Leslie Ann Klardie DMD MS

UzimaOne Prosthodontists Podcast #4 – HOST: Frederick Neal

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Frederick Neal: And she is a Prosthodontists, now for a lot of you out there, you’re probably saying; What is that? Well, today she is going to tell us exactly what a Prosthodontists does. Thank you for being with us today.

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Dr. Klardie.: Well, thank you for having me, I really am thankful that you are recognizing the Dental Community for being important to our community and community health.

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Frederick Neal: Thank you, thank you. I’m glad to have you here today and we are going to start right in with asking you, the field that you’re in, is such a specialized field, although I could be wrong, maybe it’s not and maybe it is, but I think that it is.  Could you tell us what brought you into the field?

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Dr. Klardie: Well to clarify, Prosthodontists are a specialty and is recognized by the American Dental Association. So a Prosthodontists is one of ten specialties recognized by the American Dental Association and how did I become a Prosthodontists? Every child, goes to the dentist and some have good experiences and some have bad.  Mine were not bad; it was because I needed advanced reconstruction. So that set me off on, well I can make it better and I want to make it better. So I was 13 and of I went.  I went to school, I studied hard, I went to college, I did my requirements for Science as a major and off to dental school I went. I fell in love with orthodontics, but I’m not an orthodontist. When I went for my interview, I met the dean of the school and he showed us a slide show and this gentleman had a beautiful nose and eye glasses, and as you went through the slide show, he took off his glasses and off came his nose and I went oooohhh, I want to do that. How do I give somebody dignity back? I wanted to know, I didn’t care what I had to do, I had to do that. Forget about orthodontist, I want to do that. So I went to the sergeants, I said:  Do I become a sergeant? Do I have to do reconstruction? He goes, no, you want to be Prosthodontists. I said, well, I’m going to be a Prosthodontists. And every day at school, I did my best and Prosthodontists love materials. We push materials to the limit, we work it well and we come out with an amazing, esthetic result to give confidence to patients that have need. So that’s how I started, I started because I had a need and I wanted to make it the best for everyone that needed that. So I changed in between, cause I didn’t know, I was naïve. But now knowing what I know, it was the best for me, cause is three dimensional, is artistic, is what makes me tick. So it’s what I needed to do in life.

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Frederick Neal: You know that’s very interesting that a lot of people that I talk to, a lot of professionals who are in the business, have a similar story about something that happen with them, or something that happened with someone in their family that brings them into the profession. But I have another question for you, in terms of, you know you mention about helping a person to recap their dignity. Can you elaborate a little bit on how you feel that recapturing of someone’s dignity also impacts their wellness, or how the lack of a person having a dignity because of some kind of deficiency that they have can impact their wellness?

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Dr. Klardie: Everyone has had the experience where they’ve had tooth loss or tooth ache and they don’t know who to look to or who is going to help them. So there’re many different specialties that can help us. Dentistry...every dentist starts out as a general dentist and then you branch off into a specialty, you don’t have to; there’re actually ten different specialties in dentistry.   A lot of people don’t even know that. So you go to your general dentist, you knock on the door and you think he’s going to be the jack of all trades, but maybe he shouldn’t be. Maybe you need that specialty to help you through whatever difficulties you’re having at that moment. So everybody knows that there’s a root canal out there; everyone is terrified of a root canal. They are very scary. But you don’t think that when you go to an endodontists, which is the specialty, the person for root canals, they get you out of discomfort, they don’t put you in it. You were already in discomfort. Let’s run through all the different things that maybe people should know about and all the different specialties in dentistry. And I’ve got to look at my list, because sometimes I don’t use them. So there’s dental health: The people that educate you on all the different things you can do to help yourself and this is usual a federal level. Like their helping the public know that there is help out there, so you have public health dentistry. You have the endodontist, which is a root canal specialist; you have the surgeon; so you have oral and Maxwell facial surgeon, that’s who usually take your wisdom teeth out, so people recognize that.

