Prosthodontics: Specialty Scope, Procedures, and Referral Guidelines

A prosthodontist is a dental specialist who completes three years of ADA-accredited advanced training beyond the DDS or DMD degree, focusing on the restoration and replacement of teeth and maxillofacial structures.

Core Competencies

• Complex Fixed Prosthodontics: Multi-unit bridges, full-arch implant-supported prostheses, veneers, inlays/onlays.
• Removable Prosthodontics: Complete dentures, overdentures (implant-retained), precision-attachment partial dentures.
• Maxillofacial Prosthetics: Obturators, speech-aid prostheses, orbital/auricular/nasal prostheses (for cancer, trauma, congenital defects).
• Occlusal/TMD Management: Centric relation records, splint therapy, full-mouth rehabilitation.
• Dental Implants: Surgical placement (many prosthodontists), prosthetic design, immediate loading protocols, zygomatic/pterygoid implants.
• Sleep Apnea: Custom, titratable mandibular advancement devices.
• Congenital/Developmental Conditions: Ectodermal dysplasia, cleft palate prosthetics, amelogenesis imperfecta.

When to Refer to a Prosthodontist

• Full-mouth reconstruction (>6 units, vertical dimension changes).
• Edentulous arches requiring implant-supported solutions.
• Complex esthetic demands (smile design, shade matching, gingival architecture).
• Failed previous reconstructions or biomechanical complications.
• Maxillofacial defects (post-oncologic, trauma).
• Interdisciplinary coordination (orthodontics, periodontics, oral surgery, ENT).

Board Certification

American Board of Prosthodontics (ABP) certification involves written, oral, and case presentation examinations. Maintenance of certification is required. Approximately 3,500 board-certified prosthodontists practice in the U.S.

Team Approach

The prosthodontist serves as the "architect" of the treatment plan, coordinating surgical, periodontal, orthodontic, and laboratory phases to achieve predictable, durable outcomes.