Alaska's Rarest Occupations: Or, is there a prosthodontist in the house?

• Author: Rhode, Scott
• Position: CORPORATE 100

A good prosthodontist is hard to find. Only three such specialists may be currently working in Alaska, depending on how "semi" some semi-retired dentists might be. According to the US Bureau of Labor Statistics (BLS), prosthodontist is among the rarest occupations in the country. As of May 2020, BLS counted 530 nationwide. Only private household cooks and wood patternmakers are fewer in number.

All are craft-related occupations, observes Dr. Joseph Macy, who prepares dental prosthetics at Southcentral Foundation (SCF) in Anchorage. "As a society, I don't think we tend to financially reward craftsmen," he says. "I think we tend to reward production."

Prosthodontics focuses on replacing missing teeth and fabricating appliances to replace function for cancer or trauma patients who have lost sections of their jaw or palate. Macy and his colleagues at SCF, Dr. Tiffany Lee and Dr. Bridget DeYoung, trained for an extra three years in the specialty, learning alternatives to the standard approach most dentists know.

"Prosthodontics in its very essence, if you want to be good at it, you have to know which are the right questions to ask," Macy says. "More than anything else, my training was moving me toward asking the right questions."

Their expertise is a scarce resource. "The busy-ness here is incomprehensible and insatiable," Macy says. "Every day, every appointment is filled months in advance, not days in advance. The need is well surpassing what we're able to provide."

Not that SCF is the only place for prosthetic dentistry in Alaska. General dentists do it every day, too, but Macy says, "Those general dentists who are seeking to refer out to a prosthodontist as opposed to doing it themselves now have to refer out of state if they want to seek someone who did specialty training."

One other prosthodontist used to work in Alaska: Dr. Mark Williams. In fact, Macy was Williams' first associate when Macy arrived in 1992. However, Williams retired in 2019. He continued to take patients at his practice. Advanced Dental Solutions in Anchorage, until early 2022. Now he's gone for good, sailing his boat on the Pacific Ocean.

Dr. Dale Burke, a partner at Williams' practice since 2017, has training in advanced general dentistry and experience in prosthodontics, but he is not a specialist. Even so, Williams left the practice to him. "I must say, I am not a lone ranger, and my team is a very large part of what we provide," says Burke. "They know all the techniques, equipment, and supplies required for these large cases, and they...