When Frank M.A. Vidjak, D.D.S., MSEd., speaks at conferences, a hush falls over the audience, so that other dentists can take in his every word. He is a prosthodontist.
Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or maxillofacial tissues using biocompatible substitutes. That’s a mouthful for a somewhat obscure field, but even in the elite world of Beverly Hills dentistry, he is considered a superstar. Known by both patients and colleagues as “Dr. Frank,” Dr. Vidjak has been a prosthodontist for more than two decades and with each passing year, he continues to take his profession to new levels. He is not only successful at what he does, but he actually enjoys the often long hours that come with being a perfectionist.
THE VIDJAK DIFFERENCE
What makes Dr. Vidjak different from many others in his field is that he keeps abreast of new techniques and technologies, and even has his own in-house laboratory — something rarely found in any dental office.
“People don’t know what prosthodontists do; they know about orthodontists, periodontists [gum disease specialists], endodontists [who do root canals], and oral surgeons, but when it comes to a prosthodontist, it’s like ‘prosda who?’ It is a specialty that has been around for decades, but people have just not been aware of it. We’re kind of silent in the background, for a lot of reasons.”
For starters, many general practitioners don’t see the prosthodontist as an adjunct to their own practice, he explained.“ They often see us as competitors and we’re not,” he said. “General dentists are capable professionals, and legally and ethically they can practice any aspect of dentistry that they choose,” he said. “But in the current legal environment, whatever procedure is taken on, the generalist is going to be held to the standards of that respective specialty. So, if he or she removes a tooth and something goes wrong and the patient decides to challenge the doctor for what happened, the system will question them as if they were an oral surgeon. It’s wiser to not take on certain challenges, to know when to refer to a specialist, but the desire to increase busyness, not being fully aware of the scope of treatment, or the ego often gets in the way. Mine is the only specialty where some general practitioners seem to fear we will go after their patients, since our training is so broad and deep, but we’re really very ‘generalist-friendly.’ It has been my pleasure to serve as consultant to many generalist colleagues. Doctors know that I have an ‘open door’ policy where they can present their treatment plans and questions. Oftentimes we sit in the laboratory with pretreatment waxings to evaluate aesthetic and/or functional concerns. This part of my practice has been particularly enjoyable because I get to have the opportunity to see the progression of the patient’s treatment with the concurrent professional growth of a colleague. This is very rewarding.”
Prosthodontics covers everything from sleep disorders, simple recall exams, fillings, single crowns and single implants to a patient who may need to have all 28 teeth restored. “This means we are capable to provide from simple to very complex full mouth reconstructions,” said Dr. Vidjak. “Our specialty not only deals with bringing back the smile of our patients, but also with improving the aesthetic, while providing proper function.
“If a patient has experienced trauma or disease that claims part of their face, ear, or eye, a prosthodontist can make a prosthetic component for that area,” Dr. Vidjak explained.
So, who comes to see him? People from all walks of life, from all over the world, ranging from very young to advanced ages, people from all socio-economic levels, and this also includes celebrities and important people in the government, all of whom need to get excellent dentistry and they insist on receiving the best treatment available.
“About 90 percent of what I do is crowns and bridges on teeth and dental implants, as well as removable prostheses, many of which are in transition to implant restorations. I do implant dentistry at very complex levels,” he said. “Those I see, whether they come to me directly or by referral, are aesthetically demanding, so I need to handle the art part. No matter how good something functions, if it doesn’t have the aesthetic appeal, it won’t fly.”
Because of the formal education involved in becoming a specialist, prosthodontists are the ultimate restoration specialists. Meaning, they are often seen as the last hope in treating some patients. It’s important that they be consulted from the beginning about the treatment plan, Dr. Vidjak noted.
Dr. Vidjak gets much of his drive and creativity from his parents. “My parents’ early childhood in Europe was during a time when it was being ravaged by war,” he said. “I think these experiences give a person a different perspective on life. Determined to give the family the best future possible, we immigrated to the United States.”
As for what his own future held, he dreamed of going into den- tistry as early as junior high school, following somewhat in his dad’s footsteps. “Being a mechanical engineer, by default my father had to be creative to develop a solution to a problem, he had to think out-of-box,” Dr. Vidjak recalled.
“All these years later, I can say that I see prosthodontics as a type of engineering, just on a smaller scale,” he said. “It’s the same idea, depending on what level you take it to. A lot of creative thinking has to go into developing a solution for the situations that patients present. I’m basically applying it to people while my dad applied it to the food industry and machinery. Physics is a beautiful thing: the laws do not have boundaries with respect to professions. But what really makes prosthodontics interesting is the high degree of art that is utilized in combination with science. You need to be able to handle form like a sculptor, color like an artist painter.”
