A missing tooth can be esthetic? You must be thinking, “Did I read that correctly?” Well, what I mean by this is a replacement for a missing tooth, now more than ever, can brighten your beautiful smile immensely. For those who are missing a tooth and want to get it replaced, you can rest assured that your new replacement tooth can look like a natural tooth.

Other than for appearance reasons, why is it important to replace a missing tooth? Because a tooth serves many purposes just by being there. Without a tooth there, the adjacent teeth may tip toward the open space, as there’s nothing to hold the teeth in place. Also, the tooth on the opposite jaw that bites against this missing tooth may appear to grow longer, toward the space. Finally, in replacing a tooth with a bridge or a dental implant, having a tooth replacement stimulates the underlying gums and/or bone to reduce the risk of the gums and bone receding.

Your New Beautiful Smile Will Look Natural

Why does today’s replacement for a missing tooth look more natural? Thanks to advances in cosmetic dental technology, there are many reasons for this. The first reason is the type of materials used for the restoration. Years ago, all crowns and bridges had metal foundations for increased strength. Instead of having to use a metal base under the crown or bridge, dentists today can use non-metallic porcelain as a long-lasting restorative material in most situations. Crowns and bridges with a metal base can appear to have a dark band around the gumline if not fabricated correctly. A non-metallic porcelain crown or bridge will not only allow the restoration to appear esthetic, but it will also continue to look natural even as it ages.

A second factor in a natural-looking replacement for a missing tooth, has to do with periodontal (gum) esthetics. Whether it is with a bridge or dental implant, the gums must be first prepared in achieving an optimal normal appearance. When the gums are not esthetically prepared, it is difficult to have a false tooth appear natural. Gum sculpting is a minor procedure that maximizes the natural appearance of a false tooth.

Your Cosmetic Dentist May Choose a Dental Implant

Other than a bridge, a dental implant can replace missing teeth. What is a dental implant and what role does it play in a missing tooth? A dental implant is a titanium screw that is inserted into the jaw bone and sits below the gumline. A dental restoration, such as a single crown, bridge or denture is later placed on the implant for esthetic and functional purposes. The dental implant stabilizes the teeth, especially in the instance of a denture. If it weren’t for implants, a denture may develop a tendency to “rock” or become ill fitting with time. The implant also stimulates the bone surrounding it, to reduce the risk of bone recession. As for a single esthetic tooth replacement with an implant, a crown is the restoration of choice.

There are stringent guidelines for using an implant as an esthetic option in the anterior (front) region. Because of the irretrievable nature of implants, be sure to see dentists that are experienced in placing implants and restoring dental implants. If placed incorrectly, not only will the result appear very unesthetic, it may be extremely difficult to correct.

So take advantage of modern cosmetic dentistry and implant dental technology and fill that space with a natural looking restoration. Regardless of whether you choose to replace a missing tooth with only a bridge or an implant, the end result is beneficial to your dental health and in making your smile beautiful.

Dr. Wynn Okuda is an award winning international leader in cosmetic dentistry. He is one of only 280 dentists in the world to be accredited by the American Academy of Cosmetic Dentistry (AACD). Dr. Okuda turned the dental profession on its head nearly a decade ago , replacing pain, fear, & discomfort with the Dental Day Spa system. His offices for cosmetic, restorative and implant dentistry are located in Honolulu, Hawaii.

Dr. Okuda has been featured in the New York Times, Wall Street Journal, Reader’s Digest, American Spa, Shape Magazine, Better Homes & Garden, Health & Fitness Sports Magazine, New Woman, and dozens more!

Dr. Okuda is the founder of “Give Back a Smile,” a charitable foundation of the AACD which helps survivors of domestic violence throughout the nation to restore their smiles and lives. He has assembled nearly 1,000 cosmetic dentists nationwide to help fight against domestic violence.

Esthetic dental implants have been a part of restorative and cosmetic dental procedures for over 35 years. Through the years, the dental profession has seen incredible progress in all aspects of implants, from placement techniques to implant materials to longevity and esthetic outcome. Originally invented in Sweden, dental implants are made of ultra-strong titanium alloy and look like a large screw.

