it sounds like the implants were intended to help stabilize the denture, in which case, they should reduce the movement. If your dentures rub your cheeks or if you’re biting your cheeks, you should return to the dentist or prosthodontist who made the dentures to continue to have the fit and bite refined. You should visit your dentist or prosthodontist to remedy these difficulties.
While it may take time to simply adjust to the new dentures, it is likely that if teeth were removed the same day that the dentures were given to you, then you will need follow up with your dentist or prosthodontist to assure that they continue to fit properly as you heal. If you did not have any teeth extracted and simply had new dentures made, there should be fewer adjustments. These adjustments should be more minor in nature. The heavy feeling may be because you have not previously worn dentures or partial dentures. If that is the case, it will take several weeks to completely adapt to the feel of them.
Research shows that once the teeth are removed, the jaw bone shrinks and changes shape. Typically, dentures should be checked every year, and often they should be remade when they lose their fit and are loose in your mouth after 5-10 years of use. By using dental adhesive, you may have masked the loose fit of your dentures. Even though you have adapted to these dentures, you are not receiving the function and appearance you deserve. Also, it is important that you take your dentures out at night to allow your gum tissues to rest and decrease the possibility of sore spots.
Relines of dentures should improve the fit of the base of the denture to the jaw. However, if your jaw has been without natural teeth for some time, it may be difficult to make the denture stable if there is little jawbone. Soft tissues beneath dentures can also become easily irritated by wearing dentures continually (24 hours a day). You should refrain from wearing dentures at night as this gives the skin a chance to recover from wearing them during the day. Your dentist or prosthodontist should make sure that the skin inside the mouth is healthy and take steps to treat it properly before relining. If there is enough jawbone available, relines can often be done well. If not, it may be necessary to revisit the need for either remaking or redesigning the denture.
See a prosthodontist for consultation. Some patients have to wait a period of time before dentures can be fitted to avoid these concerns. Details of the cancer treatment are important and may guide the timeline and treatment approach.
It’s hard to predict how much of the upper and lower jaw will remain after 20 years without teeth. When teeth are removed, often the bone that held them in slowly shrinks over time. This doesn’t happen to everyone, but it’s normal after tooth removal. It’s important that dentures are made properly to fit well and keep minimum stress on the bone. It’s not likely that you’ll have all the bone you started with after 20 years of not wearing a denture. Your dentist or prosthodontist should annually examine your mouth to assure ideal oral health, including the bone level that would be below your dentures.
Your dentures may be ill-fitting or the position of the implants may not be the most favorable. Usually this can be resolved by improving the fit of the denture or by adding (more) implants. Your prosthodontist can help you with this situation.
If you are using your denture adhesive correctly, there should not be a lot of adhesive left on your gums and palate when you remove your denture. Patients use a variety of methods to remove the adhesive: a piece of gauze, a tissue, a damp washcloth, or a wet toothbrush. Use no more than three or four pea-sized dabs of adhesive on each denture.
Tooth whitening lightens discolored enamel and dentin. Studies have shown that proper use of dentist-monitored, whitening systems can enhance your smile. Almost anyone can benefit. After a thorough examination and diagnosis, your prosthodontist can determine if you are a good candidate for home whitening.
Veneers may be an option if you are not happy with the spaces, color, or shape of your teeth. Following a slight preparation of the outermost surface of your teeth, a prosthodontist bonds a thin layer of porcelain permanently to the front of your teeth. Veneers may be used to correct minor flaws of an individual tooth, but are often used on multiple teeth to create a uniform smile.
Unsightly fillings can be replaced by a tooth-colored material bonded to the tooth. Instead of using the more traditional cement, this bonding process may actually improve the strength and beauty of the tooth.
From implants to permanent bridges, you have several options to replace missing teeth and blend them with your natural teeth. Using advanced materials and tooth-color matching techniques, your prosthodontist can recommend the appropriate method for optimal function and esthetics.
When a tooth exhibits moderate to severe destruction such as a large filling with recurrent decay or extensive wear, a crown, also known as a protective cap, gives you the strength, beauty, translucency, and feel of a natural tooth. Made from a variety of materials, your prosthodontist can help determine the correct crown for your mouth.
