Reframing Contemporary Prosthodontics Through an Orthopedic Paradigm

Presently, 12 dental specialties in the United States are recognized by the National Commission on Recognition of Dental Specialties and Certifying Boards (NCRDSCB).¹ A significant amount of procedure overlap exists among the various recognized dental specialties. Examples of overlap include pediatric orthodontics (between pediatric dentistry and orthodontics), exodontia and implant surgery (between oral surgery, periodontics, and prosthodontics), oral pathology and oral disease diagnostics (between oral medicine, oral radiology, and oral pathology), and temporomandibular disorder management (between oral medicine, orofacial pain, and prosthodontics), to name just a few.

The latest report from the American Dental Association on licensed dentists, for the year 2024, shows that out of a total of 203,465 licensed dentists, there are 159,562 general dentists, 3,540 prosthodontists, 5,471 periodontists, and 7,424 oral surgeons.² Notably, none of the official NCRDSCB definitions adopted by these three specialties—prosthodontics, periodontics, oral surgery—mention the term “implants.” Furthermore, the official specialty definitions for “periodontics” and “prosthodontics” do not even mention the term “surgery.”²

Expanding the Identity of Prosthodontists

According to the American College of Prosthodontists position statement on dental implants, implant therapy is a prosthodontic procedure with radiographic and surgical components.³ Placement of dental implants is part of a treatment procedure, not a specialty, and like all dental procedures it requires dental education and clinical training.³ “Implantology” is not an official recognized dental specialty in the United States or most parts of the world and is unlikely to receive specialty status because of the significant procedure overlaps among the specialties of oral surgery, periodontics, and prosthodontics.³ Use of dental implants to replace a missing tooth/teeth is governed by specific patient needs as diagnosed by the patient’s dentist. An implant is a prosthesis and medical device approved/regulated by the US Food and Drug Administration. The prosthodontic and surgical parts of implant care each can range from straightforward to complex.⁴

Prosthodontics is a broad dental specialty, and the Commission on Dental Accreditation, recognized by the US Department of Education, adopted new standards for prosthodontics specialty education in 2015, which stated that all students must be competent in the placement and restoration of dental implants, including referral.⁵ Although numerous prosthodontics training programs in the US were already providing surgical training before these standards were adopted, in the past 10 years all prosthodontics training programs in the US have compulsorily incorporated surgical training for prosthodontics residents. With an average of more than 150 graduating residents per year, approximately over 1,500 surgically trained prosthodontists have emerged over the past decade.^6,7 With a total of 3,540 prosthodontists, this means about 50% of prosthodontists are trained in implant surgery. This cohort of new-age clinicians requires a broader identity that better represents their scope of contemporary training and practice while at the same time communicating their expertise with the public and dental colleagues. Furthermore, a screening of the scientific literature trend for the highest-ranked prosthodontics journal (Journal of Prosthetic Dentistry) showed a significant increase in the number of surgery-related publications, with 73 articles published in 2015 and 289 in 2025, further underscoring the trend of increased importance of surgical prosthodontics.⁸

Procedure Overlap

The American Board of Medical Specialties currently lists 38 specialties and 89 subspecialties.⁹ Like dental specialties, there are many medical specialties that overlap each other (eg, neurology and psychiatry; family medicine, pediatrics, and internal medicine; orthopedics and podiatry/physical medicine; general surgery and surgical oncology; dermatology and plastic surgery; and many more). Out of all the medical specialties, orthopedics seems to have the closest alignment with the specialty of prosthodontics. Like prosthodontics, orthopedics encompasses a broad scope that involves diagnostic orthopedics, orthopedic surgery, orthopedic oncology, prosthetics and joint replacement, trauma, sports medicine, modern cosmetic orthopedic surgery, and more.

With this broad scope, orthopedists also face a situation similar to prosthodontists regarding procedure overlap and establishing distinction. For example, a patient with a foot injury could seek an evaluation from either an orthopedic surgeon, podiatrist, physiatrist, rheumatologist, or general surgeon. Just as prosthodontists collaborate with periodontists and oral surgeons on some cases, orthopedic doctors work with rheumatologists, general surgeons, physiatrists, podiatrists, etc. Similar to how prosthodontists collaborate with dental laboratory technicians, orthopedic doctors collaborate with prosthetists and orthotists who make custom-fitting replacements for missing limbs or other missing body parts. Just like prosthodontists treat deficits in patients with head and neck trauma and oral oncology, orthopedic oncologists treat patients with tumors of the bone, joints, and muscles. Most relatable, similar to how prosthodontists place dental implants to replace missing teeth, orthopedic surgeons place hip implants, knee implants, shoulder implants, and so on. And just like prosthodontists routinely work with screws, metal bars, resins, metal parts, pins, needles, or wires, orthopedic surgeons also handle a variety of hardware, including screws, resins, nuts, rods, splints, and more. Modern orthopedic surgeons also deal with cosmetic procedures (eg, orthoplastic surgery) just like prosthodontists perform cosmetic dentistry.

Presently, orthopedics is the most similar medical specialty to prosthodontics. Likewise, among dental specialties, none is as closely aligned with orthopedics as prosthodontics. Thus, the contemporary prosthodontist may effectively be identified as the “orthopedic surgeon of the mouth.” This identification is novel, broad, and connects easily with the public. It is not misrepresentative, nor does it infringe on the identity of any another dental specialty.

About the Author

Avinash S. Bidra, BDS, MS
Professor and Program Director, Postgraduate Prosthodontics, University of Connecticut School of Dental Medicine, Farmington, Connecticut; Private Practice, Glastonbury, Connecticut; Fellow, American College of Prosthodontists