 

There’s pathologist in the hospital, there’s radiologist, if you have that special need, the newest one is dental anesthesia, we want to be comfortable and if you have dental work, you can do the anesthesia now, these are all accredited programs, recognized by our specialty programs, which is the American Dental Association says, it’s ok to go out and seek their help, orthodontist, we all know what an orthodontist do, there’s pediatric dentist, that’s a specialty all to itself.  So they have little tools, they have all the right words to help your little people out and maybe little big people. There is a periodontist, so that’s perio which means around your tooth, so they just deal with the bone and the gums, is a specialty.  And of course there is a prosthodontists, so that’s what I am. So we’re general dentists that have gone 2 years, 3 years extra, and really know all the extra materials and higher technology and we’re not just restoring one tooth, we’re restoring a multitude of teeth, maybe full arches, reconstructing full faces in some part of our profession. So there is a specialty, on my specialty, which is Maxwell facial prosthodontists, and you’ll find us in hospitals, in VAs. We’re reconstructing the faces, unfortunately, of our soldiers right now. So we’re team leaders and we work with all the specialties, we bring them all together and figure out a plan. Not just for one tooth, for full arches and full faces to give people their dignity back. There’s many different avenues and specialties and you have to remember that we’ve gone through that extra training, it could be 2 years, it could be up to 6 years extra training beyond general dentistry, so that we can help you be the best you can be for chewing. Now you gotta remember that you have one tooth and it hurts and you get that taken care off, but if you are missing multiple teeth, then, you’re in a completely different realm. Well are you going to go limping through life, not being able to chew? Well, you’re going to be miserable, you really are. When you think about it, even when you just have a tooth ache, you’re miserable. But can you imagine you just didn’t have enough teeth to chew properly? No. So here you are, you take a scoop full of food, and you know, some guys I know I have a son who just inhales food. Well, you have to chew it, sometimes you have to come up for a breath and you’re laughing at me, cause everyone knows we inhale our food cause we just don’t have enough time and that’s the new norm. We’re sitting in front of a computer and we’re just stuffing food in our faces and you look down and you go, where did my sandwich go? You don’t remember eating it, well if you don’t remember, then you don’t remember how wonderful it tasted and you don’t remember how many bites you took to chew it.

 

