Future of Prostho

[NEdent]

so i was wondering if i could get some input on what everyone thinks about the future of prosthodontics. i know it's not the most competitive specialty, and so i was wondering why exactly that is. I've heard that new technology is allowing more and more GPs to be able to do a lot more prostho work on their own, so i was wondering what the viability of this field will be in the next ten years. thanks.

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[ChubbyBaby]

i know it's not the most competitive specialty, and so i was wondering why exactly that is.

In my opinion, prosthodontics is the most challenging residency, tied with OMFS. Most programs have you doing all of your own lab work, which is incredibly gruelling and takes up so much of your own time.

so i was wondering if i could get some input on what everyone thinks about the future of prosthodontics.

Future of prosthodontics will always be strong. Prosthodontists spend a lot of time taking of crowns/bridges that general dentists screwed up. Most dentists don't know enough to do full-mouth rehabilitations, and if they think they do, they're wrong. Prosthodontists were the first to place implants, and a lot of programs give you extensive training in them. Ultimately, it's up to your skills and personality to market yourself, however, as a whole, prosthodontists wil always be needed.

 

[Rube]

Ultimately, it's up to your skills and personality to market yourself, however, as a whole, prosthodontists wil always be needed.

Yeah, who else is going to handle my PITA denture patients

 

[aphistis]

Yeah, who else is going to handle my PITA denture patients

Exactly.

In my opinion, prosthodontics is the most challenging residency, tied with OMFS. Most programs have you doing all of your own lab work, which is incredibly gruelling and takes up so much of your own time.


Future of prosthodontics will always be strong. Prosthodontists spend a lot of time taking of crowns/bridges that general dentists screwed up. Most dentists don't know enough to do full-mouth rehabilitations, and if they think they do, they're wrong. Prosthodontists were the first to place implants, and a lot of programs give you extensive training in them. Ultimately, it's up to your skills and personality to market yourself, however, as a whole, prosthodontists wil always be needed.

Wow. Have you been spending a lot of time with academic prosthodontists?

That said, a good prosthodontist is the best around when it comes to knowledge and technique of all phases of complex restorative.

 

[ChubbyBaby]

Wow. Have you been spending a lot of time with academic prosthodontists?

If you disagree, then elaborate. Don't leave a smarky response.

 

[pietrodds]

If you disagree, then elaborate. Don't leave a smarky response.

there's not a shortage of patients that have complex Tx.... there's a shortage of pt that want and can AFFORD the Tx of a prostho. That's what he means about being around academia... academia don't understand the business of dentistry. When all you have to sell patients is a ferarri, especially in a down economy, it can be a tough go and it's hard to reap the benefits of all that extra training. In the real world, the only patients getting referred to a pros are usually the PIAs. Pros is probably one of the hardest training programs, have the highest overhead in practice, and have the hardest time getting referals. If you want to make it work, you have to establish yourself in an urban area with a large referal base, affiliate yourself with all the rich people hangouts(ie - country clubs) and make yourself THE complex Tx/implants guy. If you're not willing to be a hardcore salesman for your skills it ain't worth it. If you're going into academia or the military a pros degree is a good way to climb the bureaucratic ladder.

 

[aphistis]

there's not a shortage of patients that have complex Tx.... there's a shortage of pt that want and can AFFORD the Tx of a prostho. That's what he means about being around academia... academia don't understand the business of dentistry. When all you have to sell patients is a ferarri, especially in a down economy, it can be a tough go and it's hard to reap the benefits of all that extra training. In the real world, the only patients getting referred to a pros are usually the PIAs. Pros is probably one of the hardest training programs, have the highest overhead in practice, and have the hardest time getting referals. If you want to make it work, you have to establish yourself in an urban area with a large referal base, affiliate yourself with all the rich people hangouts(ie - country clubs) and make yourself THE complex Tx/implants guy. If you're not willing to be a hardcore salesman for your skills it ain't worth it. If you're going into academia or the military a pros degree is a good way to climb the bureaucratic ladder.

Bingo.

