Stars of aesthetic dentistry: Dr David Klaff - 19-02-2012

Stars of aesthetic dentistry: Dr David Klaff

A Past-President and Founding Member of the British Academy of Aesthetic Dentistry (BAAD), David Klaff is one of the leading experts in the field. Versha Miyanger finds out about his background work

VM: What or who made you choose a career in dentistry?
DK: I always wanted to be involved in a Health Care Profession, but a Medical Career never interested me, so I opted for a Dental Career, either as a teacher or a clinical practitioner. I have been fortunate to have experienced both of these aspects of the profession.

VM: Where and when did you qualify and what training have you undertaken apartfrom your University education?
DK:
I trained at the Dental Hospital School, University of the Witwatersrand, Johannesburg, South Africa and qualified in 1968.
Since then my continuing training has consisted of involving myself in intensive study courses usually provided by experts in the particular discipline. I have been fortunate in my career in that at specific times I have met highly trained, knowledgeable experts, whom I befriended and who allowed me to spend many hours at ‘their feet’ so to speak. The late Peter Kay Thomas was one such person, with whom I spent many months during which time he taught me prosthodontics and occlusion. Later in my career, Lorenzo Vanini has played an equal part in developing my composite expertise. Throughout my career I have been exposed to many of the ‘giants’ of dentistry and have been fortunate to absorb their teachings.

VM: When did you become a practice owner and how did you build your business?
DK:
In 1971 two linked practices, one in Harley Street, the other in Harrow, became available due to the death of the owner – I immediately sold the Harrow practice and concentrated on Harley Street. I spent two
years developing a referral mixed Private/National Health practice. Then in 1973 following a rather unfortunate incident with the regional Health Officer who refused to sanction restorative treatment on an 18 year
old woman, I resigned from the health service and concentrated on building a private practice. In 1974 I joined John Bunyan and Lambert Fick in a loose association which lasted close to eight years at which time we all went our separate ways and I moved to 57a Wimpole where I remained until last year, when Koray Feran and I moved, with other associates into the current premises.

VM: Why did you decide to concentrate on aesthetics and implants?
DK:
The Ethos of restoring the natural structure, form and function of the Oral Environment was an intrinsic and integral part of our basic Dental Training, so Aesthetics was always a basic element of my treatment planning. The protocols and rules, that are common today, developed in my, and the professions, quest for the perfectly imperceptible restoration. Removable prosthetics to me was a very unsatisfactory aspect of Restorative or Prosthetic dentistry. So I, like the profession, was always seeking a ‘fixed’ solution. I watched with sceptical interest the advent of pin implants followed by the blade variety. However, 29 years ago
I met a Periodontist from Los Angeles who taught me the science of osseo-integrated implants. We still continue our relationship today.

VM: You have been practicing dentistry for over 42 years. How do you think aesthetic dentistry has changed since then?
DK:
Beyond all recognition. I arrived in this country in 1969 and at the time ‘Aesthetics’ was a dirty word and scorned by the profession. Then slowly, due in part to the influence of the social media, and also in part, due to the quest by the profession for continuing excellence, aesthetics became implemented in even the most simple oftreatment protocols. Today our patients demand that we pay heed to the appearance of their mouths and at every level the hand mirror is demanded to see the results of any treatment. In my early years I had to insist that the patient look at what I had just completed; today it is the other way around- the patient demands the mirror and indeed many patients wish to watch the procedures as we carry them out. A close working relationship has developed between the clinical practitioners, dental publishing institutions and indeed the social media, all promoting the ‘Look Good, Feel Good Factor’ at an Ethical level. Many Aesthetic Academies and Societies have sprung up, with varying degrees of excellence as have many published journals. No self-respecting web-site designer will produce a Dental Website without the words Excellent Cosmetic Dentistry appearing somewhere. Finally disciplines, techniques and protocols have been developed and recorded. Today there is sufficient scientific information for Aesthetics to occupy a portion of Dental Training albeit at a post-graduate level. Many Universities offer a specialist degree in Aesthetics. This will increase.This is all very well provided that at all times we pay heed to the Ethics in Aesthetics. We need to discipline ourselves against over prescription, over treating and over stating our abilities – today everybody is a cosmetic expert – this is very worrying and I quote a colleague who states that a new condition of ‘Hyperenamelosis’ has developed requiring extensive removal and possibly inserting multiple veneers – we need to regulate ourselves vigorously.