So here you are, you’re chewing, how many times do we chew? I say 35 times, well if you have something super crunchy and thin, it’s not going to take that many bites, but if you have a hunk of meat, you should really be chewing your food and so when it goes down, human bites, remember that, human bites, take human bites, you chewing, you chewing, you chewing, really get into small pieces, because you’re starting health right then and there. Remember chewing is part of your health, so the smaller pieces you can get down, it mixed up with that saliva, all the enzymes and all the automatic things in your body start. Your stomach goes hey, time to wake up. Pancreas says you know, diabetes right, you know put the good stuff in, pancreas is saying, you know I’m getting ready for all the nutrients that are going to come down. You want to swallow that, you want to be healthy. You want your stomach to like use the enzymes and the acids and digestive fluids to really wrap around all those small pieces, not the big, big hunks that we just inhaled. So when we have proper nutrition, we’re extracting all the nutrients that we need in the small intestine. So you go down and say where is Dentistry? Dentistry is right there on the top, is what starts health and what is starts digestion. If you don’t have your teeth, are you really healthy? So the things that you think that, what does everyone always complains about? You know I ate that food and it made me bloated. How did you eat that food? Then you say, I have heartburn, well how did you chew that food? And then, I have acid reflux, I’m telling you if you don’t digest your food in five hours, you know is called gastric emptying, if you can’t digest that food, it’s just going to flush it out. So if you get those big hunks of meat that you just inhaled, there’s no digestion, at all. So then, you got your acid reflux, which eventually we’re seeing in the dental office because the acid’s in your throat and it hits your teeth and we’re seeing destruction, because we are not properly chewing. We can get a multitude of things that are not great, but malnutrition is really essential. So here we are, we’re eating proteins, we’re breaking it down in our stomach, maybe we are, maybe we’re not. But when we break a protein down, that’s amino acids. Amino Acids is what makes us who we are, right, it gives us our healing capacity, it gives us ability to grow. Even our kids, we want them to grow, so we want them to eat right. So we don’t have the ability to take protein and make amino acids, we have to break it down, we can’s store it, we can’t make it, so we want to be the best we can be so we need to chew foods into smaller particles, get it in there and get healthy. And there are a bunch of things that come out of being able to chew. So what does a Prosthodontists do? They help you chew, they give you the dignity to chew. So I give you a surface area and the right function to chew. Well you’re feeling good about yourself, cause you’re healthy. But we don’t only give you function, we give esthetics on top of it. Because when you feel good about your smile, you can conquer the world. We all know that, right. So we’re smiling up a storm, we can eat properly, smile is not falling out of our face, because you know, we’re worried about it. We’re just enjoying life, right, is the package, it’s the package. So what can we deliver to the community? That’s a tough one, as a whole, I don’t really have an answer to that. But one on one, I can’t give you the world. But I can give you options to make your world better. I’m better one on one, that’s why I won’t stand up in front of a big group, that’s why I’m corky about that, but if you ask me, how to be the best person you can be, I’m going to give you options for a plan. I can’t deliver everything, I need a team and I work with a team. So if you need an orthodontists;  so let’s go see what the orthodontists has to say about your smile. Is it going to make it better? So then maybe you don’t need me. Do you have some type of infection? Well I need other people to help me with the infection, because I’ve said in my specialty, that I’m going to limit what I do, but I need their opinion. So there is a periodontist, there is an endodontists, there’s you know an orthodontist, there’s a surgeon, sometimes we need the surgeon to give us an opinion. But I’m not going to be a dictator; I’m going to see what makes you tick, what drives you to be in my office. And what do you ultimately want? Now finances do come into that, but I’m not going to say to you that you can only have this, there’s many different ways to get to the finish line and it might be years down the line. So one on one with a person, we’re going to say, alright, maybe you just need a bridge, and it’s not just, because its trauma for this patients, they’ve lost one tooth and I’ve got to get them a solution. So if they need a bridge, well, how do we get there? So I’m going to walk them through, how to get there. What does it mean to get a bridge, what does it mean, implants. So when you think about all the different things that I can do, you’ll say well I only want my teeth whiten, well you have whiten teeth, but can you have whiter teeth and how white your teeth’s going to be? But that gives you confidence. I give you veneers, well what’s a veneer. Veneer is a shell shaped prostheses that I glue in the front of your teeth, glue or adhere (there’s many different terms). But it could be made out of porcelain; it could be made out of a composite material. I can do with a lab and place it on. You have an emergency, and you have a wedding the next day, I can place it right in the chair, instant gratification; well that gives you your confidence back. So what are the other things that we do, of course we do a single crown, we do bridges which is a loss of a tooth or multiple teeth. So you don’t get to take that out. A bridge, is a layman’s term, for a fix prostheses so it’s adhere to your natural teeth, right, so you don’t get to take it out every day. And then there’s removable prosthesis, and everybody knows a denture or partial. Those are the common layman terms for something you take out every day, you have to clean it, you have to clean whatever holds it in your mouth and you put it back in so you look presentable and you feel good. Mind you nobody ever really loves a removable prostheses, is the toughest one to wear, it’s the hardest one.