 

[ChubbyBaby]

there's not a shortage of patients that have complex Tx.... there's a shortage of pt that want and can AFFORD the Tx of a prostho. That's what he means about being around academia... academia don't understand the business of dentistry. When all you have to sell patients is a ferarri, especially in a down economy, it can be a tough go and it's hard to reap the benefits of all that extra training. In the real world, the only patients getting referred to a pros are usually the PIAs. Pros is probably one of the hardest training programs, have the highest overhead in practice, and have the hardest time getting referals. If you want to make it work, you have to establish yourself in an urban area with a large referal base, affiliate yourself with all the rich people hangouts(ie - country clubs) and make yourself THE complex Tx/implants guy. If you're not willing to be a hardcore salesman for your skills it ain't worth it. If you're going into academia or the military a pros degree is a good way to climb the bureaucratic ladder.

Well, thanks for summarizing what i wrote here:

Ultimately, it's up to your skills and personality to market yourself, however, as a whole, prosthodontists wil always be needed.

Even in a strong economy, complex stuff is STILL A SELL.

The question the OP asked is: will prosthodontics still be around ten years from now (viability)? I say yes. They have skills like no other general dentist, and play a niche role in our field.

 

[ChubbyBaby]

That said, a good prosthodontist is the best around when it comes to knowledge and technique of all phases of complex restorative.

bingo

 

[armorshell]

Note that you're talking about the "classic" prosth practice. It might be just as worthwhile for a prosth graduate to practice as a general dentist. I doubt it would seriously affect the referrals they get (Either removable, PITA patients or both), and they could have the recall system bringing them in restorative to do.

 

[pietrodds]

Note that you're talking about the "classic" prosth practice. It might be just as worthwhile for a prosth graduate to practice as a general dentist. I doubt it would seriously affect the referrals they get (Either removable, PITA patients or both), and they could have the recall system bringing them in restorative to do.

So how do you justify the extra 150K in tuition and 3 years of lost income in the ballpark of 300-500K only to get out and run a practice like a GP? You can bet GPs are going to be much more hesitant to refer a patient when you'd be more to keep them long term and treat the whole family as well.

If you become a prostho for the personal satisfaction of know you're the pinacle of you profession go for it but if you're doing to for any kind of a financial advantage over a GP that's going to be VERY hard to pull off. There's so much great CE out there that you can easily advance your training if that's your interest and become a better dentist without putting your life on hold.

 

[armorshell]

So how do you justify the extra 150K in tuition and 3 years of lost income in the ballpark of 300-500K only to get out and run a practice like a GP? You can bet GPs are going to be much more hesitant to refer a patient when you'd be more to keep them long term and treat the whole family as well.

I'm just waxing intellectual here, not trying to offend anyone.

If you're practicing as a GP you wouldn't need to rely on referrals, and aren't most prosth referrals because they don't want to deal with the patient anyway? Think of it as an intensive, 3 year long CE course.

You're right about the money/lost income though, can't really justify that except by the whole "pinnacle of the profession" argument. There are still prosth programs out there that pay a stipend by the way, though it's not much and there's still the lost income.

 

[tinman831]

Think of it as an intensive, 3 year long CE course.

Exactly. You could still get referrals from other GP's who don't have the training you do, and yet you don't limit yourself to strictly prosth either.

 

[mike3kgt]

So how do you justify the extra 150K in tuition and 3 years of lost income in the ballpark of 300-500K only to get out and run a practice like a GP? You can bet GPs are going to be much more hesitant to refer a patient when you'd be more to keep them long term and treat the whole family as well.

If you become a prostho for the personal satisfaction of know you're the pinacle of you profession go for it but if you're doing to for any kind of a financial advantage over a GP that's going to be VERY hard to pull off. There's so much great CE out there that you can easily advance your training if that's your interest and become a better dentist without putting your life on hold.

Have you checked into the cost of that "great CE out there"??