Dental implants are used to replace a single tooth, several teeth or a whole arch of teeth. Implants not only stabilize the restoration that sits on it, but also stimulates bone growth around the implant. If a tooth is missing, the gums and bone it was attached to are no longer stimulated by the blood supply and activity of that tooth. Therefore, with the tooth gone, the surrounding bone and gums may resorb or melt away. Furthermore, the opposing tooth (on the opposite jaw) no longer has something to bite against, and may grow towards the missing tooth’s space.

Technology Makes it Easier to Get a Smile Makeover

For implant placement, the diagnostic information provided by the two-dimensional x-ray or radiograph used is limited. Critical questions which need to be answered prior to surgery include if there was enough bone level to place an implant, the location an implant could be placed, positions of the sinuses, location of nerves and other important aspects. More recently, the CT or computed tomography scan tremendously improves the diagnostic abilities of the implant dentist by providing more detailed information needed not only during the initial diagnostic phases, but also during the actual surgery.

CT scans assist in lowering risks of irreversible nerve damage and developing predictable success in attaining the best outcome for most situations. This is especially true if there is question if adequate bone is present in a site with a missing tooth or teeth.

Implants are placed during a surgical procedure, directly in the jawbone. The number of implants required depends on each person’s individual situation. The surgical site with the implants are then left (under the gums) to allow the bone to grow around the implant and “osseo-integrate”. Four to six months after the first surgery, the implant is uncovered from under the gums. An “abutment” or implant post is then connected to it, and the gums are given time to heal around this abutment. About a month later, a final tooth restoration is custom-made to fit onto the abutment. This final restoration could be a crown, bridge or denture. Thanks to advances in cosmetic dental technology in materials, the final restorations look more natural.

A second factor in natural-looking restorations has to do with periodontal (gum) esthetics. In the placement of a dental implant, the gums must first be prepared in achieving an optimal normal appearance. When the gums are not esthetically sculpted, it is difficult to attain a natural result. Gum sculpting is a cosmetic dental procedure that maximizes the natural appearance around a restored implant tooth.

Implants can ensure a healthy diet is maintained. Before implants, people with dentures (a full arch of false, removable teeth) or partials (several false, removable teeth) had no options when they were unable to get a firm, strong bite on food. Nutrition and overall health is highly dependent on a person’s ability to chew a variety of foods. A person may shy away from certain foods either because certain teeth are missing, their teeth don’t meet each other (occlude) properly, or there is not enough force due to slippage of a denture. For example, the inability to chew foods with a firmer consistency may lead a person to eat more unhealthy foods like french fries instead of fresh vegetables. It is challenging to eat a balanced diet of only softer foods.

Most Patients are Pain Free Once They’ve Healed From Cosmetic Surgery

There seems to be a common misconception that implants will continually hurt as long as they are in. The fact is that this is not the case if the implant is properly placed and heals correctly. Naturally, there is some discomfort immediately after surgery. However, advancements in medication for dentistry can address the pain. As the site quickly heals, post surgical pain subsides.

How long a implant can last is reliant on many factors. Although no restoration in dentistry is guaranteed to last forever, dental implants could last ten to fifteen years, or more, depending on how well the implant is cared for professionally and at home.

Dental implants may sound too good to be true, but unfortunately not everyone is a good candidate for implants. According to the Academy of General Dentistry, each patient must: (1) Have a comprehensive exam to determine if they are a candidate, (2) Be in good health, (3) Have healthy gums, (4) Have adequate bone structure, (5) Have excellent oral hygiene habits, such as brushing and flossing, (6) Maintain regular dental visits.

We live in such a great era of cosmetic dentistry where people are able to benefit incredibly from technology in implant dentistry. Combining cosmetic dental procedures with implant dentistry allow people to have implants in the most visible area of their smile and have it look natural. Implants offer bone and gum stimulation, and stability to restorations which lets people eat to their heart’s desire. Although there is no exact replacement to a healthy, natural tooth, dental implants that are assisted with the latest in CT scans allow dental professionals to give their patients one more reason to smile.