Dr. Vidjak cannot speak about prosthodontics without mentioning the influence his prosthodontic specialty program director, Dr. Jack Preston, has had on his life. Dr. Preston’s dedication to the profession and his unlimited desire to improve and learn is exemplary. “One of the aspects of the program that I particularly enjoyed was that we had to do all our own lab work. ‘If you cannot do it yourself, how can you teach it to someone else?’ Dr. Preston would ask. I found this to be invaluable because of the high level of dependency on oftentimes very complex laboratory procedures. I am proud to be able to think of him as my mentor and friend,” explained Dr. Vidjak. It’s the detail and the challenges of prosthodontics that attracted Dr. Vidjak in the 1980s, just as much as it does now. Prosthodontists are among the best-trained in biomechanics, which is understanding the effect that forces have on the stomatognathic system (mouth, teeth, jaws and pharynx). “ We, as dentists, do not fully appreciate the degree to which we are ‘Doctors of Force Management’,” Dr. Vidjak observed. “Most failures are a result of functional overload.
“I still get a thrill out of doing this because I have always liked the small details and the challenge of control. As a kid, I was always dealing with trying to have good mental 3-D imaging because there were no computers. You would have to draw and piece things together and then visualize the result. I’m now putting together the science and art of this, and I love that because I get to use my hands to directly shape whatever I am dealing with. In other professions like architecture, someone has to put it on paper and someone else does the creating; but here, I do the planning and the creating myself.”
Dr. Vidjak graduated from the USC School of Dentistry. After earning his D.D.S. degree, he completed his specialty training in prosthodontics at USC, as well as an M.S. in Medical Education (also at USC). While in his Prosthodontic Specialty program, he was privileged to restore the first patients with dental implants. This was quite an event at the time! Unexpectedly, he found himself teaching at the USC School of Dentistry. “When I chose dentistry, I never thought I would be teaching,” he said. “I always thought, ‘you go to school and then you go into practice.’ When I was in specialty training, the chairman of Restorative Dentistry at USC asked if I would be interested in teaching. At that time people were clamoring to get a full-time teaching position, so I figured there was something to this. Who knew it would turn out to be 13 years — I was thinking only five years, tops.”
His positions were many, including Clinical Director of the Advanced Prosthodontic Program and Clinical Director of the International Student Program, which concentrates on dentists earning their degree equivalency. Though now in full-time private practice, he is still very active in teaching through his many professional organizations and most importantly, with his patients.
ACADEMICS AND PRIVATE PRACTICE
“While I was teaching at USC I was also practicing on the outside,” he said. “I liked that because it allowed me to talk about real life experiences, where patients aren’t so tolerant as you learn in a classroom or the university clinic. I loved teaching because you learn so much in the process. It was great for everyone, but I needed different challenges, and I’m a clinician at heart, so I needed to move on.” Dr. Vidjak has maintained his private practice in Beverly Hills since 1989.
These days, Dr. Vidjak can be found Monday through Thursday at his modern, high-tech office, which has gorgeous views of northern Beverly Hills as it spreads up into the hills. There is a wonderful waterwall fountain in the reception area to help patients relax a few minutes before their appointment; he also
utilizes aromatherapy to keep them calm once they are in the chair. “Dentistry, in my opinion, is more about service and the quality level of the treatment provided than the price paid for it,” he said. “Dentistry should be perceived as a service-oriented profession, not as the product-oriented entity that it is today. We are partly to blame for this: we have allowed patients to go on thinking that a filling is a filling, a crown is a crown, etc. In my practice, we work very hard to educate patients to realize that it takes a lot more than hardware or materials to create a successful outcome. We have to know how to treat people and let them know they are special and that they matter.” Dr. Vidjak has a fee-for-service practice, but as a service for his patients, their insurance forms are processed. “Insurance companies generally will not pay for cutting-edge techniques and materials,” he explained. “ They tend to excessively intervene in the treatment planning process through both direct and indirect means. There are few policies that always allow people access to the care they deserve.” In order to keep abreast of what’s going on in the profession, Dr. Vidjak regularly attends meetings, seminars and other continuing education courses. He continues to lecture on all topics pertaining to prosthodontics, nationally and internationally. In addition, he has published scientific articles in peer-reviewed journals, as well as continuing his academic involvement. “Even though I feel that I am teaching every day with my patients, I still enjoy teaching in an academic environment,” he said. “It’s fun to have colleagues present who want to learn, and conversely, I can gain knowledge from them. It is stimulating and promotes professional growth. Dentists are bombarded by all forms of media promoting various individuals, groups, or organizations offering the ‘latest and greatest’ in dentistry, often through individuals or organizations with dubious credentials or backgrounds. Today, unfortunately, there is no policing of the continuing education system. Seminars just have to be presented by apparently credible teachers, but they don’t have to meet accreditation standards.”