Just a couple of examples:
To complete the entire Dawson restorative curriculum: about $40,000
To complete the Pankey continuum: $18,000 (essentials) + $8,000 (masters) + $19,000 (esthetics masters) = $45,000!
To complete the LVI mastership: $45,000 (core courses I-VII)... not including some $40,000 more possible if you want to take NMD, implant, endo, cosmetics, etc. courses.
To complete only the prosthetic Misch implant curriculum: about $15,000
To complete the Misch implant surgical program: $35,000
To complete the Massad denture 2-day course: $13,000

For comparison sake: completing training in Prosth, you receive education in 1. Occlusion (Dawson, Pankey), 2. Full mouth rehab (Pankey, LVI), 3. Implant restoration and placement (Misch), and 4. Advanced techniques in CD (Massad). So all said and done, you could easily spend $190,000 + !!! These are also for strictly week/end courses that only give you a synopsis and/or intensive training over the course of a couple of days. At the end of each training sessions, you are encouraged to practice the techniques on your patients at your own office.

Those who haven't spent any time in private practice do not understand the value of the last statement I mentioned. When a patient is spending thousands of dollars for treatment at your own personal office where you have to get it right the first time and do it comfortably, well, and as fast as possible. There is not as much opportunity to try a few different techniques just because you want to, especially when daily production is on the line and each cartridge of PVS will cost you $$$.

Remember most importantly the value in spending time at a dental school is to free yourself from the stress of overhead, clear your mind and focus on the "why's" of what your doing instead of just the "how's".

Private practice is a hard thing to give up, it's is incredibly hard justifying giving up a 6-figure salary to go back to school and either 1. pay tuition or 2. earn a meager stipend. One cannot answer for you what do you value or how financially prepared you are to make a move like this, only you can figure it out for yourself.

I know all of this from personal experience, I am starting a 3 year prosth program next year after 2 years of clinical practice. My motivation, for the education and the career focus in my clinical practice. I can justify my time and focus on patients who truly care about restorative dentistry as well as those PITA denture patients...

 

[mike3kgt]

So how do you justify the extra 150K in tuition and 3 years of lost income in the ballpark of 300-500K only to get out and run a practice like a GP? You can bet GPs are going to be much more hesitant to refer a patient when you'd be more to keep them long term and treat the whole family as well.

If you become a prostho for the personal satisfaction of know you're the pinacle of you profession go for it but if you're doing to for any kind of a financial advantage over a GP that's going to be VERY hard to pull off. There's so much great CE out there that you can easily advance your training if that's your interest and become a better dentist without putting your life on hold.

Have you checked into the cost of that "great CE out there"??

Just a couple of examples:
To complete the entire Dawson restorative curriculum: about $40,000
To complete the Pankey continuum: $18,000 (essentials) + $8,000 (masters) + $19,000 (esthetics masters) = $45,000!
To complete the LVI mastership: $45,000 (core courses I-VII)... not including some $40,000 more possible if you want to take NMD, implant, endo, cosmetics, etc. courses.
To complete only the prosthetic Misch implant curriculum: about $15,000
To complete the Misch implant surgical program: $35,000
To complete the Massad denture 2-day course: $13,000

For comparison sake: completing training in Prosth, you receive education in 1. Occlusion (Dawson, Pankey), 2. Full mouth rehab (Pankey, LVI), 3. Implant restoration and placement (Misch), and 4. Advanced techniques in CD (Massad). So all said and done, you could easily spend $190,000 + !!! These are also for strictly week/end courses that only give you a synopsis and/or intensive training over the course of a couple of days. At the end of each training sessions, you are encouraged to practice the techniques on your patients at your own office.

Those who haven't spent any time in private practice do not understand the value of the last statement I mentioned. When a patient is spending thousands of dollars for treatment at your own personal office where you have to get it right the first time and do it comfortably, well, and as fast as possible. There is not as much opportunity to try a few different techniques just because you want to, especially when daily production is on the line and each cartridge of PVS will cost you $$$.

Remember most importantly the value in spending time at a dental school is to free yourself from the stress of overhead, clear your mind and focus on the "why's" of what your doing instead of just the "how's".

