Professor David Poswillo

Outstanding maxillofacial surgeon

David Ernest Poswillo, oral and maxillofacial surgeon: born Gisborne, New Zealand 1 January 1927; Director of Oral Surgery, Christchurch Hospital 1953-68; Professor of Teratology, Royal College of Surgeons 1969-77; Consultant Oral Surgeon, Queen Victoria Hospital, East Grinstead 1969-77; Professor of Oral Pathology and Oral Surgery, University of Adelaide 1977-79; Professor of Oral Surgery, Royal Dental Hospital, London 1979-83; Professor of Oral and Maxillofacial Surgery, United Medical and Dental Schools of Guy's and St Thomas' Hospitals 1983-92 (Emeritus); Secretary General, International Association of Oral and Maxillofacial Surgeons 1983-89; CBE 1989; Chairman, Working Party on Anaesthesia, Sedation and Resuscitation in Dentistry 1990; President, BAOMS 1990-91; Chairman, Committee on Dental and Surgical Materials 1993-95; Chairman, Scientific Committee on Tobacco and Health 1994-98; married 1956 Elizabeth Russell (died 2002; two sons, two daughters); died Farnborough, Kent 3 June 2003.

David Poswillo was an outstanding surgeon, teacher and scientific investigator. His contribution to a better understanding of facial deformity, and his strong advocacy for patients, driven by seemingly unlimited personal energy, commanded recognition and respect throughout the world.

He was born in New Zealand, in Gisborne in 1927. He qualified in dentistry at the University of Otago in 1948 and, following a period of postgraduate study in England, returned to New Zealand where, from 1953 to 1968, he worked as consultant oral surgeon in the Plastic Surgery Unit at Christchurch Hospital, and in private practice.

At an early stage Poswillo realised that a better understanding of the nature of disease, as a basis for management and prevention, was fundamental to good patient care. It was during this period that he developed what was to become a lifelong interest in the problems of patients with craniofacial deformities and particularly cleft lip and palate. His early, groundbreaking research, conducted in his garden shed without the infrastructure of a major academic institution, fortuitously came to the notice of the international community. In 1967 he was awarded the Nuffield Dominion Travelling Fellowship to continue his work at the Royal College of Surgeons of England in London and the Oral Surgery Unit at the University of Zurich.

His qualities soon became apparent and the following year he was appointed Professor of Teratology at the Royal College of Surgeons, a post created for him with generous support from Action for the Crippled Child. He established links internationally and the improved understanding of the pathogenesis of deformity which emerged had a real impact on the management of this group of patients. He maintained his clinical work as a consultant in the Plastic and Jaw Injuries Centre at the Queen Victoria Hospital, East Grinstead, in Sussex.

Within the practical craft of surgery, he inspired lateral thinking and the need to question established practice. He encouraged his trainees to undertake research and for several their research projects led to the award of Hunterian Professorships of the Royal College of Surgeons while they were still trainees.

In 1977 he returned to the southern hemisphere as Professor and Chairman of the Department of Craniofacial Surgery in Adelaide. However, in 1979 he came back to England as Professor of Oral Surgery at the Royal Dental Hospital of London School of Dental Surgery. With the closure of the school in Leicester Square in 1983 he moved south of the river as Professor and Head of the Department of Oral and Maxillofacial Surgery at the United Medical and Dental Schools of Guy's and St Thomas' Hospitals.

His contributions to the scientific literature were prolific and honours were showered upon him. He served variously as President of the Section of Odontology of the Royal Society of Medicine and of the British Association of Oral and Maxillofacial Surgeons, and, from 1983 to 1989, as Secretary General of the International Association of Oral and Maxillofacial Surgeons. He gained particular pleasure from his election as a Trustee of the Hunterian Collection at the Royal College of Surgeons in 1994; it was fitting that he should become guardian of this great scientific collection, put together in the 18th century by John Hunter, the father of scientific surgery.

With his depth and breadth of experience, and ability not to beat about the bush, Poswillo was in demand for government committees. He was chairman of three Department of Health projects in the 1990s - the Working Party on Anaesthesia, Sedation and Resuscitation in Dentistry, the Committee on Dental and Surgical Materials and the Scientific Committee on Smoking and Health. The "Poswillo Report" of the first, in 1990, represented a watershed in the improvement of safety in the way dental treatment was provided in Britain. Many units set up in the wake of the resulting reforms bear his name.

He held executive and advisory positions in many bodies with diverse remits including the management of craniofacial anomalies; injuries in the unborn child; toxicity of chemicals in food, consumer products and the environment; adverse drug reactions and environmental health. He was an executive member of the World Health Organisation Human Task Force.

A practising surgeon of ability and compassion, an inspirational teacher, an innovative scientist contributing to the furtherance of knowledge in so many fields, a driving professional leader, David Poswillo was a great humanitarian and an effective advocate for patients. It was only in the last few years that his extraordinary energy and intellect started to slow up due to failing health. The death last year of his beloved wife, Elizabeth, was a major blow to him.

David Barnard

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