Denturist
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A denturist in the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
and
Canada Canada is a country in North America. Its Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...
, clinical dental technologist in the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
and
Ireland Ireland (, ; ; Ulster Scots dialect, Ulster-Scots: ) is an island in the North Atlantic Ocean, in Northwestern Europe. Geopolitically, the island is divided between the Republic of Ireland (officially Names of the Irish state, named Irelan ...
, dental prosthetist in
Australia Australia, officially the Commonwealth of Australia, is a country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
, or a clinical dental technician in
New Zealand New Zealand () is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and List of islands of New Zealand, over 600 smaller islands. It is the List of isla ...
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 Dentures (also known as false teeth) are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable ( removable partial denture or comp ...
and partial dentures) directly to the patient.


Definitions

Denturism is defined as the practice by denturists of examining oral health, planning treatment, making artificial
dentures Dentures (also known as false teeth) are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable ( removable partial denture or comp ...
including other removable oral appliances and fitting them to patients. It is a recognized profession throughout the world and currently utilized in many countries including
Australia Australia, officially the Commonwealth of Australia, is a country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
,
New Zealand New Zealand () is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and List of islands of New Zealand, over 600 smaller islands. It is the List of isla ...
,
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
,
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
and
Canada Canada is a country in North America. Its Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...
. In the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, denturism is only legislated and practiced in 7 states (Maine, Arizona, Idaho, Montana, Washington, Oregon, and Colorado).Lombardi V. Legislation nternet National Denturist Association. ited 2018May14 Available from: http://nationaldenturist.com/legislation However, in
Australia Australia, officially the Commonwealth of Australia, is a country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
, the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
and
Canada Canada is a country in North America. Its Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...
, all states, provinces and territories recognize the profession.Australian Dental Prosthetist Association. ADPA; ited 2018May13 Available from: https://www.adpa.com.au/about-us/about-the-adpaDenturism in Canada nternet Denturist Association of Canada. ited 2018May15 Available from: http://www.denturist.org/about.htmlA Proud Heritage nternet Dental Technologists Association. ited 2018May14 Available from: https://www.dta-uk.org/dta-heritage.php The criteria and training to become a denturist vary by country and region; however, after completion of required prerequisites which are completion of a dental technology program or several years of 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. Due to the diversity in training, the scope of practice for a denturist can vary among countries; however, the general principle remains the same. Denturist curriculum contains courses such as, General
biology Biology is the scientific study of life and living organisms. It is a broad natural science that encompasses a wide range of fields and unifying principles that explain the structure, function, growth, History of life, origin, evolution, and ...
,
Microbiology Microbiology () is the branches of science, scientific study of microorganisms, those being of unicellular organism, unicellular (single-celled), multicellular organism, multicellular (consisting of complex cells), or non-cellular life, acellula ...
, Human
anatomy Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...
, Head and Neck anatomy, Dental anatomy,
Physiology Physiology (; ) is the science, scientific study of function (biology), functions and mechanism (biology), mechanisms in a life, living system. As a branches of science, subdiscipline of biology, physiology focuses on how organisms, organ syst ...
, Dental Materials, Dental technology theory,
Infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
prevention and control, Radiographic interpretation,
Periodontology Periodontology or periodontics (from Ancient Greek , – 'around'; and , – 'tooth', genitive , ) is the Specialty (dentistry), specialty of dentistry that studies supporting structures of Tooth, teeth, as well as diseases and conditions th ...
,
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,
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,
Nutrition Nutrition is the biochemistry, biochemical and physiology, physiological process by which an organism uses food and water to support its life. The intake of these substances provides organisms with nutrients (divided into Macronutrient, macro- ...
,
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,
Pathophysiology Pathophysiology (or physiopathology) is a branch of study, at the intersection of pathology and physiology, concerning disordered physiological processes that cause, result from, or are otherwise associated with a disease or injury. Pathology is ...
, Oral
pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
,
Pharmacology Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics, pharmacodynamics, therapeutic use, and toxicology. More specifically, it is the study of the interactions that occur betwee ...
,
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,
Ethics Ethics is the philosophy, philosophical study of Morality, moral phenomena. Also called moral philosophy, it investigates Normativity, normative questions about what people ought to do or which behavior is morally right. Its main branches inclu ...
, Removable and Fixed
prosthetics In medicine, a prosthesis (: prostheses; from ), or a prosthetic implant, is an artificial device that replaces a missing body part, which may be lost through physical trauma, disease, or a condition present at birth (congenital disorder). Prosthe ...
, Implantology, Removable oral appliances, Clinical & Laboratory theory, Practice management, etc. 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.