Dr. Wynn Okuda is an award winning international leader in cosmetic dentistry. He is one of only 280 dentists in the world to be accredited by the American Academy of Cosmetic Dentistry. Dr. Okuda turned the dental profession on it’s head nearly a decade ago , replacing pain, fear, & discomfort with the Dental Day Spa system. His offices for cosmetic, restorative and implant dentistry are located in Honolulu, Hawaii.

Dr. Okuda has been featured in the New York Times, Wall Street Journal, Reader’s Digest, American Spa, Shape Magazine, Better Homes & Garden, Health & Fitness Sports Magazine, New Woman, and dozens more!

Dr. Okuda is the founder of “Give Back a Smile”, a charitable foundation of the A.A.C.D. which helps survivors of domestic violence throughout the nation to restore their smiles and lives. He has assembled nearly 1,000 cosmetic dentists nationwide to help fight against domestic violence.

There is a situation that some people choose to ignore, and have done so for many years. It’s the “neglected” smile. There are some people who have not seen a dentist for 5, 10, 15 or more years. I know many of you (in jest) are wishing you could say the same, however the serious reality is that professional and personal dental neglect is extremely detrimental to your oral health.  But you can still have a beautiful smile!

There are many reasons why a smile may have been neglected. It could be as simple as that your dentist retired and another one wasn’t found yet. Or maybe as complex as deep-seated dental fears and anxiety that makes going to the dentist the absolute, and I mean absolute, last priority. Or perhaps there are other urgent things going on, such as major health issues or taking care of a loved one. Regardless of the reason, after years of not seeing a dental professional, it may be very difficult to take steps to start seeing the dentist again.

Remake Your Neglected Smile – You Can Have a Wonderful, Bright Smile

So if you are someone who hasn’t been to the dentist in a very long time, keep in mind that your oral health is always in your hands. Whether the last time you saw a dentist was six months or six years ago, it does no good to just spend time fretting about the unfortunate state of your teeth. The main thing to focus on is what you’re going to do today to get your smile back in shape. Once you make the decision to have dental health become a priority, you have overcome the biggest obstacle.

If you do not visit the dentist and hygienist regularly for examinations and cleanings, you have a greater chance of losing teeth to periodontal (gum) disease. Periodontal disease still remains the major cause of adult tooth loss and affects about 75% of Americans throughout their lifetime. Periodontal disease is a “silent disease” as its warning signs may be subtle. With gum disease when you first feel discomfort or pain it may already be too late to save your teeth. It starts with plaque, which is a sticky, colorless layer of bacteria that forms on your teeth. If not removed thoroughly each day by your brushing and flossing, it hardens into tartar or calculus, which irritates the gums and will eventually lead to irreversible damage to the gums and underlying bone.

In addition to being at risk for periodontal disease, people who don’t regularly visit the dentist are more likely to develop advanced tooth decay. When a cavity first forms, it affects only the enamel or hardest surface of the tooth. If the decay is treated and repaired with a restoration, it will help to stop further damage to the tooth from that entry point. However, left untreated, bacteria would continue to feed on the tooth, which may damage the tooth pulp. Once there is exposure of the pulp, which houses the nerves, the tooth can be saved only through root canal therapy and an extensive tooth restorative procedure. Furthermore, by not visiting the dentist regularly, other essential examinations cannot be performed, such as an oral cancer screening.

There are many other negative aspects of having neglected teeth. Patients who finally decide to seek dental treatment tell me that their neglected smile affected their social life and professional life. They claim their visibly damaged smile forced them to not smile or not say anything to avoid embarrassment and attention to their teeth. They talk about settling to live with pain, discomfort and sensitivity. Also they would limit what they ate to softer foods, because of the discomfort of chewing.

The positives of curing the neglected smile are numerous. Starting to take steps towards a healthy smile today means increasing the chances of saving as many teeth as possible. Beyond that, patients who have undergone extensive cosmetic and restorative dental procedures not only say they regained their self-confidence socially, they feel they are able to dynamically do better professionally. All of these people also mention they regret not fixing their smile long ago.