VM: You are a member of the British Academy of Aesthetic Dentistry (BAAD); the European Academy of Aesthetic Dentistry EAED, the American Academy of Esthetic Dentistry (AAED); The American Academy of Restorative Dentistry (AARD) and Treasurer of the International Federation of Esthetic Dentistry (IFED). How do manage to juggle your huge workload?
DK:
Wow!!! I just do – I don’t know how, but I do have spare time

VM: You lecture regularly around the world. What do you enjoy most about speaking and have you noticed any differences in dentistry around the world?
DK:
The interaction between myself and strangers and seeing their faces when they grasp the concept(s). Twenty years ago when I started to lecture seriously there were vast differences even within regions of a country. Today one can lecture in Riga, Casablanca, St. Petersburg, Seoul, Liverpool or Cape Town and we find that the knowledge and expectations are similar wherever one goes. Depending on the financial resources so will clinical aspects differ –obviously in wealthier countries with more facilities there is a levelling of clinical expertise throughout with a big drop in poorly resourced countries.

VM: What is the most satisfying aspect of your work?
DK
: Re-establishing health to the mouth, and then noting that many years later the patient has maintained health whether in local composite restorations or full mouth crown and bridgework.

VM: What is the most popular treatment you offer?
DK: Anterior minimal invasive composite restorations, rebuilding aesthetics without local anaesthetic. Patients are very grateful for this minimalistic form of treatment which if performed with correct discipline
has an excellent longevity without causing destruction.

VM: Professionally, what are you most proud of?
DK:
I answer this in two parts.
Clinical: Looking at treatment I inserted many years ago and finding that over the years all the patients have required is are on-going Hygiene programmes. I have now been in Dentistry long enough to have to renew crown and bridgework in certain cases – to find the teeth still infection free, whether with caries or periodontal involvement, is a wonderful feeling.
Extra-clinical: Being accepted at first presentation as a member of The European and American Academies - these are all very prestigious societies, so to present ones work and then be elected on the strength of that is very satisfying and humbling.

VM: What has been your biggest challenge?
DK:
With the other co-founders, the establishment of the British Academy of Aesthetic Dentistry 18 years ago. We formed this Academy when, as I have stated previously, Aesthetics was a dirty word. We
offered excellence in science, social and  camaraderie which ensured the success and  opened the way for Aesthetics to become part of Dental treatment – this was a struggle in the early years

VM: What has been your biggest mistake?
DK:
Easy – not taking a degree in Orthodontics – I would have continued to practice as a Prosthodontist, but this deep knowledge on tooth movement control would have been a great help in many complex cases
that I had to struggle with. The ability to intrude or extrude teeth would have been a great benefit in developing aesthetics.

VM: How do you relax in your spare time?
DK:
Watching the Springbok Rugby Team; the Protea Cricket team and Manchester United Football Team keeps me pretty busy – I have a season ticket to Old Trafford and go to almost every home game in a season. I dabble in computing and photography and I claim the most comprehensive collection of De Niro, Pacino and Nicholson DVDs

VM: What do you think is the future of aesthetic dentistry?
DK:
Very promising – the publishing industry and the profession will merge and become even more symbiotic; The various academies and societies will also interact much more constructively and not be in destructive competition. More Universities will offer a degree or diploma in Aesthetic Dentistry.

VM: What are your top tips in maintaining a successful aesthetic practice?
DK
:

 

  • Your credentials must be widely recognised in the dental community.
  • Rely on proven science to approach your care
  • Be totally honest in describing your skills and education
  • Rely on a clear policy of informed consent
  • Always hold yourself to ‘First Do No Harm’
  • Charge fair and honest fees
  • Involve multi-disciplinary specialists whenever possible

 

 

 

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