Recognizing Maxillofacial Prosthetics as a Subspecialty in India: Need of the Hour
Department of Prosthodontics and Crown and Bridge, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
Corresponding Author: Himanshi Aggarwal, Department of Prosthodontics and Crown and Bridge, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India, Phone: +91 9369610205, e-mail: email@example.com
How to cite this article Aggarwal H. Recognizing Maxillofacial Prosthetics as a Subspecialty in India: Need of the Hour. Int J Prosthodont Restor Dent 2020;10(3):95–96.
Source of support: Nil
Conflict of interest: None
The Dental Council of India (DCI) is the recognizing apex body for dental sciences education in India.1 Prosthodontics and crown and bridge is one of the nine recognized dental specialties in India that pertains to the diagnosis, treatment planning, rehabilitation, and maintenance of the oral function, comfort, appearance, and health of patients with clinical conditions associated with missing or deficient teeth and/or maxillofacial tissues by using biocompatible substitutes.1,2
Maxillofacial prosthetics (MFP) is one of the subdivisions of prosthodontics; the others being fixed prosthodontics and removable prosthodontics.3 According to the Academy of Prosthodontics, “Maxillofacial prosthetics is that branch of prosthodontics concerned with the restoration and/or replacement of the stomatognathic and craniofacial structures with prostheses that may or may not be removed on a regular or elective basis”.1 Beyond the scope of common dental specialties, maxillofacial prosthodontists offer a wide variety of treatments, providing rehabilitative prosthesis or therapeutic appliances for individuals with anatomic compromises of the head and neck due to congenital or acquired traumatic or surgical defects.4,5
Although a part of prosthodontics, MFP is not taught in detail in most of the undergraduate and postgraduate dental curriculum, resulting in a serious scarcity of healthcare professionals capable of managing patients with maxillofacial defects. Additional clinical skills, knowledge, and experience are required for the successful rehabilitation of such patients.6 In contrast to developed countries like the United States, Japan, etc., where MFP is quite advanced; it is still at a nascent stage in most of the developing countries including India.7
Unlike medical education, where superspecialty/subspecialty exist, currently, there are no subspecialties recognized in dentistry in India and the United States.1,7 However, recently in August 2020, the American College of Prosthodontists released a position statement emphasizing the need of giving a subspecialty status to MFP to address the extensive, complex, and diverse needs of this cohort of the challenged patient population that requires MFP services.7
Head and neck cancers account for 30–40% of all cancers in India compared to 3–4% in the United States and it is estimated that approximately 188,969 people will develop head and neck cancer in 2020 in contrast to 65,000 for the United States.7,8 The latter recognized the need for dedicated education programs in MFP more than half a century ago, which resulted in the formulation of various advanced training/fellowship programs in MFP.3,4 A combined 48-month integrated prosthodontics residency program or a 12-month fellowship program following completion of a prosthodontic residency is available.4 Presently, there are seven 12-month MFP fellowship programs and one 48-month combined program accredited by the Commission on Dental Accreditation (CODA) in the United States.4
However, in India, despite the increase in oral cancer cases and increased need for MFP rehabilitation services, there is a relative scarcity of options available for advanced training in MFP. Fewer training options such as a 1-year dental rehabilitative oncology fellowship offered by Healthcare Global Enterprises Ltd (HCG), Bengaluru; 2-year Homi Bhabha National Institute (HBNI)-dental and prosthetic surgery fellowship offered by Tata Memorial Hospital, Mumbai is available.9,10 There is an utmost need to recognize such fellowships and define minimum educational criteria to meet the essentialities of MFP. Recognizing MFP as a subspecialty will provide impetus to institutions to initiate and strengthen MFP training programs. A large task force of systematically and extensively trained maxillofacial prosthodontists are imminently and inevitably needed in India. It is the need of the hour to recognize this to ensure that the patients with maxillofacial defects are not just treated but rehabilitated in the true sense.
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