He said that he is teaching with two groups that have core faculty, all of whom had or have bona fide academic appointments. “These people have a wealth of clinical experience, as well as a good under- standing of the dental literature and are truly leaders in the field.” One such group where Dr. Vidjak has been a faculty member in the Department of Continuing Education at USC. He is also a director and faculty member at the Advanced Restorative Institute. He also feels that a vast amount of information is being presented to dentists with little hope of reviewing most of it. “We really should spend more time seeking knowledge from peer-reviewed journals that have proper references. This will lead dentists to practicing evidence- based dentistry,” Dr. Vidjak advised. And few dentists are familiar with the details of the history of dental technology and literature, so often things are received as new breakthroughs that have long been available for those who do their homework.
Dr. Vidjak is a member of the American Dental Association, California Dental Association, Los Angeles Dental Society, American College of Prosthodontists, Beverly Hills Academy of Dentistry, San Gabriel Dental Implant Study Club, Advanced Treatment Planning Study Group, and West Los Angeles ITI Study Club. He is a fellow of the prestigious International College of Dentists and the Pierre Fauchard Society.
THE VIDJAK LAB
But perhaps one of the best ways he keeps on the cutting edge is through his own in-house laboratory. Dr. Vidjak is proud of his spacious lab area, where he devotes a significant amount of time preparing cases for the dental technician or completing the procedures himself. Even when he receives something from an outside lab, he inevitably will make modifications. “Having a full lab is unusual because space is expensive,” he said. “I use my lab day-in and day-out to do everything and I think what I get accomplished there more than compensates for the cost. When I was in school, we used to spend nights working in the lab and I would find myself spending the night at school! As a result, what I am most proud of in my practice is that I am very hands-on.”
Dr. Vidjak’s lab is fully functional and equipped to handle just about everything , he said. He added that dentists frequently have to send back a prosthesis to a lab several times to get exactly what they want or to correct deficiencies. “By maintaining a lab in my office, I can do the most important work and not worry about that. Very few dentists have anything like this,” he said. “For me, it’s a place where I can create a crown or whatever is needed, as well as serving as a place where I can gather my thoughts; it’s like therapy, so why pay an analyst? It’s my own private sanctuary and nobody touches my space.”
As for what lies ahead for this man of education and determination, Dr. Vidjak said that the future of his practice does indeed look bright and that he credits much of that to technological advancements and dedication to trying to do one’s best.
“There is always something new coming down the pipeline, which you have to look at with critical eyes,” he noted. “It’s fascinating to note how rapidly prosthodontics has evolved due to advancements in materials, technology, and techniques. This has been particularly evident in implant and adhesive dentistry. We are now able to conservatively restore teeth with bonded restorations. However, what has really turned the profession inside out has been implant dentistry. If teeth are missing, dental implants can be used, usually leaving neighboring teeth unaffected while restoring function and aesthetics. The advent of dental implants to be used within a human being has really changed people’s lives. It has given them new hope — for example, you can take someone that is dentally disabled and give them a quality of life and a sense of confidence that they would otherwise not have. The trick is that it takes proper treatment planning. Prosthodontic treatment plans used to be determined by what remained. Now what remains seems to be determined by the prosthodontic treatment plan.”
“This is where the art and science of what I do comes in and why it’s important to tie the two together,” he said. “I think prosthodontics is centered on finding the ‘why’ — why the patient is presenting the particular problems and determine the best way to resolve it. If you are going to come up with treatment options for a patient, you need to understand what is going on with the person and that takes time.” He is a strong believer in collaborating with the general dentist or other specialists right from the start. “ You don’t want to have one dentist doing the initial treatment, only to find out that it doesn’t fully mesh with the overall plan because a team approach wasn’t implemented. Everyone involved, including the patient, should be in agreement about the goals and expectations and how to get there. We need to take a whole-systems approach to deciding what the treatment plan should be. There are usually a lot of different ways to do things that don’t get fully explored. You need to educate the patient or he or she will not be able to make an informed decision. This is where the vital role of prosthodontics lies,” he said.
When he isn’t in his practice, Dr. Vidjak plays hard enjoying running, fishing, scuba diving, motorcycle riding, and spending time with his wife, Fanny. “She’s my inspiration; she helps give me the energy to persist in my demanding profession.”“I love what I do, even though I often have incredibly long days,” he said. “If I can educate people and change their lives, what better reward can I ask for?”