Overcome Fear by Taking in the Dental Day Spa

So start now – there’s no reason to wait any longer. It’s time to start over on the road to optimal dental health. If you need to find a dentist, start by talking to family, friends and co-workers about their dentists. Think about what you want from a dentist and match it to the needs of those you’re talking with. For example, if it’s dental anxiety that keeps you away from the dentist, keep in mind that new approaches such as massage therapy and other spa pamperings help to counteract a lot of the problems of dental fear. Remember, if someone says they also haven’t been to a dentist in years, that’s not justification for you to stop your pursuit of good dental health. Keep on asking around.

When you do go to your first appointment, take a friend or family member if it gives you assurance, or would help you to make sure you go to the appointment. You should be able to tell the dental staff your concerns about dental treatment. If they don’t know, they can’t take measures to address them or make you feel more relaxed.

It’s never easy to leave your comfort zone, regardless of where that zone is. To take that first step, you have to make a decision that this is what’s important for you. Only then can you continue on your path, step by step, to a healthier smile!

Dr. Wynn Okuda is an award winning international leader in cosmetic dentistry. He is one of only 280 dentists in the world to be accredited by the American Academy of Cosmetic Dentistry (AACD). Dr. Okuda turned the dental profession on its head nearly a decade ago , replacing pain, fear, & discomfort with the Dental Day Spa system. His offices for cosmetic, restorative and implant dentistry are located in Honolulu, Hawaii.

Dr. Okuda has been featured in the New York Times, Wall Street Journal, Reader’s Digest, American Spa, Shape Magazine, Better Homes & Garden, Health & Fitness Sports Magazine, New Woman, and dozens more!

Dr. Okuda is the founder of “Give Back A Smile,” a charitable foundation of the AACD, which helps survivors of domestic violence throughout the nation to restore their smiles and lives. He has assembled nearly 1,000 cosmetic dentists nationwide to help fight against domestic violence.

It seems that the popularity of teeth whitening and bleaching continues to grow.  And with that, so does the number of toothpastes, gels and procedures available to the public that claim to whiten their dark, yellow or stained teeth.  Some products may work fine.  However, some products can leave a person in a worse situation than before they started using them.  Unwanted side effects may include accelerated gum disease, or having teeth of mismatched colors.  Don’t fall victim to using the product that is merely the most convenient to obtain.  Asking your dentist about what is the best whitener for you may save you money, time and heartache.

WHAT CAUSES TEETH TO DARKEN?

Several factors may cause our teeth to discolor through the years.  The red wines, coffee, tea and cola we drink expose our teeth to staining liquids.  Although they only affect the surface at first, through the years this stain becomes a part of the tooth.  Smokers also have an additional attack on their teeth from tobacco.

Even if we stay away from dark beverages and smoking, there are other reasons why teeth darken.  For one, the tooth may simply yellow with age.  Other people may have discolored teeth from the start, caused by medications taken by them or their expectant mother years ago.  Finally, if the tooth is injured either by impact or decay reaching the pulp, it may cause a grayish or brownish appearance that originates in the middle of the tooth.

PROS AND CONS OF OVER-THE-COUNTER TEETH WHITENERS

Is teeth bleaching the solution for all these situations?  The television infomercials, products in the drugstore and advertisements sure make it seem that way.  They promise whiter teeth in days or sooner, no matter what.  But what should you really believe?  On the one hand, people want a product that is inexpensive and easy to access.  But on the other hand, people also want a product that works and won’t harm them.

Quite a few dental whitening products in the drugstore only affect the surface of the tooth.  These pastes work on the outside layer of the tooth with a mild abrasive, to remove a minimal amount of stain built up by coffee drinking and smoking.  Some people complain about tooth sensitivity after using toothpaste like this for a period of time.  Frankly, a professional cleaning by a dental hygienist would be more effective, and it also addresses optimizing dental health by removing calculus and tartar.

Other dental whitening products may be harmful to the gums and other soft tissue of the mouth.  “One-size-fits-all” bleaching trays may not fit well, and therefore force large amounts of bleaching gel against gums for hours.  In some people this may cause mild irritation; in others with certain dental conditions such as gum disease, this may accelerate the disease process.  Through a comprehensive oral exam and evaluation of x-rays, your dentist can tell you if it is safe for you to bleach.

