The examples and perspective in this article may not represent a worldwide view of the subject.(May 2020) |
A denturist in the United States and Canada, clinical dental technologist in the United Kingdom and Ireland, dental prosthetist in Australia, or a clinical dental technician in New Zealand is a member of the oral health care team and role as primary oral health care provider who provides an oral health examination, planning treatment, takes impressions of the surrounding oral tissues, constructs and delivers removable oral prosthesis treatment (including dentures and partial dentures) directly to the patient. [1] [2] [3] [4]
Denturism is defined as the practice by denturists of examining oral health, planning treatment, making artificial dentures including other removable oral appliances and fitting them to patients. [1] [2] [3] [4] It is a recognized profession throughout the world and currently utilized in many countries including Australia, New Zealand, United States, United Kingdom and Canada. In the United States, denturism is only legislated and practiced in 7 states (Maine, Arizona, Idaho, Montana, Washington, Oregon, and Colorado). [1] However, in Australia, the United Kingdom and Canada, all states, provinces and territories recognize the profession. [2] [3] [4]
The criteria and training to become a denturist vary by country and region, however after completion of required prerequisites which are completion of dental technology program or years experience in denturitry with completion of core required courses, generally the denturism programs take 3–5 years and the qualification ranges from a Diploma to a master's degree. [5] [6] Due to the diversity in training, the scope of practice for a denturist can alternate between countries, however the general principle remains the same.
Denturist curriculum contains courses such as, General biology, Micro biology, Human anatomy, Head and Neck anatomy, Dental anatomy, Physiolosy, Dental Materials, Dental technology theory, Infection prevention and control, Radiographic interpretation, Periodontology, Histology, Embryology, Nutrition, Psychology, Pathophysiology, Oral pathology, Pharmacology, Gerontology, Ethics, Removable and Fixed prosthetics, Implantology, Removable oral appliances, Clinical & Laboratory theory, Practice management, etc. [7]
The program is competitive and selective. Prospective students are encouraged to complete and earn Dental Technology Degree prior to applying Denture Specialist Program. By acquiring Dental Technology knowledge prior to entering Denture Specialist Program would help students to follow course works with better understanding. Work experience from denturist clinic, denture laboratory and other dental field is plus to be succeed before and after graduation. [8]
Denturists are an important part of the dental team. They often work alongside general dentists, dental specialists and other members of a dental team in both private and public sectors of the oral health workforce. [9] They can also work independently in their own clinic with patients providing appropriate management and treatment of dentures and other oral appliances. Denturists are well educated in clinical and technical knowledge of denture care, as well as completing many hours of practical skills in producing dentures. They ultimately receive more comprehensive study in oral prosthetics than any other health professional including the general dentist [10] since dental schools less emphasis in their curriculum about removable prosthetics and focus on implantology in contrast denturist schools teaches mainstream of removable prosthetics and dentures and spend several years for training. [9] Therefore, the collaborative role of denturists provides an important model of re-allocating dental services to alleviate stresses from the general dentists, reserving time for restorative, cosmetic, hygiene, and emergency dental procedures. [11]
Denturists differ from both dental technicians and prosthodontists. [12] Dental technicians are registered members of the dental team who support dental practitioners in the delivery of dental services. [13] Prosthodontists are qualified dentists, who have specialized in making fixed or removable appliances for patients. [14]
The use of "false teeth" has prevailed throughout the course of history. Archaeological evidence dating back to 1500 B.C. was found in Egypt. [15] The Egyptians would use real teeth threaded with a gold wire to create a false set of teeth. In northern Italy 700 B.C., the Etruscans made dentures out of animal teeth. [16] Hence the world of dental prosthodontics began to take shape. Despite being made of low quality material and having short life spans, dentures were relatively popular.
The first complete set of dentures is attributed to 16th century Japan. [17] They were known as the Japanese box and are quite similar in shape to modern day dentures.
In the 1700s, ivory dentures were developed from walrus, elephant or hippopotamus tusks. [18] Alexis Duchateu crafted the first porcelain dentures in 1770. [4] These were prone to cracking and appeared too white to be natural teeth. Duchateus was a pharmacist, since Denturist, as an occupation was yet to be established. [18]
In the 1800s, the incidence of dental decay and tooth loss began to increase rapidly. [19] The industrialisation period meant the consumption of sugar among British citizens increased by 500 percent. [19] A need for an alternative form of dentures was needed.
