The Society for Clinical Dental Technology is a voluntary Association representing the ambitions of those South African Dental Technicians aspiring to get additional clinical training to become direct denture providers, globally generally called Denturists, also Clinical Dental Technicians (CDTs) or Dental Prosthetists in other English speaking jurisdictions and the appropriate translations into Danish, Dutch, French, Finn, German and Slovak languages. See also What is Denturism?  As a result of two motivational reports (1992 and 1998) tabled by The Society to the South African Dental Technicians Council (SADTC), National Department of Health and the Minister of Health, various workshops were conducted by the SADTC, to investigate the desirability of such a category in South Africa, involving all the relevant stakeholders. This process went through various progressions.

Functional dentures or the lack thereof, affects all aspects of human functioning, nutritional health and general health. It concerns the rehabilitation of oral function, mastication, speech, aesthetic appearance and human dignity. In the words of Dr Burton Conrod, FDI President: “A healthy smile and the ability to speak and eat without pain or discomfort are critical to general health and well-being.”

According to the 2010 Revision of the United Nations World Population Prospects, the World population over 60 are predicted to exceed 21% by 2040. That equates to 1 in 5 people on the planet to exceed the age of 60, which implies a huge need for dentures, with service and training consequences that can no longer be ignored! The worldwide recession is taking its toll and causes havoc amongst the poor and the elderly.

In some countries, including South Africa, the customary fragmented procedure remains, whereby a Dental Surgeon go-between facilitates the clinical measurement procedures and the Dental Technician “custom-makes” the appliance in isolation from the denture wearer. Patients are often not given fully disclosed treatment-options and have to accept what they get, often complaining about unsuitable aesthetic appearance and/or dysfunction.

The international tendencies are that Dental curricula have slowly but unavoidably contained a de-emphasis on the technical component in favour of the biological basis of Dentistry and there is no doubt that dental trainees are qualifying with fewer technical skills than was the case in the past and in fact, are needed to meet the routine requirements of denture provision. A course devoted to specializing in denture prosthodontics must lead to a superior clinician in the Denturist than in the Dentist.

Internationally professional Denturists are members of the Oral Health Team (OHT), specifically trained and educated in the skills and knowledge necessary to provide independent denture services to the community. Equipped with solid technical training and experience as a Dental Technician, they are trained further in sciences, clinical skills and interpersonal skills. Denturists are thus expertly equipped to design, create, construct, and modify prosthesis to ensure optimal fit, maximum comfort, and general well-being.

Recognition of Denturists is gradually spreading globally. The Society is affiliated with the International Federation of Denturists (IFD) and motivated by the examples of our colleagues overseas where some 40 pieces of legislation globally regulate the profession in various countries including Australia (all 6 states, 2 territories and numerous smaller Indian and Pacific Ocean Islands), Canada (all 10 provinces and 2 territories), Denmark, Finland, Switzerland (4 of the 26 Cantons, national legislation pending), USA (6 states with various pending) United Kingdom (England, Scotland, Wales, Northern Ireland and the Channel Islands), Ireland, New Zealand, the Netherlands, Malta, etc. In at least another 20 locations Dental Technicians have established clinical ambitions.

Unlike other Oral Health Care practitioners, Denturists are trained in all aspects of direct denture-fitting and fabrication, from consultation, treatment planning, taking impressions and clinical intra-oral evaluation, to personally creating removable oral appliances throughout all the laboratory procedures and aftercare. Denturism practice is a subset of the practice of Dentistry, and parallels with their approved education, training and competence. It involves the Scope of Practice for Dental Technicians, plus the fitting of removable oral appliances, also in a cooperative spirit with Dentists and other members of the Oral Health Team (OHT), when appropriate.

Denturists provide removable oral appliances directly to a patient, some procedures* collaboratively with other oral health practitioners. The Range of services Denturist’s provide, differs between countries, but generally comprises oral examinations and consultation, treatment-planning, design, construction and fitting of patient-removable prosthetic appliances, which may include:

When Denturists encounter challenges that are beyond their training or expertise, such patients are referred. Healthcare providers are obliged to seek consultation, if possible, whenever the welfare of patients will be safeguarded or advanced, utilizing those who have special skills, knowledge and experience. Inter-professional referrals advance co-operation within the Oral Healthcare Team and are in the best interest of the patient for attaining expert treatment and optimal efficiency.

The most prevalent group requiring removable prostheses are the elderly. Denturists are aware of the presentation of oral diseases and disorders in elderly patients, and the range of psychological and social factors involved in such situations as well as the associated complexities.

The profile of denture wearers is typically the elderly and underprivileged with special needs and poor socio-economic circumstances. Dentistry have become an elitist service for medical scheme driven services. Initiatives to introduce Denturism is concerned with providing equitable rehabilitation-services to the edentulous (teeth-impaired) population, which includes large numbers of the often-neglected categories of the poor and the old.

The Society is in a process of drawing up a Code of Conduct to prescribe the ethical relationship of Denturists with the Patient, fellow Denturists, other members of the OHT, as well as society as a whole; All members of the Association, will underwrite this Code, and accept responsibility for ethical compliance of all members, once the profession are implemented. Furthermore the Society will assist to assure that a Patient Charter is established and managed by the Regulator, to provide a mechanism for recourse by any dissatisfied denture clients

Parliament has given the SADTC and HPCSA a statutory mandate to regulate a direct denture provider in South Africa. The Society for CDT wishes to express its commitment to the establishment of this category and intends to present its case to any forum or debate towards that goal. An open debate with all stakeholders, including the public as denture consumers, is required, to facilitate an inclusive deliberation to resolve the introduction of a long-overdue category of Denturist.