TEETH WHITENING WITH A DENTIST-APPROVED BLEACHING SYSTEM

So let’s say you do commit yourself to a dentist-approved bleaching system and are all set to go.  There are two ways for dentists to assist you with bleaching.  As the name suggests, “in-office” bleaching takes place in the dental office.  A gentle bleaching gel is placed on your teeth, and a light source is applied.  Depending on the lightening you want to attain, this procedure may achieve your desired lighter shade in one appointment.  Sometimes one appointment is not enough, and a follow-up appointment may be needed.

“Home bleaching” takes place outside the dental office, either while you sleep or at your leisure.  A custom-fitted, clear plastic tray is made in the dental office.  Again, a gentle bleaching gel is placed in the tray, and the tray is fitted snugly over your upper or lower teeth.  Optimal results are usually achieved in about 10 days of use.  Both these types of procedures allow flexibility and control over the whiteness you achieve.

NOT EVERYONE IS A CANDIDATE FOR TEETH BLEACHING

But wait!  There’s still a major question left:  Will teeth bleaching address your specific dental needs?  The answer is:  It depends.

Although dentist-prescribed bleaching is a safe and simple way to whiten teeth, unfortunately not everyone is an eligible candidate for this procedure.  Basically, the bleaching gels are able to address the outer layer of the tooth.  However, if the stains are very dark and deep in the teeth, bleaching is not the answer.

The ideal dental situation for bleaching is someone with no fillings or restorations in the front of the mouth, straight teeth, and yellowing or darkening of the teeth mainly due to years of drinking red wine, cola, coffee and tea.  Staining due to medications such as tetracycline or injuries is not likely to be benefited by bleaching on a long-term basis, as the stain is too deep within the tooth.  In addition, because of extreme sensitivity and/or other conditions of the gums, certain patients are unable to bleach their teeth.

ASK YOUR DENTIST ABOUT OTHER AVAILABLE OPTIONS TO ACHIEVE A BRIGHT SMILE

However, don’t be disappointed if you are not a good candidate for bleaching.  There are many other ways to cosmetically give you the bright smile you’ve always wanted.  Ask your cosmetic dentist what your options are.

It’s important to remember that every person’s dental situation is unique.  The infomercials, other advertisements, and numerous dental products at the drugstore attempt to offer one cure for countless cosmetic dental problems.  By talking with your dental professional and not taking the easy shortcut, you will be assured of safe teeth whitening and won’t spend unnecessary money on products that won’t work for you.

Look in the mirror…and give yourself a big smile.  Are you happy with the smile looking back at you?  How much does it matter?  According to the American Academy of Cosmetic Dentistry (AACD), 90 percent of Americans agree that an attractive smile is an important social asset.  Seventy-five percent agree that an unattractive smile can hurt a person’s chances for career success.  However, only 50 percent of Americans are satisfied with their smile.

THE POSITIVE ASPECTS OF A SMILE

Why does a smile say so much?  Mainly because it’s in a central, very noticeable position of one’s face.  It’s also one of our key sources of non-verbal communication.  A smile conveys a powerful range of emotion to others, from acceptance to confidence, to greeting to happiness.  Many experts state that a smile, or lack of one, can make a significant difference in our professional and personal lives.  Barbara Walters once said, “There are few times in our life when it isn’t too melodramatic to say that your destiny hangs on the impression you make.”  According to Maui resident and lecturer Sam Horn in her book Concrete Confidence, smiling is essential in creating a solid first impression, and in putting yourself and others at ease in that first five minutes of an interaction.  She writes, “The very first step to establishing a positive response in another person is to flash them a genuine, heartfelt smile….  Simply said, it’s hard to dislike someone who smiles at you.  A smile sets up a reciprocal reaction.  Recipients almost involuntarily smile back.”

She continues that, just as in one-on-one interactions, smiling makes a striking difference for public speaking.  Especially for beginners, if a speaker is preoccupied with their fears, they often greet their audience with a stern look and launch into their speech.  The effect is appearing unfriendly and harsh.  If a big, warm smile is the initial greeting, they appear friendly and establish immediate rapport.  “A smile can raise the mood and increase the receptivity of those within its perimeter.”

