My professional journey began in a dental laboratory school and progressed to graduation from Dentistry in the Ukraine. I continued my studies at Boston University, Goldman School of Dental Medicine at an undergraduate and graduate level. After graduation in prosthodontics I joined the faculty as an assistant professor and taught at both levels. Now after fourteen years in private practice I see prosthodontics as being divided into two types, and they are not fixed and removable. One is con-formative and the other is reconstructive:
-Conformative prosthodontics deals with treatment modalities of conditions which fall within normal physiologic patient parameters These parameters are patient specific and do not require any change to that environment. Treatment is based on knowledge that is obtained at an undergraduate prosthodontic level.
-Reconstructive prosthodontics deals with the treatment modalities of abnormal conditions which often are tolerated and adapted to by the patient. It is based on the knowledge obtained during postgraduate studies.
This division defines the developments in dentistry as well as in society. The contemporary prospective patient not only wants “renovation of a house” (i. e. confirmative dentistry) but also “construction of a new home” (i. e. reconstructive dentistry). The more dental patients who can afford a new home, the more of them who also want a new, a better, a brighter, a whiter smile. These ever increasing contemporary demands mean we need more dentists capable of performing reconstructive dentistry.
Demand creates supply, which in turn leads to further developments and innovations in a profession. Dentistry is no different. General dentistry now encompasses knowledge and treatment modalities that used to be the domain of the specialist. It is normal; it is progress. Specialized treatments are refined by specialists and are becoming routine. They are introduced to a wider group of practitioners who implement them in their practices. This transition is a win-win for both dentist and patient.
Currently this demand is being mostly met by a growing number of continuing education courses attempting to package, in a cook book format, a very complex field of reconstructive dentistry and teaches it over short period of time. The most amazing part is that the most visible ones are being taught by nonspecialists. I am not trying to diminish the clinical skills of anyone, however there are reasons for a three/four year university-based training program to become a specialist in one of the recognized dental specialties.
Continuing education in dentistry is playing a major part in the development of the profession. While on faculty at Boston University I witnessed as the school and every department went though the accreditation process by ADA Commission on Accreditation. It was a major learning experience for all. As faculty, the goals and objectives of our teaching had to meet defined standards as set by committee.
Continuing education courses are bridging the gap, however there are problems. Content and quality could be questionable at best. Unfortunately, I have encountered situations where upon completion of some of these CE courses, dentists end up in trouble both collegially and civilly.
Continuing education courses get an approval only, not an accreditation, from the AGD, ADA, CDA and/or from a local governing board. Is that approval sufficient enough to replace an accreditation? I don’t have a solution to this existing problem. It is up to governing institutions to monitor and accredit CE programs.
Dear doctors, at this time, it is you, who on behalf of your patients, have to make a decision whether continuing education courses or a graduate program in prosthodontics will make you a true specialist in reconstructive dentistry.
Prosthodontics has always been a cornerstone of reconstructive dentistry, developing the principles of building strong functional foundations that are the standards of practice today. It is always at the forefront of education disseminating knowledge to the profession.
In this issue of the Oral Health, I would like to introduce an article on posts and cores, a topic that will always remain controversial. It has been written as a position paper for the Academy of Fixed Prosthodontics by Dr. Steven Morgano, my mentor. This article is currently mandatory reading for all postgraduate prosthodontic programs. I hope that it will be helpful in finding answers to many questions that you might have regarding foundation restorations for endodontically treated teeth.
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Prosthodontics has always been a cornerstone of reconstructive dentistry, developing the principles of building strong functional foundations that are the standards of practice today
