A denturist in the United States and Canada, clinical dental technician in the UK or (in Australia) a dental prosthetist, is a member of the oral health care team who provides an oral health examination, takes impressions of the surrounding oral tissues, constructs and delivers removable oral prosthesis (dentures and partial dentures) directly to the patient.
They differ from prosthodontists, who are qualified specialist dentists for making fixed or removable appliances for patients.
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Definitions
Denturism is defined as the practice by denturists of making artificial dentures and fitting them to patients.. A denturists role is dedicated to solely providing removable full and partial dentures to their patients. It is a recognised profession throughout the world and currently utilised in many countries including Australia, United States, United Kingdom and Canada.
Maps Denturist
Denturism
The International Federation of Denturists consists of national organizations of denturism from around the world who are interested in furthering the profession, and providing the world's edentulous population with affordable, professional denture care.
Denturism is legislated and practiced in five U.S. states: Maine, Arizona, Washington, Oregon, and Colorado. Denturitry is legislated and practiced in the state of Montana. According to the College of Denturists of Ontario, denturism has been a regulated profession in the Canadian province since 1973. In Alberta, the profession has been regulated since 1961; first under the "Dental Mechanics Act", and subsequently since 2002, under the Health Professions Act of Alberta as reported by the College of Alberta Denturists (http://www.collegeofabdenturists.ca) All Canadian provinces and territories recognize the profession.
More recently the United Kingdom has legislated the profession. In the U.K. denturists are termed "Clinical Dental Technicians". According to the Clinical Dental Technician's Association, "Professional Clinical Dental Technicians are members of the Dental Health Care Team specifically trained and educated in the skills and knowledge necessary to provide a removable appliance service directly to the community. Equipped with solid technical training as a Dental Technician and post-technician training in sciences, clinical skills, and interpersonal skills, the Clinical Dental Technician can design, create, construct and modify (repair and rebase) a removable appliance to insure optimal fit, maximum comfort and general well-being of patients. These skills enable the Clinical Dental Technician, whilst remaining a member of the Dental Health Care Team to work independently of other Dental Health Care providers."
Australia is another country where the profession of denturism is regulated. In Australia a denturist is referred to as a dental prosthetist. The Australian Dental Prosthetists Association is the national organization in Australia.
History of Denturism
Dentures throughout the Ages
The use of "false teeth" has prevailed throughout the course of history. Archaeological evidence dating back to 1500 B.C. was found in Egypt . 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 . 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 . 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 . Alexis Duchateu crafted the first porcelain dentures in 1770 . 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 </ref> Kelly, J.R. and Benetti, P., 2011. Ceramic materials in dentistry: historical evolution and current practice. Australian Dental Journal, 56(s1), pp.84-96.</ref>.
In the 1800s, the incidence of dental decay and tooth loss began to increase rapidly . The industrialisation period meant the consumption of sugar among British citizens increased by 500 percent . A need for an alternative form of dentures was needed.
In 1815, the battle of Waterloo, gave rise to the highly demanded "Waterloo teeth" . 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 .
In 1820, Claudius Ash was given the task of crafting a new and improved form of dentures . Ash was a silversmith and goldsmith . He constructed porcelain on 18-karat gold plates . 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 (.
In the 1850s, Ash and his company developed Vulcanite (hardened rubber that seated porcelain teeth) . 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 . 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 . Having a clear occupation for dentures alone became a requirement .
Legal Recognition of Denturists
The 1919 Tasmanian Dental Act made a clear distinction between the role of a Dentist and the practice of denture making . For a patient that required dentures, a consultation by referral from a Dentist became normal procedure .
Denturism - that is the field of dentures - was not recognised until more recent times .
The Health Amendment Act (1933) was the first legal document that gave rise to the practice of Denturism in Canada . The Dental Mechanics Act of Alberta (1961) was the future update to this legislation allowing Denturists to begin work in the field . They were also known as "Dental Mechanics" or "Denture Therapists" .
