Position Statement: Scope of Practice

Scope of Practice

Position Statement of the American College of Prosthodontists
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The scope of practice for dental specialists is defined for each individual specialty as approved by the National Commission on Recognition of Dental Specialties and Certifying Boards (NCRDSCB), by the Commission on Dental Accreditation (CODA) Standards, and by the ADA Principles of Ethics and Code of Professional Conduct.

The National Commission on Recognition of Dental Specialties and Certifying Boards (NCRDSCB) has authority of recognition of dental specialties and their certifying boards.^{1, 2}  The definition of the Prosthodontic specialty is as follows: Prosthodontics is the dental specialty pertaining 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 oral and maxillofacial tissues using biocompatible substitutes.³  See also the ACP Position Statement: the National Commission on Recognition of Dental Specialties and Certifying Boards (NCRDSCB).⁴

The Commission on Dental Accreditation (CODA) develops and implements accreditation standards that promote and monitor the continuous quality and improvement of dental education programs.^5-7 These Standards define what must be taught by the educational programs to have U. S. Department of Education (USDOE), American Dental Association (ADA), National Commission on Recognition of Dental Specialties and Certifying Boards (NCRDSCB) and American College of Prosthodontists (ACP) program recognition and for specialists to obtain Specialty Board certification. In essence each specialty’s CODA Standards define that specialty’s scope of practice taught to individuals being trained in each specialty. Prosthodontic Standards Available at:  https://www.ada.org/~/media/CODA/Files/prostho  See also the ACP Position Statement: The Commission on Dental Accreditation.⁸

Specialty Standards evolve as they are updated with advancing knowledge and technology. Practicing specialists not originally trained with these updates must learn and routinely apply these advancements to gain competence to have them appropriately become part of their scope of practice.

The Parameters of Care for the Specialty of Prosthodontics is an ACP document prepared to help identify, define, and quantify many of the aspects of the delivery of prosthodontic specialty services to the public. ⁹ Its stated purpose is to help clinicians in providing the highest-quality level of clinical care, establish a consensus of professional opinion, and serve to constantly enhance clinical performance.  

Areas requiring advanced knowledge and skill that are not required training by the Prosthodontic CODA Standards but have elements of knowledge and skill requirements that overlap with the Prosthodontic Standards and are not included in another specialty’s scope of practice may become part of a prosthodontist’s scope of practice. In this instance the prosthodontist should acquire additional continuing education and become competent in managing and providing care in that area of need. 

The nonmaleficence (do no harm) portion of the ADA Code of Ethics ¹⁰ states that dentists have a duty to refrain from harming the patient. “This principle expresses the concept that professionals have a duty to protect the patient from harm. Under this principle, the dentist's primary obligations include keeping knowledge and skills current, knowing one's own limitations and when to refer to a specialist or other professional, and knowing when and under what circumstances delegation of patient care to auxiliaries is appropriate.” Available at ADA.org/ethics. 

Scope of practice is the terminology used by State Board of Dental Examiners to define the procedures, actions, and processes that are legally permitted by licensed dentists in each state. It is defined in each state’s dental practice act. States generally follow ADA Policy and CODA Standards in determining legal scopes of practice.

It is the position of the American College of Prosthodontists to support the process of determining specialty scope of practice through the National Commission on Recognition of Dental Specialties and Certifying Boards, the Commission on Dental Accreditation, and the ADA Principles of Ethics and Code of Professional Conduct. The ACP further supports and encourages State Boards of Dentistry to use these documents to develop their legal scopes of practice for licensure and for dentists to follow in their dental practice.

References

1. American Dental Association (ADA). Constitution and Bylaws. Chapter IX Commissions, Section 30 Duties, page 20. Revised January 1, 2020. Available at: https://www.ada.org/~/media/ADA/Member%20Center/FIles/ADA_2021_Bylaws.pdf?la=en

2. American Dental Association (ADA). Governance and Organizational Manual of the American Dental Association. Chapter IX Commissions, page 25, September 9, 2019, Available at: https://www.ada.org/~/media/ADA/Member%20Center/FIles/CEBJA_Governance_Manual_Update_June_2021_WTOC_Final.pdf?la=en

3. American Dental Association (ADA).  NCRDSCB: Specialty Definitions, Prosthodontics. Available at: https://www.ada.org/en/ncrdscb/dental-specialties/specialty-definitions

4. American College of Prosthodontics (ACP). ACP Position Statement: The National Commission on Recognition of Dental Specialties and Certifying Boards (NCRDSCB). Available at: https://www.prosthodontics.org/about-acp/acp-position-statements/

5. American Dental Association (ADA). Constitution and Bylaws. Chapter IX Commissions, Section 30 Duties, page 19. Revised January 1, 2020. Available at: https://www.ada.org/~/media/ADA/Member%20Center/FIles/ADA_2021_Bylaws.pdf?la=en

6. American Dental Association (ADA). Governance and Organizational Manual. Chapter IX Commissions pages 25, September 9, 2019.  Available at: https://www.ada.org/~/media/ADA/Member%20Center/FIles/CEBJA_Governance_Manual_Update_June_2021_WTOC_Final.pdf?la=en

7. Commission on Dental Accreditation (CODA). Evaluation and Operational Policies and Procedures Manual (EOPP). January 2020. Available at: https://www.ada.org/~/media/CODA/Files/eopp.pdf?la=en

8. American College of Prosthodontics (ACP). ACP Position Statement: The Commission on Dental Accreditation. Available at: Available at: https://www.prosthodontics.org/about-acp/acp-position-statements/

9. American College of Prosthodontists (ACP). Parameters of Care for the Specialty of Prosthodontics. J Prosthodont 2020; 29: 3-147. doi.org/10.1111/jopr.13176. Available at: https://www.prosthodontics.org/acp-publications/parameters-of-care/