Consultation with or Referral to a Prosthodontist



Consultation with or Referral to a Prosthodontist

When your patient presents a complex esthetic or function challenge….your best option may be a referral to a prosthodontist.

• Patients whose treatment involves multidisciplinary management

• Patients with serious esthetic problems

• Patients requiring complex implant-supported prostheses

• Patients with severe Occlusal deficiencies

• Patients requiring rehabilitation after traumatic injury or oral cancer surgery

• Frail elderly denture patients with cognitive or neuromuscular deficits

Prosthodontists

Prosthodontists are dental specialists trained in state-of-the-art techniques and procedures required for patients who need complex treatment to restore optimum oral function and esthetics.

Drawing on the Prosthodontist’s advanced training and specialized skills adds an important dimension to the treatment planning and patient care provided by the General Dentist.

Prosthodontists collaborate with General Dentists and other specialists to develop solutions to the dental and oral health concerns of the individual patient.

Whether working in and advisory capacity with the General Dentist or actually providing specialized treatment, the Prosthodontist’s collaboration can be a valuable asset in the planning and delivery of care for patients with complex oral conditions.

When your prosthodontics patient presents complex esthetic and functional challenges

Patients requiring treatment by several specialties:

Patients whose extensive rehabilitation requirements involve care from several dental and medical disciplines present special and time consuming problems for General Dentist.

Prosthodontists are trained to manage and appropriately stage the treatment needs of such patients. When the rehabilitation is complete or simply well underway, the patient returns to the referring General Practitioner for ongoing maintenance care.

Complex implant-supported restorations:

Treating the patient whose significant esthetic problems combine with severe Occlusal deficiencies requires development of a detailed multi-contingency plan of care. The complexities of designing and placing multi-implant-supported restorations can be substantial, particularly for patients with significant bone loss.

When sinus lift procedures or other strategies for increasing bone support are necessary, preoperative imaging and surgical guides help ensure optimal and accurate implant placement. Consultation with or referral to a Prosthodontist is crucial.

Challenging prosthesis designs:

Treating patients with severely resorbed ridges, bony interferences or significantly inadequate vertical dimension can be difficult and the design and placement of prosthodontic appliances for such patients is often time consuming and frustrating. With such patients, consultation with or referral to a Prosthodontist can help assure a satisfactory outcome.

For patients with Class 3 or Class 4 Complete Edentulism, consultation with or referral to a Prosthodontist is strongly recommended. The Classification System for Complete Edentulism developed by the American College of Prosthdontists and widely accepted by U.S. dental schools, categorizes edentulous patients according to level of complexity.(See T. McGarry, et al., Classification System for Complete Edentulism, J Prosthodontics 8 (1):27-39, March 1999.)

Geriatric Patients:

The design and fabrication of new dentures for patients with impaired cognitive status or diminished neuromuscular skills may necessitate a complex mental and emotional evaluation supplementing an assessment of bone volume and tissue condition. Neurological or psychological problems such as depression or cognitive disorders, including all stages of Alzheimer’s disease, complicate treatment planning and delivery. Prosthodontists are trained in the management of such patients.

Complications:

Implementing treatment plans for patients whose oral/Occlusal condition has evolved in unexpected and complicated ways during dental treatment can be challenging. Because not every outcome can be predicted during planning, referral of these patients to a Prosthodontist may be the best option.

Functional Deficits:

Patients with severe functional deficits resulting from trauma, cancer surgery or as a result of developmental defects such as a cleft palate or other craniofacial anomalies present special challenges. Procedures that fail to take into account the long-term Occlusal requirements of such individuals may lead to further functional or esthetic problems.

Maxillofacial reconstruction:

Special skills are needed in treating the patient who requires prosthetic replacement of extraoral maxillofacial structures (e.g.,ear, nose) or rehabilitation of severe burn scars.

Prosthodontists have extensive experience with the specialized materials and attachments that can facilitate design and replacement of lost anatomic structures.

Your prosthodontist colleagues draw on their advanced training and experience to assist you:

• By acting in an advisory capacity as you plan treatment for patients with difficult problems.

• By providing specialized treatment as an element in your treatment plan.

• By managing patients with complex and/or multidisciplinary treatment needs.

Strengthening your practice with prosthodontic consults and referrals

Experienced dentists and practice management experts agree that establishing referral relationships with a specialist colleague is a practice builder. Here are some if the ways in which a strong referral relationship with your Prosthodontist colleague will strengthen your practice.

• Referring the patient with complex treatment needs to a Prosthodontist increases the time available to meet the demands of ongoing care for your other patients.

• Referring patients with complex problems builds patient loyalty, demonstrating to patients that their best interests take precedence over other considerations.

• Referral is a two-way process – as the General Practitioner refers patients with special needs to the specialists, the specialist in turn will refer patients seeking regular care to the General Practitioner.

• Our patients deserve the highest standard of care regardless of who provides that care. General Dentists are held to the specialist’s standard of care when they provide treatment considered to be in the specialist’s domain.

Your experience will tell you when referral to a specialist is in your patient’s best interest as well as cost effective for your practice. Call on your prosthodontist colleague for consultation, assistance, or referral.

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