In 1815, the Battle of Waterloo gave rise to the highly demanded "Waterloo teeth". [20] These were dentures crafted primarily from the teeth of dead soldiers seated in a base of animal ivory. Waterloo dentures gave the appearance of natural teeth and were not as prone to breakage as porcelain dentures. [20]
In 1820, Claudius Ash was given the task of crafting a new and improved form of dentures. [21] Ash was a silversmith and goldsmith. [4] He constructed porcelain on 18-karat gold plates. [21] The springs that held the dentures together were also made of gold. Dentures that were previously made from natural teeth or porcelain were both aesthetically and functionally inferior in comparison to Ash's design. [21]
In the 1850s, Ash and his company developed Vulcanite (hardened rubber that seated porcelain teeth). [21] His company was the leading supplier of this form of dentures in Europe. Charles Goodyear was awarded the patent for Vulcanite-based dentures in 1851. [22] Dentures, at the time, were primarily focused on aesthetics. Early in the 20th century, Dentistry shifted from treatment based therapy to prevention and as such, dentures that were in line with good health became more favourable. [23] Having a clear occupation for dentures alone became a requirement. [23]
The 1919 Tasmanian Dental Act made a clear distinction between the role of a Dentist and the practice of denture making. [23] For a patient that required dentures, a consultation by referral from a Dentist became normal procedure. [23]
Denturism – that is the field of dentures - was not recognised until more recent times. [23]
The Health Amendment Act (1933) was the first legal document that gave rise to the practice of Denturism in Canada. [24] The Dental Mechanics Act of Alberta (1961) was the future update to this legislation allowing Denturists to begin work in the field. [25] They were also known as "Dental Mechanics" or "Denture Therapists." [25]
This gave rise for the need for legal recognition of denturists in other countries. [25] In the United States, the first legally recognised Denturists were found in Oregon, 1971. [26] In 1974, denturists were first legally recognised and in 1978, Denture Therapists began practicing. [26]
The increasing rate of ill-fitting, misaligned, unstable and unsupportive dentures motivated three Denturists in 1956 to pursue international recognition. [27] Rolf Pfenniger, Hannes Stiebler and Stephan Grabert formed the Internationale Arbeitsgemeinschaft der Zahnprothetiker. In English, this is the International Federation of Denturists. [27]
Denturists have campaigned for the right to practice independently in many states, with the argument that they can provide greater access and lower-cost prosthetic services. [28] This argument has been disproved by examining other jurisdictions in the world which have both dentists and denturists. In Canada, six years after regulating of denturists commenced, the fees quoted in their fee guide were similar to those of dentists. Consequently, most of these campaigns have so far failed.
In some jurisdictions, denturists must operate under the supervision or oral health certificate of a dentist. Many dentists argue that this does not happen. For example, in 1991, investigators hired by the Arizona Dental Association found that only three out of the state's 13 denturists advised callers to see a dentist before visiting them. [29] Many denturists argue that from a business point of view dentists are viewed as competition and in many locations dentists may "steal their business" after doing an exam. [30] With the work of the IFD and other denturist campaigns across the globe, there is hope for clearer recognition and scope in future.