 

So we do the removable and then also there is the latest and greatest and really the gold standard is dental implants and you’ll see advertisements at night when you watch cable tv, you’ll see them on every magazine. So dental implants, is a metal fixture that goes into your body, is bio compatible, meaning your body will accept it, is a titanium,  special titanium and what makes it successful is your body has the ability to grow bone, up against it. So there’re many different type of implants out there. The best ones have a surface coating and a surface configuration, where it engages the bone and encourages the bone to grow up again it. And that’s what we look for. So the periodontist which is a specialty and an oral surgeon, which are the two that we recommend as prosthodontist to place the dental implants and they’re going to monitor, whether your body is accepting it and there is an average, depends on where you go in the united states, some types of implants, the best quality bones, they can load or actually put into function a dental implant within the first two weeks. We’re a little bit more conservative on this coast, so in three months we’re going to say that’s the ideal time to say that your body has grown enough bone against it and made it stable enough that we can put it into function. That’s what we do in our practice, we give you the best time to make sure that bone is really where we want it for strength. So dental implants are an option, you can do one tooth, you can do multiple teeth and then you can do full arches, but you have to remember, that you really want to have somebody in the dental profession, that’s going to tell the surgeon, where to place the implant and is very unfortunate that we’ve met some patients that have just jump the gun and gone to someone in the dental profession that says there’s a space in your smile, let’s just place an implant there. Well, is not always the best place to put it, and sometimes they are not at the right angle. So you always have to be very careful with one; who is placing it and where it’s been placed, and a lot of people don’t know that and is a shock when you come into a prosthodontist office and they say well that’s a very nice implant and it’s in the bone, but I can’t use it to give you that beautiful smile you’ve always wanted. So that’s a shock and we don’t want our patients to have that shock, so always, if you are thinking about an implant, go to someone who is a restorative dentist and a prosthodontist is a restorative dentist, they’re going to get you to the next team member that’s going to place the implant in the right position so there’s less discomfort or annexed or disappointment because it’s been placed incorrectly. So we’re bringing the team in again, what I don’t do, I know someone who can do it, who’s been trained, I mean I know about what they do, but I choose not to do it, because if they do it every day, they’re better at it than me.  They don’t want to do what I do and I don’t want to do what they do.

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Frederick Neal: Yes, that’s an interesting observation that the industry is not just one person anymore. That overtime it’s become a field that has grown so much that it is required now, it is a need for individuals to specialize in certain areas and one individual staying within this scope of practice and understanding what the other, the others do and how those things work together is also just as important as is knowing what you do. So that brings me to a question, with their being so many different types of practices within the dental field.  Where would a person begin who is looking to have something done, from just basically let’s not say something but, to generally begin to search out a good dentist. Where should they begin?

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Dr. Klardie: General dentist can be exceptional, but you have to remember, some of them have limited training and some only have weekend training, so what you want to do is meet your general dentist and have them talk to you about what your needs are and there’s nothing wrong about getting a second opinion.  And a really good general dentist will say if you have extensive reconstruction that’s needed, you want them to say to you, there’s a specialist that can do that with you. You don’t want them to be the jack of all trades; you don’t want them to be the one that’s trying something out on you, because there is a whole specialty that does it every day. So how do you pick which one you’re going to go to? Of course if you’re looking on websites, you can look up a specialty, a trained specialist, especially in the state of New Jersey has to have a specialty ID number, everything we advertise has to have that specialty ID number, alright. So that’s your first and of course you can look on their websites they’ll have a website, and see whether that’s the type of person you want and go meet them. You’re a team with them, if you’re going to work with them; you’re going to want to work well with that person. It’s a personality, you don’t want somebody barking orders at you, I mean I don’t. I want someone that I feel very comfortable with their chair side manner, very comfortable with how they explain things, we’re educators. In our practice we sit down and we spend a lot of time in educating, you want all the different options, because you don’t know what they are. And then you can come back later and say, tell me more about this option or something is just not for me. So when you’re going to look for a specialist if you go to a general first and they say you need a big bridge, well that would be a prosthodontist, maybe you need gum surgery, well that’s a periodontist.  So go meet with somebody that has that specialty accreditation, and they’ve had that extra training, they’ve been around for a while and then go meet with them. That’s the best way to do it, now you have to remember, there’s two advertising words that even a prosthodontist can’t ever advertise. There are no cosmetic dentists, we can’t advertise that and there are no implant dentist, as a Prosthodontist, is all in compassing with us, it is not a specialty. So if you see a general dentist advertising that, he could be very good at that, but he doesn’t have a specialty on it or implantology. Alright, so you want to really say, ok do I want the jack of all trades or do I want the opinion of someone who does it every day.

