PROSTHODONTICS - American College of Prosthodontists

The American College of Prosthodontists12. Identify the setting(s) in which these services are customarily provided and whether thishas changed in the past ten years. If this has changed, what has been the impact on professionand public?The primary setting for prosthodontic services over the past 25 years has predominately been inprivate practice and continues to show strong trends in that sector. In 1986 it was noted that49.6% of prosthodontists were in private practice (Laney, et al, 1986) followed by 25.2% in theFederal services, 21.4% in academia and 3.8% listed hospital as their primary setting wheremaxillofacial prosthetic services were provided. Furthermore, with the combined (implant, fixedand removable prosthodontics) advanced education prosthodontics training programs haveencouraged a consolidation of treatment modalities whereby these services can be offered inthe private practice without necessarily involve a university or hospital setting when the patient’smedical health is not compromised. This observation is also true for maxillofacial prostheticprocedures but to a lesser degree as the need for team approach to care involving othermedical specialties is paramount. Recent advances in microvascular flaps and craniofacialimplants have changed the scope of care for the maxillofacial prosthodontist eliminating someconventional maxillofacial prosthetic procedures but creating other more advanced proceduresin their place.In 2000, the American College of Prosthodontists (ACP) database (corrected to exclude studentand retired members) lists 1464 (62%) members in private practice, 364 (15.3%) in education,289 (12%) Federal Services, 121 (5%) hospital, and 99 (4%) in administrative/public health.This data shows a shift toward the private practice sector with a lessening of the FederalServices and academia settings at that time. The current (2009) ACP membership database(corrected to exclude student, alliance, international and retired life members) further indicatesthe emphasis on private practice with 75.4% of the members reporting private practice as theirprimary activity, 15.7% education and 8.9% Federals Services.The increase from roughly half (49.6%) to three quarters (75.4%) of prosthodontists engaged inprivate practice is a significant shift in emphasis that has occurred over the past twenty years. Itis likely that a trend of this magnitude reflects increased demand for prosthodontic servicesamong that portion of the population seeking dental services (Douglass, 1990, 2002; Nash andPfeifer 2007). The increasing number of older adults retaining teeth for a longer span of timeoften results in more complex treatment needs requiring additional time and more advancedskills to maintain (Dickey, 1999; Nash and Pfeifer, 2006, 2007).The ACP holds growth as one of its strategic concerns and there is evidence that the efforts oforganized Prosthodontics is succeeding in expanding the numbers of prosthodontists availableto meet the need of the expanding patient base who require specialist care involvingprosthodontics. To align the understanding of the need by professions, the specialty is alsoengaged in a long term effort to educate both the public and medical and dental colleaguesregarding the value of prosthodontic specialty-level of care. Together, the expansion of needand the development of awareness have provided strong footing for the growth of the specialtyto better serve the public need.Prosthodontics - 242010 CDEL Re-recognition of the Specialty Report 24 of 279