{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/prosthodontists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Prosthodontists",
    "soc_code": "29-1024",
    "category": "Healthcare",
    "us_employment": 870,
    "median_annual_wage": 311180
  },
  "verdict": "SAFE",
  "risk_resistance": 84,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 15,
    "embodiment": 19,
    "liability_shield": 19,
    "trust_premium": 16,
    "judgment_accountability": 15
  },
  "reasoning": {
    "task_resistance": "CAD/CAM mills, intraoral scanners and AI shade/margin software have genuinely taken the design and lab layer, which is why this sits at 15 rather than 18 — but osteotomy drilling to depth, torquing a fixture into variable bone density, seating and adjusting a full-arch prosthesis against a patient's own report of where it feels high, and staging soft-tissue healing over six to twelve months are chairside acts no scanner performs.",
    "embodiment": "The entire clinical day happens with instruments inside a moving, bleeding, gagging oral cavity of a conscious patient — flap elevation, bone grafting, retracting a tongue while cementing at 30 Ncm — and the only reason it isn't 20 is that the operating field is at least a lit, suctioned, semi-controlled chair rather than a roadside or a wet crawlspace.",
    "liability_shield": "Practice requires a state dental licence plus board-recognized prosthodontic residency, and the specialist personally signs the treatment record, the implant surgical note and the informed consent for irreversible tooth preparation — malpractice claims for failed implants, nerve injury or occlusal disease name that individual, with no supervising entity to absorb it.",
    "trust_premium": "Patients are referred in for a five-figure, multi-year full-mouth or maxillofacial reconstruction and choose the specialist on the basis of that consult and before-and-after judgment about their face; it stops short of 19 because the referring general dentist, not the patient, often controls who they see.",
    "judgment_accountability": "Deciding whether a compromised tooth is worth saving or should be extracted for an implant, how much vertical dimension to restore, and when a peri-implant lesion means explantation are irreversible calls made on incomplete bone and periodontal evidence — 15 rather than higher because established prosthodontic protocols and radiographic staging criteria bound most of those decisions."
  },
  "rationale": "Prosthodontics is millimeter-precision work inside a living mouth: preparing abutment teeth, placing and torquing implants, taking impressions or intraoral scans, adjusting occlusion by feel and patient feedback, and managing soft-tissue healing over months. AI and CAD/CAM already do a lot of the design layer — crown margins, digital smile design, shade matching, treatment-plan drafting, insurance narratives — but the operative and prosthetic-fit work stays with a licensed specialist who is personally liable for the restoration. The 870-person national headcount is a small, referral-driven specialty where patients pay specifically for the surgeon's hands and the aesthetic judgment call.",
  "outlook": "By 2035 the design and lab side of prosthodontics is largely software-driven and margins on simple restorations compress, but the specialist's hands, license, and accountability for complex reconstruction remain in demand.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "task_resistance",
        "change": "As chairside CAD/CAM and AI design software absorb the routine single-unit crown and denture-setup tier (Exocad/3Shape automated margin marking, Pearl and Overjet FDA-cleared radiographic AI), the residual caseload concentrates in full-arch implant rehabilitation, maxillofacial prosthetics, and failed-case revision — work that is almost entirely operative judgment. Watch for referral mix data from ACP showing rising share of complex full-arch and revision cases per prosthodontist.",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "liability_shield",
        "change": "State dental boards adopting explicit rules that AI-generated treatment plans, implant surgical guides, or design files require review and signature by the licensed treating dentist — mirroring the ADA's Standards Committee on Dental Informatics work and existing board positions on teledentistry supervision. Also watch malpractice carriers (e.g. TDIC, MedPro) adding conditions that coverage for guided-implant misplacement requires documented practitioner verification of the digital plan.",
        "plausibility": "plausible",
        "would_add": 1
      },
      {
        "dimension": "trust_premium",
        "change": "Referral-driven fee-for-service specialty where full-arch cases are largely cash-pay; any further shift as corporate DSO chains market algorithm-driven prosthetics at low cost would sharpen the specialist-hands premium at the top end. Watch ACP or ADA fee survey data on the spread between specialist and general-dentist full-arch fees.",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "If ABP board certification requirements or state informed-consent statutes formalize the prosthodontist as the accountable decision-maker for irreversible tooth reduction and implant-vs-retain calls — the classic ambiguous, unrecoverable decision — the ownership of that call becomes documented rather than assumed. Watch for consent-form and record-keeping mandates naming the specialist for irreversible procedures.",
        "plausibility": "plausible",
        "would_add": 2
      }
    ],
    "ceiling_note": "Already at 84 with embodiment 19 and liability_shield 19 — there is very little headroom, and the realistic gains are a few points of task-mix concentration. The bigger risk to this occupation is not AI but headcount: 870 workers means the specialty's fate turns on whether general dentists with AI-assisted CAD/CAM and guided surgery absorb mid-complexity implant cases, which erodes referral volume without touching any dimension score."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 430,
        "wage": 185150
      },
      {
        "y": 2018,
        "emp": 380,
        "wage": 176540
      },
      {
        "y": 2019,
        "emp": 490,
        "wage": 239200
      },
      {
        "y": 2020,
        "emp": 530,
        "wage": 239200
      },
      {
        "y": 2021,
        "emp": 790,
        "wage": 100950
      },
      {
        "y": 2023,
        "emp": 570,
        "wage": 234000
      },
      {
        "y": 2024,
        "emp": 760,
        "wage": 239200
      },
      {
        "y": 2025,
        "emp": 870,
        "wage": 311180
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 102.3,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}