This gave rise for the need for legal recognition of denturists in other countries . In the United States, the first legally recognised Denturists were found in Ontario, 1971 . In 1974, denturists were first legally recognised and in 1978, Denture Therapists began practicing .
The increasing rate of ill-fitting, misaligned, unstable and unsupportive dentures motivated three Denturists in 1956 to pursue international recognition . Rolf Pfenniger, Hannes Stiebler and Stephan Grabert formed the Internationale Arbeitsgemeinschaft der Zahnprothetiker. In English, this is the International Federation of Denturists .
International Federation of Denturists
The International Federation of Denturists (IFD) was established in order to support and unite Denturists worldwide. The main aims of the IFD are: - Represent the views of all Denturists on a global scale
- Promote the interests and well-being of all Denturists
- Create a united international climate for Denturists to practice
- Promote research opportunities in the field.
- Promote higher standards of education
- Develop a code of ethics - Collect statistical information and pass this on to members for the purposes of continued development
- Conduct promotional activities on international and national levels
- Promote recognition and acceptance of Denturists' services.
Training In Different Countries
Australia
United States
United Kingdom
Canada
Scope of Practice in Different Countries
Australia
Dental prosthetic are nationally registered to work as an independent practitioner to consult, assist, treat, manage and engaged directly with patient.
Scope of practice
o Creating impressions of peoples' teeth so you can make customized partial or complete dentures and mouthguards
o Referring patients with more complex issues to a dentist or specialist dentist
o Ensuring the finished denture and mouthguards fits appropriately
o Maintaining and repairing existing dental prostheses
o Educating patients on oral health hygiene techniques
United States
United Kingdom
Clinical dental technicians (CDTs) are registered dental professionals that can:
o prescribe and provide complete dentures direct to patients
o provide and fit other dental devices on prescription from a dentist
o take detailed dental history and relevant medical history
o perform technical and clinical procedures related to providing removable dental appliances
o carry out clinical examinations within theirscope of practice
o take and process radiographs and other images related to providing removable dental appliances
o distinguish between normal and abnormal consequences of ageing
o give appropriate patient advice
o recognise abnormal oral mucosa and related underlying structures and refer patients to other healthcare professionals if necessary
o fit removable appliances
o provide sports mouth guards
o keep full, accurate and contemporaneous patient records
o vary the detail but not the direction of a prescription according to patient needs
Additional skills which CDTs could develop include:
o oral health education
o re-cementing crowns with temporary cement
o providing anti-snoring devices on prescription of a dentist
o removing sutures after the wound has been checked by a dentist
o prescribing radiographs
o replacing implant abutments for removable dental appliances on prescription from a dentist
o providing tooth whitening treatments on prescription from a dentist
Canada
Denturists are independent practitioners. The profession of Denturism has developed and grown since its legal recognition in 1961 to incorporate an ever-expanding scope of practice.
Scope of practice:
o Denturists provide removable dentures directly to a patient.
o Perform a complete visual/digital oral examination and evaluation of the patient. This includes obtaining a complete medical and dental history of the patient.
o Makes impressions, makes necessary jaw relation records, selects the artificial teeth, and designs the dentures.
o Fabricates and inserts the dentures in the mouths of patients.
o Performs any adjunctive services such as Repair or Relines or Adjustments of removable dentures.
o Supervises auxiliary personnel in the performance of their delegated duties.
