What is a prosthodontist? A prosthodontist is a dentist who specializes in the restoration and replacement of teeth. Most prosthodontists receive two to three years of additional training after dental school in a program accredited by the American Dental Association based either at a hospital or a university. The training includes reviews of the literature, lectures, treatment of patients and laboratory experience in fabricating restorations. What dental procedures does a prosthodontist do? Prosthodontists are the experts in dental rehabilitation and have mastered many procedures including: crowns, caps, bridges, veneers, removable partial dentures, dentures and dental implants. In addition to restoring dental implants with restorations, many prosthodontists are surgically placing implants as well. What is a facial prosthesis? A facial prosthesis is an artificial replacement of a missing or malformed facial feature. The facial prosthesis can be made to replace any missing part of the face; ear, eye, nose, eyebrows, eyelids, eyelashes, cheek . . . A person needing a facial prosthesis may have been born without the facial structure, may have lost part of their face due to trauma, accident or cancer. Some patients use the facial prosthesis as a “band-aid” until they are cleared for surgery and can have the plastic surgeon reconstruct the missing part. This allows the cancer doctors good access to the area to make sure that the cancer has not come back to the area. Other people who have had large doses of radiation are not good candidates for plastic surgical reconstruction. The facial prosthesis is used to help people missing facial structures appear like everyone else and to interact in society on a more normal basis. The facial prosthesis often helps with self-esteem and self-confidence. How are facial prostheses made? Facial prostheses are fabricated on an individual basis. A facial impression is made and then the missing facial structure is sculpted for the patient. Facial characteristics, contour, proportion and symmetry are all taken into consideration in sculpting the replacement facial structure. The actual prosthesis is then processed in medical grade silicone in the color of the patients skin with numerous layers of colors for a life-like appearance, and additional colors can be added later to complete the match to the persons skin. The procedure to fabricate a facial prosthesis is painless and requires no anesthesia or sedation. What is the material the facial prosthesis is made from? Medical grade silicone rubber is typically used for the prosthesis as it can be colored to the persons’ skin tone. Facial prostheses are life-like replacements of missing facial structures but have their limitations. Over time the medical grade silicone will change color due to ultraviolet radiation (effects from the sun), skin oils, atmospheric conditions, makeup application and aging. Cleaning eventually wears the surface and edges of the prosthesis. What are the limitations of facial prostheses? The purpose of the facial prosthesis is for the person to interact in society on a more normal basis. It allows the wearer to go to the grocery store, movies, and engage in their daily routines without strangers noticing anything different or be worthy of head-turning. Upon close inspection the prosthesis is evident as it is made from silicone and not skin. Patients are able to swim with their prostheses using a non-water-based adhesive. How is the facial prosthesis held into place? Typically there are two methods to hold the facial prosthesis into place. The first is a medical grade adhesive that is painted onto the edges of the prosthesis and positioned onto the skin. The adhesive is removed daily from the prosthesis and skin. The second is with osseo-integrated implants that are integrated into the bone of the patient. Osseo-integrated implants are titanium, bone anchored implants. Clip systems or magnets are routinely used to snap the prosthesis into place. Implant retained prostheses allow the wearer to abandon the use of adhesives or use the adhesive as an additional source of retention for comfort or psychological security. Not all people are candidates for craniofacial implants due to medical conditions, remaining bone, radiation etc. This treatment option can be discussed with a craniofacial surgeon and Prosthodontist. Who makes these facial prostheses? Numerous specialists may be included to work as a team to provide an esthetic facial prosthesis. Plastic surgeons perform microvascular surgery to transfer bone and tissue from other parts of the body to replace the structures that have been removed. Oral & maxillofacial surgeons place craniofacial implants for implant retained prostheses. Maxillofacial Prosthodontists are dentists trained in the design and construction of prostheses, esthetic and functional devices that replace the parts of the mouth, jaw, head and or neck that are missing. Anaplastologists sculpt the missing facial parts to fit the patients remaining contours for a life-like appearance. Is a prosthodontist different from a “cosmetic dentist”? The American Dental Association recognizes nine dental specialties, and the ADA does not include “cosmetic dentistry” as a specialty. Prosthodontists receive extensive training and experience in dental esthetics and cosmetics during their graduate programs which currently last three years. Many cosmetic dentists receive training during seminars or a series of courses, but this training is usually limited to weekend or possibly weeklong courses. Will the prosthodontist complete all of my required treatment? The prosthodontist is best viewed as the “architect” of your dental project. She has the vision of your final outcome, both the esthetics of your smile and the improved function of your bite. Often other dental specialists may participate in your treatment to help establish a solid foundation for your restorations. Every prosthodontist develops a treatment plan customized for each individual patient, and she will determine if adjunctive procedures by another doctor are necessary. What is a Board Certified Prosthodontist? A Board Certified Prosthodontist has successfully completed extensive examinations by the American Board of Prosthodontics. These examinations involve written and oral examinations in prosthodontic theory and literature, the presentation of three different patient treatments, documented from the beginning to the end of the treatment and examinations over the rationale of this treatment. As a Diplomate of the American Board of Prosthodontics, the prosthodontist must successfully complete a re-certification examination every eight years. Is Dr. Horkowitz a provider in my insurance network? Insurance companies rarely differentiate between fees charged by general dentists and those charged by specialists. Therefore, most specialists are not considered providers. The insurance will still contribute to the cost of your treatment, and our office staff will help you achieve your maximum benefit. Will insurance pay for my treatment? Your insurance company will cover most procedures, at least to some degree. Most companies have a yearly maximum allowable benefit, and some companies disallow certain procedures. A pretreatment authorization often is the best way to determine the extent your insurance company will cover your treatment. Our staff will gladly assist with any of your insurance questions. Does the office follow strict infection control procedures? Yes, our office is completely compliant with OSHA and follows the guidelines published by the American Dental Association regarding infection control in the dental office. How much will my treatment cost and how will I pay for it? Every patient receives an individualized treatment plan following an appointment devoted to the gathering of information. The patient’s desires will be addressed as well as his/her dental needs. Once a treatment plan is developed and the patient agrees to treatment, payment options can be explored with our office staff. How long will my treatment take? The length of treatment time depends on many factors including the procedures involved. Once your individualized treatment plan is established, please feel free to discuss the time required for treatment with Dr. Horkowitz-Tsaoussis by sending her an e-mail or meeting with her in person.