The following programs of study have currently been approved by the Dental Board of Australia for the profession of dental prosthetics. On successful completion of the selected courses, individuals are required to register with the Australian Health Practitioner Regulation Agency to practice legally as a dental prosthetist. [31]
Education Provider | Qualification | Course Type | Course Length (Years) |
---|---|---|---|
Griffith University | Bachelor of Dental Prosthetics (undergraduate entry) | Bachelor's Degree | 3 |
Griffith University | Graduate Diploma of Dental Technology in Prosthetics (post-graduate entry only) | Graduate Diploma | 1 |
Griffith University | Master of Dental Technology in Prosthetics (post-graduate entry only) | Master's Degree | 1.5 |
Griffith University | Master of Dental Technology in Prosthetics/Graduate Diploma of Dental Technology in Prosthetics (exit point only) (post-graduate entry only) | Master's Degree | 1/1.5 |
RMIT University | Advanced Diploma of Dental Prosthetics (undergraduate entry) | Advanced Diploma | 2 |
TAFE New South Wales Sydney Institute | Advanced Diploma of Dental Prosthetics (undergraduate entry) | Advanced Diploma | 2 |
TAFE South Australia | Advanced Diploma of Dental Prosthetics (undergraduate entry) | Advanced Diploma | 2 |
TAFE Queensland | Bachelor of Dental Prosthetics (undergraduate entry) | Bachelor's Degree | 3 |
The following programs of study have currently been approved by the Denturist Association of Canada for the profession of denturism. On successful completion of the selected courses, individuals are then required to complete a Qualifying Examination administered by the College of Denturists, consisting of two components: a written examination and a structured clinical examination. Upon successful completion of the examination, individuals may then register with the College of Denturists of Ontario to practice legally as a denturist. [32]
Education Provider | Qualification | Course Type | Course Length (Years) |
---|---|---|---|
CDI College | Advanced Diploma of Dental Technology | Advanced Diploma | 3 |
College Edouard-Montpetit | College Diploma of Techniques of Denturology | Advanced Diploma | 3 |
George Brown College | Ontario College Advanced Diploma (Denturism) | Advanced Diploma | 3 |
Georgian College | Ontario College Advanced Diploma (Denturism) | Advanced Diploma | 3 |
Northern Alberta Institute of Technology | Diploma of Dental Technology | Advanced Diploma | 3 |
Oxford College of Arts, Business and Technology | Ontario College Advanced Diploma (Denturism) | Advanced Diploma | 3 |
In the United States, there are certain prerequisites that need to be completed before individuals can apply at either of the two programs of study approved by the National Denturist Association USA. The prequisites vary from prior work experience to related education in the dental field.
On successful completion of the selected courses, individuals are then required to complete a jurisdiction, written and clinical examination offered by each legislated state. Upon successful completion of the examination, individuals can register with each legislated state and the National Denturist Association USA to practice legally as a denturist. [33]
Education Provider | Qualification | Course Type | Course Length (Years) |
---|---|---|---|
American Denturist College | Denturist | Diploma, Bachelor's degree | 3~4 |
The following programs of study have currently been approved by the General Dental Council for the profession of clinical dental technologist. Required prerequisites must be completed prior to enter Clinical Dental Technology Program. On successful completion of the selected courses, individuals are required to register with the General Dental Council to practice legally as a clinical dental technologist. [34]
Education Provider | Qualification | Course Type | Course Length (Years) |
---|---|---|---|
Edinburgh Postgraduate Dental Institute | Clinical Dental Technology | BSc | 3 |
Kent, Surrey and Sussex Postgraduate Dentistry | Clinical Dental Technology | BSc | 3 |
University of Central Lancashire | Clinical Dental Technology | BSc | 3 |
The scope of practice differs in each country, based on the training undertaken.
The following scope of practice has been outlined by the Australian Dental Association for registered dental prosthetists. [35]
Dental prosthetists in Australia can:
The following scope of practice has been outlined by the National Denturist Association for registered denturists.
Denturists in the United States can:
The following scope of practice has been outlined by the General Dental council for registered clinical dental technologist. [36]
Clinical dental technologist in the United Kingdom can:
Additional skills which CDTs in the UK could develop include:
The following scope of practice has been outlined by the Denturist Association of Canada for registered denturists. [3]
Denturists in Canada can:
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.
A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Dentures are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable. However, there are many denture designs, some of which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, the distinction being whether they fit onto the mandibular arch or on the maxillary arch.
Cosmetic dentistry is generally used to refer to any dental work that improves the appearance of teeth, gums and/or bite. It primarily focuses on improvement in dental aesthetics in color, position, shape, size, alignment and overall smile appearance. Many dentists refer to themselves as "cosmetic dentists" regardless of their specific education, specialty, training, and experience in this field. This has been considered unethical with a predominant objective of marketing to patients. The American Dental Association does not recognize cosmetic dentistry as a formal specialty area of dentistry. However, there are still dentists that promote themselves as cosmetic dentists.
A dental technician is a member of the dental team who, upon prescription from a dental clinician, constructs custom-made restorative and dental appliances.
A dental implant is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown, bridge, denture, or facial prosthesis or to act as an orthodontic anchor. The basis for modern dental implants is a biological process called osseointegration, in which materials such as titanium or zirconia form an intimate bond to the bone. The implant fixture is first placed so that it is likely to osseointegrate, then a dental prosthetic is added. A variable amount of healing time is required for osseointegration before either the dental prosthetic is attached to the implant or an abutment is placed which will hold a dental prosthetic or crown.