Licensing in Different Countries
Australia
United States
United Kingdom
Clinical dental technicians (CDTs) are registered dental professionals that can:
o prescribe and provide complete dentures direct to patients
o provide and fit other dental devices on prescription from a dentist
o take detailed dental history and relevant medical history
o perform technical and clinical procedures related to providing removable dental appliances
o carry out clinical examinations within theirscope of practice
o take and process radiographs and other images related to providing removable dental appliances
o distinguish between normal and abnormal consequences of ageing
o give appropriate patient advice
o recognise abnormal oral mucosa and related underlying structures and refer patients to other healthcare professionals if necessary
o fit removable appliances
o provide sports mouth guards
o keep full, accurate and contemporaneous patient records
o vary the detail but not the direction of a prescription according to patient needs
Additional skills which CDTs could develop include:
o oral health education
o re-cementing crowns with temporary cement
o providing anti-snoring devices on prescription of a dentist
o removing sutures after the wound has been checked by a dentist
o prescribing radiographs
o replacing implant abutments for removable dental appliances on prescription from a dentist
o providing tooth whitening treatments on prescription from a dentist
Canada
Role in the Dental Team
Traditional Duties
Distinguishing From Other Dental Professionals
See Also
Related Topics
References
Traditional duties
According to the United States National Denturist Association website, denturists can perform the following functions:
1. Perform a complete visual/digital oral examination and evaluation of the patient. This includes obtaining a complete medical and dental history of the patient. It should be noted that a denturist is not a doctor or dentist and will not diagnose diseases of the head and neck.
2. Take impressions of the oral tissue and make necessary jaw relation records, select artificial teeth, design the dentures.
3. Fabricate and insert dentures in the mouths of patients.
4. Perform any adjunctive services such as a repair to dentures, relines and adjustments of removable dentures.
5. Supervise auxiliary personnel in the performance of their delegated duties.
Further, in Alberta, Canada, denturists may also do the following:
6. Treat traumatized oral tissues.
7. Order radiographs (but not interpret them).
8. Provide implant supported dental prosthesis, both fixed or removable.
9. Provide sports mouthguards.
10. Provide anti-bruxism (night guard) devices.
11. Provide tooth-whitening services.
12. Creating a clone of your denture (denture cloning)
In the UK Clinical Dental Technicians are registered with the General Dental Council in London. This is following graduation from the Royal College Of Surgeons London. Clinical Dental Technicians can work directly with patients for the provision of complete Dentures, if the patient has no remaining teeth. If the patient still has remaining natural teeth, they see the dentist first to check those remaining teeth, the Dentist then refers them to the Clinical Dental Technician for the provision of partial dentures. UK based Clinical Dental Technicians scope of practice is therefore different to those points 1 to 12 above.
Training
In order to become licensed as a denturist an individual must graduate from an accredited Denturist College, usually two to three years in length, in addition to having at least four years experience and background in dental technology in most states and some provinces.
Controversy
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. This argument has been disproved by examining other jurisdictions in the world which have both dentists and denturists. For example, six years after the Canadian province of Ontario began regulating denturists, 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. 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.
Distinguishing from dental technicians
A licensed denturist or dental prosthetist is not a dental technician. Historically, a large number of the original denturists, or dental prosthetists, were schooled as dental technicians who sought to further their education in denturism.
This training and experience gives denturists a unique advantage in that they have become extremely familiar with cases of edentulism, and both the clinical and laboratory procedures in which to treat edentulous and semi-edentulous patients.
Denturists in Canada and the USA(for the most part), are independent primary healthcare providers.
Dental technicians (or dental technologists), are not primary healthcare providers; rather, they are an auxiliary profession of dentistry and denturitry which forms part of the healthcare team. Technicians provide laboratory services based on a received prescription, from a dentist or denturist, and they provide a product to the referring dentist or denturist, for that practitioner to place into a patient's mouth.
Distinguishing from other dental professionals
According to the International Federation of Denturists, "University-trained dentists perform the full range of services related to the patient dental health care and well being (assessment, diagnosis, treatment etc.). The scope of practice for Denturists includes clinical work, but clearly delineates and draws distinctions between adjustment and/or alteration to natural teeth/tissues of the mouth, and appliances. Denturists work with prosthetic (artificial replacement) devices only. Dental technicians, by contrast, work in laboratories and are trained to make appliances for dentists. They have neither the clinical education nor the legislated mandate to work directly with patients."
See also
- Dentistry
- Dentures
- Dental auxiliary
- Dental assistant
- Dental therapist
- Dental hygienist
- Dental technician
- Prosthetist (non dental)
- Esteem Dental Care
References
Source of the article : Wikipedia
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