Proper tooth brushing habits are the key to maintaining a healthy, pain-free mouth. Whether you use a manual or electric toothbrush, the same principles apply to develop the correct tooth brushing techniques. Because it is important to clean your gums as well as your teeth and to avoid damaging the gums, you should always use a soft-bristled toothbrush.
Clean the area where the gums meet the teeth by placing the toothbrush at a 45-degree angle, touching both the gums and the teeth and make small circles with the brush for several seconds. Then move the brush to the chewing surfaces of the back teeth and clean them with a front to back motion of the toothbrush. Electronic toothbrushes may enhance the proper tooth brushing techniques by automatically providing the proper cleansing motion and encouraging specific time interval, usually two minutes, for a thorough cleaning.
Flossing is easy once you get in the habit of flossing regularly. The technique is the same for all types of floss:
Initially the gums may bleed when flossing, but with continued and regular tooth flossing the gums will become healthy and stop bleeding.
Many people experience anxiety before their dental treatment. This dental anxiety may stem from past experiences or just a perception that the dental procedures will be painful. Many methods are available to help reduce or remove dental anxiety. Some people can relieve their anxiety simply by discussing their fears with their prosthodontist and learning more about the planned procedure.
Be open with your prosthodontist about your anxiety and have a discussion on the treatment that is right for you.
Nitrous oxide or "laughing gas" is given to a person with a mixture of oxygen and has a calming effect that helps anxious people relax during their dental treatment. When using nitrous oxide, the patient remains conscious and can talk to the prosthodontist during their procedure. The effects wear off almost immediately allowing the person to drive home following the treatment.
Nitrous oxide rarely has side effects when given properly by a prosthodontist. Using nitrous oxide during a dental procedure will reduce dental anxiety for a number of people, but very anxious patients may require a prescription medication.
Sedation is meant to help people calm their nerves through the use of medication or inhaled gas prior to and/or during a treatment procedure. Sedation is helpful for patients with fears related to dental treatment, for patients with a low pain tolerance, or perhaps for patients requiring longer dental appointments. There are different types of sedation used depending on the situation.
Sedation is endorsed by the American Dental Association and is an effective way to help many patients feel comfortable during their dental visit. Before using sedation or anesthetic, it is important to tell your doctor about any medications or herbal supplements you are taking or medical treatments you are receiving.
Any prescription anti-anxiety treatment, including IV sedation, will require the individual to be in good general health and to have a driver to take him or her home after the dental procedure.
Anesthesia relates to blocking or temporarily removing sensation from your body or mouth to allow medical or dental treatment without discomfort. Local anesthetics are typically used for dental procedures to remove sensation or “numb” a specific area. General anesthesia is more commonly used in a hospital setting to remove sensation from the entire body during a medical surgery.
Several antibiotics exist that are well-suited to treat dental infections (used as antibiotic therapy), and your prosthodontist can decide the best antibiotic based on the type of infection and your medical history.
People with certain medical conditions such as specific heart conditions (including artificial heart valves) or total joint replacements of the knee and/or hip may need to take antibiotics (antibiotic prophylaxis) before any invasive dental procedures. Some dental procedures may allow bacteria to enter the blood stream. The bacteria in the blood stream can eventually reach either the damaged area of the heart or the artificial joint and cause an infection. In extreme situations, the risk may become life-threatening. Your prosthodontist may consult with your cardiologist to determine the appropriate protocol for you.
Prosthodontists are specialists in replacing or restoring missing teeth. It is estimated that 120 million Americans are missing one or more teeth, and 36 million Americans are missing all of the teeth in one or both of their jaws.
With dental restorations such as dentures and dental implants, people can enjoy health, natural smiles and improved quality of life. Dental restorations may be supported by natural teeth or by dental implants.
Dental restorations can be expensive. It's important to protect your investment!
Patients with dental restorations can keep their teeth healthy using a lifelong recall and maintenance approach. This can reduce risk for failure of tooth and implant-borne restorations.
In addition to maintaining regular dental hygiene practices, prosthodontists recommend that patients with dental restorations should have clinical examinations to clean, adjust, repair, or replace their restorations at least every six months.