Frederick Neal: Right. That seems to be a sticking point for a lot of people today, that they don’t know how to find the proper person that they should be dealing with and you know, our Podcast is really structure around that as being one of the primary objectives that we want to try to express to our listening audience, that you always do better when you work with a professional. And the first tier of building trust, so that we can establish a relationship is understanding that we have the credentials, we have the training, we have the time put in already, you know and a lot of people that I speak to now, they have 15, 20, 30 years, 40 years in practice in doing what they do and this is definitely someone that you need to talk to, as opposed to your friend or you know, the guy that’s standing at the corner or the late night commercial that you’ve seen. So that brings me to another question about being in the practice that you’re in, you don’t only have to practice medicine, but you also have to run your business.

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Dr. Klardie: Yeah.

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Frederick Neal:  And what are some of the difficulties that you find in trying to balance the medicine aspect in your practice and running the business?

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Dr. Klardie: Oh goodness, I’m not very good at business questions. Where do you want me to focus on, how do I make a business or how do I feel about the business?

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Frederick Neal: Basically the everyday running of the business that has to happen, does that impact, also at times, the time that you spend, you know, trying to delegate to the practice itself of what you do.  You know, I run into a lot of people that have their own businesses and it’s always this problem with balancing, you know, I really want to do what I do, but I have to also deal with the advertising, I want to do what I do, but then I got to to deal with this contractor that is coming and is fixing the wires on the wall and is like, ok

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Dr. Klardie: That’s never fun and I must say, because I’m not an owner of a practice, I’m an associate. So years ago I decided not to buy into the practice, because business is daunting. So I’m a spoiled brat, I’m telling you, really, I give 110% just to educating and treating my patients.

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Frederick Neal:  That’s a good place to be.

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Dr. Klardie: And I enjoy it, because I know business it’s very distracting. So when I come in, my patient’s need me and we have a dedicated time that we know a procedure takes. I usually give more because I’m teaching you something or I’m moving slower, because you need me to move slower. And is fearful, dentistry is fearful. People bring in a lot of baggage and it’s unfortunate. My older patients sometimes I have to talked them in the door, come on in, come on in, it’s okay on this side of the door, it’s alright. Come talk with me. So I spend a lot of time and I don’t really do a lot of the business aspect, so I’m kind of shy with that. That’s a tough question for me.

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Frederick Neal: And that’s interesting that you talk about the time that you spend with the patient in dealing with helping the patient to move from a point of anxiety to a point of comfort when coming in and that’s important because a lot of positions would probably say you know you need to make another appointment and come another time and don’t forget to pay your deductible before you leave, thank you very much.  So with the fact that we have the internet, we have the TV, we have magazines; we have all sorts of media that people are exposed to. Why do you think that is today that people really know very little about the advancements?

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Dr. Klardie: In Dentistry?

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Frederick Neal:  Yes.