Role in the dental team

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. 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 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. 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. Denturists differ from both dental technicians and prosthodontists. Dental technicians are registered members of the dental team who support dental practitioners in the delivery of dental services. Prosthodontists are qualified dentists, who have specialized in making fixed or removable appliances for patients.


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 Egypt ( , ), officially the Arab Republic of Egypt, is a country spanning the Northeast Africa, northeast corner of Africa and Western Asia, southwest corner of Asia via the Sinai Peninsula. It is bordered by the Mediterranean Sea to northe ...
. 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 The Etruscan civilization ( ) was an ancient civilization created by the Etruscans, a people who inhabited Etruria in List of ancient peoples of Italy, ancient Italy, with a common language and culture, and formed a federation of city-states. Af ...
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 Japan is an island country in East Asia. Located in the Pacific Ocean off the northeast coast of the Asia, Asian mainland, it is bordered on the west by the Sea of Japan and extends from the Sea of Okhotsk in the north to the East China Sea ...
. They were known as the Japanese box and are quite similar in shape to modern day dentures. In the 1700s,
ivory Ivory is a hard, white material from the tusks (traditionally from elephants) and Tooth, teeth of animals, that consists mainly of dentine, one of the physical structures of teeth and tusks. The chemical structure of the teeth and tusks of mamm ...
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. In the 1800s, the incidence of dental decay and tooth loss began to increase rapidly. The
industrialisation Industrialisation ( UK) or industrialization ( US) is the period of social and economic change that transforms a human group from an agrarian society into an industrial society. This involves an extensive reorganisation of an economy for th ...
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 The Battle of Waterloo was fought on Sunday 18 June 1815, near Waterloo, Belgium, Waterloo (then in the United Kingdom of the Netherlands, now in Belgium), marking the end of the Napoleonic Wars. The French Imperial Army (1804–1815), Frenc ...
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 A goldsmith is a Metalworking, metalworker who specializes in working with gold and other precious metals. Modern goldsmiths mainly specialize in jewelry-making but historically, they have also made cutlery, silverware, platter (dishware), plat ...
. 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 Charles Goodyear (December 29, 1800 – July 1, 1860) was an American self-taught chemist and manufacturing engineer who developed vulcanized rubber, for which he received patent number 3633 from the United States Patent Office on June 15, 1844 ...
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.Prior, TG. The Dentists Act (1919). Acting Government Printer, Tasmania. Dental Board of Tasmania. http://www.austlii.edu.au/au/legis/tas/num_act/tda191910gvn46225/tda191910gvn46225.pdf Having a clear occupation for dentures alone became a requirement.


Legal recognition of denturists

The 1919
Tasmania Tasmania (; palawa kani: ''Lutruwita'') is an island States and territories of Australia, state of Australia. It is located to the south of the Mainland Australia, Australian mainland, and is separated from it by the Bass Strait. The sta ...
n 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 Canada is a country in North America. Its Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...
. The Dental Mechanics Act of
Alberta Alberta is a Provinces and territories of Canada, province in Canada. It is a part of Western Canada and is one of the three Canadian Prairies, prairie provinces. Alberta is bordered by British Columbia to its west, Saskatchewan to its east, t ...
(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 United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, the first legally recognised Denturists were found in
Oregon Oregon ( , ) is a U.S. state, state in the Pacific Northwest region of the United States. It is a part of the Western U.S., with the Columbia River delineating much of Oregon's northern boundary with Washington (state), Washington, while t ...
, 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.Malherbe D. Provision of removable prosthetics by denturists-what is the controversy. Laboratory World: International Dentistry South Africa. 2006 Jan. Rolf Pfenniger, Hannes Stiebler and Stephan Grabert formed the Internationale Arbeitsgemeinschaft der Zahnprothetiker. In English, this is the International Federation of Denturists. 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. 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. 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. With the work of the IFD and other denturist campaigns across the globe, there is hope for clearer recognition and scope in future.


Training in different countries


Australia

The following programs of study have currently been approved by th
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 The Australian Health Practitioner Regulation Agency (Ahpra) is a cross-jurisdictional statutory authority responsible for the regulation of 16 common Health professional, health professions in Australia. While legislated responsibility for regul ...
to practice legally as a dental prosthetist.


Canada

The following programs of study have currently been approved by th
Denturist Association of Canada
for the profession of denturism. On successful completion of the selected courses, individuals are then required to complete
Qualifying Examination
administered by th
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 th
College of Denturists of Ontario
to practice legally as a denturist.


United States

In the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, there are certain prerequisites that need to be completed before individuals can apply at either of the two programs of study approved by th
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 th
National Denturist Association USA
to practice legally as a denturist.