Your prosthodontist will create an at-home maintenance plan that is tailored to you. These are some key steps to ensure the health of your restored teeth:
1. Brush your teeth with a fluoride toothpaste at least twice a day.
2. Floss your teeth once a day.
3. Use a mouthwash recommended by your prosthodontist.
4. Wear a night guard (if recommended by your prosthodontist) to protect your restorations.
5. Don't smoke or chew tobacco.
6. Avoid eating a high-sugar diet.
With these recommendations, your restored teeth are more likely to last longer, feel good, and look great.
As the building blocks of our body, cells maintain our tissues and organs. When cell production and regulation lapse, abnormal growths or malignant tumors destroy healthy tissues and spread or metastasize the diseased cells to other parts of the body.
About two-thirds of cancer of the mouth or oral cavity occurs in the floor of mouth and tongue, but can occur in the upper or lower jaw, lips, gums, and cheek lining. Just behind the mouth is an area known as the orophyarnx. Oropharygeal cancer (one-third of cases) occurs in the back of the tongue, tonsils and throat tissue.
People who use tobacco are six times more likely to develop oral cancer. Eight of 10 oral cancer patients are smokers. Heavy alcohol drinkers are also more at risk. 80% of people diagnosed with oral cancer consumer more than 21 drinks weekly. Finally people with a history of oral human papilloma virus infections are at greater risk to develop oral cancer even if they don’t smoke or drink.
The American Cancer Society recommends a comprehensive oral evaluation and soft tissue exam annually, yet only one in five patients reports having an oral cancer exam in the last year. Your prosthodontist is trained to perform a comprehensive evaluation of your mouth including the associated structures in the head and neck area.
An oral cancer screening is painless; treatment for advanced oral cancer is not.
Digital imaging is a relatively new technology in dentistry and offers features that enhance the viewing of any problem areas. Digital X-rays use low levels of radiation and an electronic sensor to create a black and white picture teeth and surrounding bone. The images are displayed almost instantly on a computer screen and are stored in the computer allowing easy electronic transmission.
Digital X-rays are used inside the mouth to examine the teeth, the jaw-bone, and dental restorations. They play an important role in the diagnosis of decay and failing crowns and fillings, the correct placement of dental implants, and the proper treatment of teeth requiring root canals.
All dental X-rays, including digital X-rays, use very low levels of radiation and are very safe. Protective lead aprons can be used.
This type of dental X-ray allows the prosthodontist to see your teeth or jaws as a 3D image. It can be one of the most useful ways to allow a safe and predictable outcome for dental implants. State-of-the-art technology makes it possible for implant-supported replacement teeth to look, feel, and function like natural teeth.
CAD/CAM stands for “computer-aided design / computer-aided manufacturing”. Prosthodontists use CAD/CAM systems to design and create crowns, bridges, dentures, and other prostheses more quickly than was possible before.
Using advanced 3D printing technology, CAD/CAM turns a computer model into physical reality. Prosthodontists who offer “chairside” CAD/CAM can provide some treatments, such as crowns and veneers, in a single visit.
Dental lasers are a new treatment option for diseases of hard and soft tissues and teeth. The dental laser is a machine that focuses a beam of energy down a hollow tube of a thin strand of glass filament. Lasers are a safe way to allow your prosthodontist to remove extra gum tissue. This focused heated energy can remove the tissue being worked on. It also lessens bleeding and swelling, and kills bacteria limiting disease potential.
Using laser surgery may also reduce the need for dental anesthesia, giving your prosthodontist more control with bleeding, less swelling after a procedure, and less discomfort.
Radiography refers to the use of X-ray radiation to create images of structures of the body. Like medicine, digital radiography is gradually replacing the traditional dental radiographs using film. Either technique uses low levels of radiation to create a black and white picture of the various structures in and near the mouth. X-rays are used inside the mouth to examine the teeth, the jaw-bone, and dental restorations.
Dental X-rays play an important role in the diagnosis of decay and failing crowns and fillings, the correct placement of dental implants, and the proper treatment of teeth requiring root canals. X-rays are utilized to help with evaluation of the upper and lower jaws, the sinuses and the temporomandibular joints. All dental X-rays, including digital X-rays, use very low levels of radiation and are very safe. Protective lead aprons can be used to cover various body parts X-rays are taken.