Prosthodontics, also known as dental prosthetics or prosthetic dentistry, is the area of dentistry that focuses on dental prostheses. It is one of 12 dental specialties recognized by the American Dental Association (ADA), Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of Ireland, Royal College of Surgeons of Glasgow, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons. The ADA defines it as "the dental specialty pertaining 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 or oral and maxillofacial tissues using biocompatible substitutes."
A dental hygienist or oral hygienist is a licensed dental professional, registered with a dental association or regulatory body within their country of practice. Prior to completing clinical and written board examinations, registered dental hygienists must have either an associate's or bachelor's degree in dental hygiene from an accredited college or university. Once registered, hygienists are primary healthcare professionals who work independently of or alongside dentists and other dental professionals to provide full oral health care. They have the training and education that focus on and specialize in the prevention and treatment of many oral diseases.
Geriatric dentistry is the delivery of dental care to older adults involving diagnosis, prevention, management and treatment of problems associated with age related diseases. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. In the elderly population poor oral health has been considered a risk factor for general health problems. Older adults are more susceptible to oral conditions or diseases due to an increase in chronic conditions and physical/mental disabilities. Thus, the elderly form a distinct group in terms of provision of care.
Inflammatory papillary hyperplasia (IPH) is a benign lesion of the oral mucosa which is characterized by the growth of one or more nodular lesions, measuring about 2mm or less. The lesion almost exclusively involves the hard palate, and in rare instances, it also has been seen on the mandible. The lesion is mostly asymptomatic and color of the mucosa may vary from pink to red.
Dental assistants are members of the dental team. They support a dental operator in providing more efficient dental treatment. Dental assistants are distinguished from other groups of dental auxiliaries by differing training, roles and patient scopes.
Toothlessness or edentulism is the condition of having no teeth. In organisms that naturally have teeth, it is the result of tooth loss. Organisms that never possessed teeth can also be described as edentulous. Examples are the members of the former zoological classification order of Edentata, which included anteaters and sloths, as they possess no anterior teeth and no or poorly developed posterior teeth.
A dental auxiliary is any oral health practitioner other than a dentist & dental hygienist, including the supporting team assisting in dental treatment. They include dental assistants, dental therapists and oral health therapists, dental technologists, and orthodontic auxiliaries. The role of dental auxiliaries is usually set out in regional dental regulations, defining the treatment that can be performed.
Dental laboratories manufacture or customize a variety of products to assist in the provision of oral health care by a licensed dentist. These products include crowns, bridges, dentures and other dental products. Dental lab technicians follow a prescription from a licensed dentist when manufacturing these items, which include prosthetic devices and therapeutic devices. The FDA regulates these products as medical devices and they are therefore subject to FDA's good manufacturing practice ("GMP") and quality system ("QS") requirements. In most cases, however, they are exempt from manufacturer registration requirements. Some of the most common restorations manufactured include crowns, bridges, dentures, and dental implants. Dental implants is one of the most advanced dental technologies in the field of dentistry.
Dental prosthetist may refer to:
Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.
In dentistry, the neutral zone refers to that space in the oral cavity where the forces exerted by the musculature of the tongue are equal and balanced with the forces exerted by the buccinator muscle of the cheek laterally and the orbicularis oris muscle anteriorly.
Alveoloplasty is a surgical pre-prosthetic procedure performed to facilitate removal of teeth, and smoothen or reshape the jawbone for prosthetic and cosmetic purposes. In this procedure, the bony edges of the alveolar ridge and its surrounding structures is made smooth, redesigned or recontoured so that a well-fitting, comfortable, and esthetic prosthesis may be fabricated or implants may be surgically inserted. This pre-prosthetic surgery which may include bone grafting prepares the mouth to receive a prosthesis or implants by improving the condition and quality of the supporting structures so they can provide support, better retention and stability to the prosthesis.
A complete denture is a removable appliance used when all teeth within a jaw have been lost and need to be prosthetically replaced. In contrast to a partial denture, a complete denture is constructed when there are no more teeth left in an arch; hence, it is an exclusively tissue-supported prosthesis. A complete denture can be opposed by natural dentition, a partial or complete denture, fixed appliances or, sometimes, soft tissues.
Overdenture is any removable dental prosthesis that covers and rests on one or more remaining natural teeth, the roots of natural teeth, and/or dental implants. It is one of the most practical measures used in preventive dentistry. Overdentures can be either tooth supported or implant supported. It is found to help in the preservation of alveolar bone and delay the process of complete edentulism.