Private practice is a hard thing to give up, it's is incredibly hard justifying giving up a 6-figure salary to go back to school and either 1. pay tuition or 2. earn a meager stipend. One cannot answer for you what do you value or how financially prepared you are to make a move like this, only you can figure it out for yourself.

I know all of this from personal experience, I am starting a 3 year prosth program next year after 2 years of clinical practice. My motivation, for the education and the career focus in my clinical practice. I can justify my time and focus on patients who truly care about restorative dentistry as well as those PITA denture patients...

 

[mike3kgt]

So how do you justify the extra 150K in tuition and 3 years of lost income in the ballpark of 300-500K only to get out and run a practice like a GP? You can bet GPs are going to be much more hesitant to refer a patient when you'd be more to keep them long term and treat the whole family as well.

If you become a prostho for the personal satisfaction of know you're the pinacle of you profession go for it but if you're doing to for any kind of a financial advantage over a GP that's going to be VERY hard to pull off. There's so much great CE out there that you can easily advance your training if that's your interest and become a better dentist without putting your life on hold.

Have you checked into the cost of that "great CE out there"??

Just a couple of examples:
To complete the entire Dawson restorative curriculum: about $40,000
To complete the Pankey continuum: $18,000 (essentials) + $8,000 (masters) + $19,000 (esthetics masters) = $45,000!
To complete the LVI mastership: $45,000 (core courses I-VII)... not including some $40,000 more possible if you want to take NMD, implant, endo, cosmetics, etc. courses.
To complete only the prosthetic Misch implant curriculum: about $15,000
To complete the Misch implant surgical program: $35,000
To complete the Massad denture 2-day course: $13,000

For comparison sake: completing training in Prosth, you receive education in 1. Occlusion (Dawson, Pankey), 2. Full mouth rehab (Pankey, LVI), 3. Implant restoration and placement (Misch), and 4. Advanced techniques in CD (Massad). So all said and done, you could easily spend $190,000 + !!! These are also for strictly week/end courses that only give you a synopsis and/or intensive training over the course of a couple of days. At the end of each training sessions, you are encouraged to practice the techniques on your patients at your own office.

Those who haven't spent any time in private practice do not understand the value of the last statement I mentioned. When a patient is spending thousands of dollars for treatment at your own personal office where you have to get it right the first time and do it comfortably, well, and as fast as possible. There is not as much opportunity to try a few different techniques just because you want to, especially when daily production is on the line and each cartridge of PVS will cost you $$$.

Remember most importantly the value in spending time at a dental school is to free yourself from the stress of overhead, clear your mind and focus on the "why's" of what your doing instead of just the "how's".

Private practice is a hard thing to give up, it's is incredibly hard justifying giving up a 6-figure salary to go back to school and either 1. pay tuition or 2. earn a meager stipend. One cannot answer for you what do you value or how financially prepared you are to make a move like this, only you can figure it out for yourself.

I know all of this from personal experience, I am starting a 3 year prosth program next year after 2 years of clinical practice. My motivation, for the education and the career focus in my clinical practice. I can justify my time and focus on patients who truly care about restorative dentistry as well as those PITA denture patients...

 

[mike3kgt]

So how do you justify the extra 150K in tuition and 3 years of lost income in the ballpark of 300-500K only to get out and run a practice like a GP? You can bet GPs are going to be much more hesitant to refer a patient when you'd be more to keep them long term and treat the whole family as well.

If you become a prostho for the personal satisfaction of know you're the pinacle of you profession go for it but if you're doing to for any kind of a financial advantage over a GP that's going to be VERY hard to pull off. There's so much great CE out there that you can easily advance your training if that's your interest and become a better dentist without putting your life on hold.

Have you checked into the cost of that "great CE out there"??