United Kingdom

The following programs of study have currently been approved by th
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 th
General Dental Council
to practice legally as a clinical dental technologist.


Scope of practice in different countries

The scope of practice differs in each country, based on the training undertaken.


Australia

The following scope of practice has been outlined by th
Australian Dental Association
for registered dental prosthetists.
Dental prosthetists in
Australia Australia, officially the Commonwealth of Australia, is a country comprising mainland Australia, the mainland of the Australia (continent), Australian continent, the island of Tasmania and list of islands of Australia, numerous smaller isl ...
can: * perform both visual and digital oral health examinations. * prescribe oral prosthetics to dental technicians. * prescribe radiography. * Supervise auxiliary personnel in the performance of their delegated duties. * Create impressions of peoples' teeth, in order to make customized partial or complete dentures and mouthguards. * Refer patients with more complex issues to a dentist or specialist dentist when appropriate. * Treat bruxism and sleep apnea by using night guard and anti snoring device. * Treat teeth whitening by using custom bleach tray. * Maintain and repair existing dental prostheses. * Educate patients on oral health hygiene techniques.


United States

The following scope of practice has been outlined by th
National Denturist Association
for registered denturists.
Denturists in the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
can: * Perform both visual and digital oral health examinations. * Obtain medical and dental history. * prescribe oral prosthetics to dental technicians. * prescribe radiography. * planning treatment, design and fit full dentures including implant retained dentures for patients who are missing all of their teeth. * Planning treatment, design and fit removable partial dentures including implant retained dentures for patients who are missing only one or a few teeth. * Treat bruxism and sleep apnea by using night guard and anti snoring device. * Treat teeth whitening by using custom bleach tray. * Educate patients on oral health hygiene techniques. * Supervise auxiliary personnel in the performance of their delegated duties. * replacing implant abutment for Oral appliances.


United Kingdom

The following scope of practice has been outlined by th
General Dental council
for registered clinical dental technologist.SCOPE OF PRACTICE nternet Gdc-uk.org. 2018 ited 17 May 2018 Available from: https://www.gdc-uk.org/api/files/Scope%20of%20Practice%20September%202013.pdf
Clinical dental technologist in the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
can: * perform both visual and digital oral health examinations. * treatment by using removable oral appliances directly to patient * prescribe oral prosthetics to dental technicians. * Provide and fit other dental devices (including mouthguards). * Supervise auxiliary personnel in the performance of their delegated duties. * Take a detailed medical and dental history. * Perform technical and clinical procedures related to providing removable dental appliances. * Carry out clinical examinations within their scope of practice to examine for details such as space and retention. * Take and process radiographs and other images related to providing removable dental appliances. * Distinguish between normal and abnormal consequences of ageing. * Give appropriate patient advice. * Recognize abnormal oral mucosal lesions and related underlying structures and refer patients to other healthcare professionals if necessary. * Vary the detail but not the direction of a prescription according to patient needs. Additional skills which CDTs in the UK could develop include: * Providing oral health education. * Re-cementing crowns with temporary cement. * Providing anti-snoring devices. * Removing sutures after the wound has been checked by a dentist. * Prescribing radiographs. * Replacing implant abutments for dental appliances. * Providing tooth whitening treatments.


Canada

The following scope of practice has been outlined by th
Denturist Association of Canada
for registered denturists.
Denturists in
Canada Canada is a country in North America. Its Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...
can: * perform both visual and digital oral health examinations. * Provide removable oral appliances directly to a patient. * Perform a complete visual/digital oral examination and evaluation of the patient. This includes obtaining a complete medical and dental history of the patient. * Treat bruxism and sleep apnea by using night guard and anti snoring device. * Treat teeth whitening by using custom bleach tray. * prescribe radiography. * prescribe oral prosthetics to dental technicians. * Take impressions and make necessary jaw relation records * Select the artificial teeth and designs the dentures. * Fabricate and insert the dentures in the mouths of patients. * Perform any adjunctive services such as repairs, relines or adjustments of removable dentures. * Supervise auxiliary personnel in the performance of their delegated duties.


See also

*
Dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the Human tooth, teeth, gums, and Human mouth, mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, dis ...
*
Dentures Dentures (also known as false teeth) are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable ( removable partial denture or comp ...
*
Dentist A dentist, also known as a dental doctor, dental physician, 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 provi ...
* Dental auxiliary ** Dental assistant ** Dental therapist **
Dental hygienist 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 hygie ...
**
Dental technician A dental technician is a member of the dental team who, upon prescription from a dental clinician, constructs custom-made restorative and dental appliances. There are four major disciplines within dental technology. These are ''fixed prosthesis ...
* Prosthetist (non-dental)


References

{{reflist Prosthodontology Restorative dentistry