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Dr. Klardie: Is very interesting. Just because we have resources, doesn’t mean we access the ones that mean something to us. Now the American college of Prosthodontist, we have a big advertising campaign, just to teach you about what’s out there. But does anyone know that the American College of Prosthodontist even exists? So that’ a difficulty, I mean they ‘ve been trying to educate the public. I don’t know how successful it is, but that the shame, that’s why I’m thankful that you are actually talking with us, because we do make a difference, we do.  And I don’t know why we don’t have pop ups saying “hey, did you see your dentist today”? Which one you want to see? Which one do you want to see though? I mean and that’s difficult, it really is, because you’ll run to the guys on the corner, but is he the right guy for you, or I’ll say gal too, you know practitioner. So I don’t know why people with all the resources we have now, can’t lock into dentistry. Maybe is because is not in the forefront of really anything medicine. Don’t we always go to the doctor when we have a problem? But are we being proactive and going every year and doing the basics, like getting our tests done vs having your teeth cleaned? We’re always waiting you know, we’re always procrastinators and it’s usually that’s when you don’t want to hear it, now you need something. So maybe we need to be a society that’s a little more proactive? I’d like to see insurance, if you have insurance, say, and I know they exist out there, you know if you go to see the doctor twice a year, we’ll give you a discount on maybe your insurance or something like that. Cause then, is a well visit and we’re catching everything before and is the same with dentistry, if I can catch it when is little, is a little problem. We like little problems, I like little problems every once in a while, makes my day go great, but we take on the big ones, we take the ones that have come in from other dentists and the “I don’t know what to do” or “they tried it and it just didn’t work” people are angry. So I want to see little, but we have to take on the big. And people are upset at that point in time. You know, so I would say if we could teach anybody to do something for themselves, would be to be more proactive about who you want to be in the future, you want to be healthy and that’s in your mouth and that’s your whole body. And that’s what I have to focus on now and I don’t know about the media. I don’t think anybody is researching dentistry, unless they have the need. It’s usually pain driven.

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Frederick Neal:  Do you think in the industry today that people are now better off than they were say 20 or 30 years ago?

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Dr. Klardie: Oh definitely, oh definitely. The technology that we have now is amazing. We use computers, we have in our practice a machine that can scan all your teeth, we stitch together all this different photos, like maybe a thousand photos and it makes a picture of your mouth, a three dimensional picture of your mouth. Well, wouldn’t you much rather have those pictures of your mouth three dimensionally that a lab can print out or would you want me to put that nice impression material in your mouth that’s nice and gooey nobody likes?

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Frederick Neal: Yes, I’ve had that. It’s challenging.

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Dr. Klardie: It is, so for some patients we can actually take the 3D scan and make all the prosthetics and that includes implants, so the technology is out there. You know, so we’re moving right along, its amazing right now to be in dentistry, leaps and bounds all the things we have to do. So it has improved. We do pain management, that’s always a great thing, you know, so TMJ, so people right now, you talk about sleep apnea, prosthodontists also do that. Clef palettes, you know people have that need too. Traumas, unfortunately, we deal with a lot of traumas. So people need their smiles back and we use the team to help with facial problems too, you know their lips, that might have been traumatized and stuff like that, so we can do that seamlessly, because we’re connected now, we know whom to talk to, we get you through it, so definitely much better. The materials that we use are amazing, more durable, more esthetic and beautiful options.  We do it in the chair for an emergency or now you can actually send it out digitally to the lab, is faster turnover; the products are more précised because they’re milled. It’s just amazing out there right now.

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Frederick Neal: I think that question really covers up the last question I was going to ask about what your thoughts, what would be your last, should I say, what would you say to individuals out there in the listening audience about your practice and coming to you and what you could do for them. But I think you’ve already kind of covered everything, but I like the listening audience to know that Dr. Klardie is the best. She is the best of the best and I’ve had a relationship with her organization here in Berkley Heights, NJ over 20 years and the care and patience and just loving acceptance that you will get coming here is probably more than you’re going to get anywhere else. So my advice to you is that even if you don’t know where you’re going. Call here first. If you don’t know who you’re going to go see, call here first. If you don’t want to see a dentist and you’re afraid to see one, call here first. So basically my last word to you is call here first.

And thank you ladies and gentlemen for listening and thank you so much Dr. Klardie for being with us today and we love you and we hope to do this again very soon.

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Dr. Klardie: Thank you so much. I appreciate everything you’ve done for us today and take care, enjoy.

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Frederick Neal: Thank you!