Just a couple of examples:
To complete the entire Dawson restorative curriculum: about $40,000
To complete the Pankey continuum: $18,000 (essentials) + $8,000 (masters) + $19,000 (esthetics masters) = $45,000!
To complete the LVI mastership: $45,000 (core courses I-VII)... not including some $40,000 more possible if you want to take NMD, implant, endo, cosmetics, etc. courses.
To complete only the prosthetic Misch implant curriculum: about $15,000
To complete the Misch implant surgical program: $35,000
To complete the Massad denture 2-day course: $13,000

For comparison sake: completing training in Prosth, you receive education in 1. Occlusion (Dawson, Pankey), 2. Full mouth rehab (Pankey, LVI), 3. Implant restoration and placement (Misch), and 4. Advanced techniques in CD (Massad). So all said and done, you could easily spend $190,000 + !!! These are also for strictly week/end courses that only give you a synopsis and/or intensive training over the course of a couple of days. At the end of each training sessions, you are encouraged to practice the techniques on your patients at your own office.

Those who haven't spent any time in private practice do not understand the value of the last statement I mentioned. When a patient is spending thousands of dollars for treatment at your own personal office where you have to get it right the first time and do it comfortably, well, and as fast as possible. There is not as much opportunity to try a few different techniques just because you want to, especially when daily production is on the line and each cartridge of PVS will cost you $$$.

Remember most importantly the value in spending time at a dental school is to free yourself from the stress of overhead, clear your mind and focus on the "why's" of what your doing instead of just the "how's".

Private practice is a hard thing to give up, it's is incredibly hard justifying giving up a 6-figure salary to go back to school and either 1. pay tuition or 2. earn a meager stipend. One cannot answer for you what do you value or how financially prepared you are to make a move like this, only you can figure it out for yourself.

I know all of this from personal experience, I am starting a 3 year prosth program next year after 2 years of clinical practice. My motivation, for the education and the career focus in my clinical practice. I can justify my time and focus on patients who truly care about restorative dentistry as well as those PITA denture patients...

 

[scotty1324]

You can say that again!

 

[dentwannabe]

lol.

mike i didnt get that, could you post that response again??

j/k. but on a serious note, I see what you're saying. pietrodds, wat CE programs were you thinking of?

 

[pietrodds]

lol.

mike i didnt get that, could you post that response again??

j/k. but on a serious note, I see what you're saying. pietrodds, wat CE programs were you thinking of?

start with single tooth dentistry courses like getting good with posterior composites which Dental school does not prepare you for, then take endo, surgery, crown and bridge, implants...

once you get good at that which I think it takes at least 2 years after school to have a strong basis than you can start focusing on full mouth reconstruction philosophies(I recommend Frank Spear). It's a waste of money imo to take the 30K course when it still takes you 1.5 hours to do a crown prep! That's also why pros is a hard residency. You're expected to do big cases using evidence based science which you are forced to recite from route memorization but you haven't developed the hand skills yet unless you've been out of school for awhile prior to doing pros. Pros will always have a place in dentistry as they establish the guidelining engineering principles that all restorative dentists use but I just think the financial benefits of following such a path are questionable at best. Many who are draw to the specialty are analytical, introverts by nature and the frustration comes when you have to promote/sell yourself and your Tx because it will always be substantially high than the GP down the street. It's the extrovert that is able to sell Tx more easily and I don't know many extroverted pros guys. Personally, I never understood how you can go right into a specialty out of Dschool when you've never really done dentistry. I did more dentistry in my first two weeks of GPR than 4 years of dental school. It's like reading a book about golf for 4 years but never really going out and swinging a club... how do what you want to specialize in(i.e.- just putting or just driving balls) when you haven't even tried playing the game a golf... not to take this too off-topic...

The majority of patients just want and need single tooth dentistry. In fact, there's plenty of good dentists who do VERY well NOT doing full mouth rehabs nor want to do these kind of cases. I have a short attention span and don't like being married to patients and have found that I actually don't enjoy these big cases as much as I thought I would. To each his own...

A career in dentistry is a marathon and not a sprint... I've taken over 500 CE hours since graduation 5 years ago and am just starting to find my 'marathon pace.' Take your time and enjoy yourself. The best advice is to talk to other prosthos out there and get their perspective and see what they think the future of pros is.

Sorry so long!