Sam Horn also writes that another important factor in a good first impression is eye contact.  In fact, research has shown that people who pair a smile with eye contact are more successful in their interactions with others than those who do not smile.  Smiling people are in general perceived to be more trustworthy and can often be more persuasive, whether in a business or social setting.

So fundamental is a smile in our society that our nation expressed heartfelt sympathy several years ago when we heard through the media about seven-year-old Chelsey Thomas of California who could not smile.  She was born with Moebius Syndrome, which is a rare disorder where the nerves and muscles do not permit facial expression.  Can you imagine a life where you could not express your joy or happiness with a smile?  Can you imagine a life where people assume you’re mad all the time?  We all thought it was horrendous.  Gladly, we were able to all breathe with relief when she could be helped with corrective surgeries.

SMILING IS GOOD FOR YOU!

According to an article in Men’s Health magazine, there are a multitude of other reasons why you should smile.  This article states, “If there has ever been a simple strategy for improving the quality of life, it’s smiling.”  As a benefit to yourself, smiling can make you feel good.  Certainly we smile when we’re happy, but did you know that you feel happier when you make yourself smile?  Smiling produces positive feelings and changes your emotional state for the better.  So instead of waiting for the effect to cause you to smile, initiate the effect yourself: show your aloha and smile.

A smile can also help bring about better health for you, as smiling reduces stress.  People under stress tend to have a lowered immune system, which may lead to illness.  So in addition to getting a flu shot, keep grinning.

EVEN MORE GOOD REASONS TO SMILE

As you probably know, other people make conclusions about you based on your smile.  What may surprise you is that it happens in all facets of life.  For example, people like to be around smiling people.  Your smiling tells others they are well regarded and will feel better about themselves.  In one survey, women rated smiling as the number one physical characteristic which initially attracted them to men.  A smile beat out other features, such as eyes and physique!  So never underestimate the power of a smile.

Another study showed smiling increased the perception of a person’s ability on the job.  While still another study concluded that when polling college students about punishing their peers, those who smiled in their photos tended to receive a more lenient punishment for college academic infractions than those who didn’t smile, regardless of guilt.  Now this is not to say that a dazzling smile can take the place of hard work in your career, or a huge grin can get you out of a speeding ticket, but you have to admit it is interesting to know what research does show.

THE LIFE-CHANGING POWER OF A SMILE MAKEOVER

So, does a smile have the power to change your life?  Absolutely.  You may want to take the challenge given by an article in American Salesman titled, “Experiment with a Smile.”  The author suggests that tomorrow when you start off your day, put a little smile on your face.  Not a big grin that will cause others to talk about you behind your back, but a pleasant crack of a smile, and keep it there.  The author hypothesizes that this exercise will have a magnificent effect.  “Problems you are having will vanish.  Your mind becomes attuned to positive high spirits.  The air will feel better to your face.  That smile will penetrate into your very heart and soul.  You cannot tune in goodwill and the friendship of others when you are broadcasting indifference.  It is surprising how people will notice you.  The smile has a magnetic power of attraction.  It even penetrates into the mind and consciousness of others.”  The author says to turn smiling into a habit, to do it all day, every day, and you will enjoy the benefits of your happy expression.

Someone once said, “A smile is a passport that will take you anywhere you want to go.”  I have seen great changes in patients after a smile makeover.  They went from being self-conscious of their smile to wanting to smile all the time; from being uncertain of themselves and their goals to feeling very confident and achievement-oriented.  Because of this, I am a firm believer in the power of the smile and the extraordinary effect on its owner.  So remember to wear your smile all day, every day, and see the gifts of happiness come back to you!

This is not your father’s dental office.

Within the last decade, the cosmetic dentistry profession has evolved at great speed.

At our office, art and science have merged to deliver a complete care package.  We don’t just fix broken crowns or do root canals – we enhance a person’s lifestyle and well-being.  Procedures range from simple teeth bleaching to porcelain veneers to complex full-mouth reconstruction.  They address a patient’s desire to close gaps or straighten teeth, have a brighter smile, replace missing teeth or aged restorations, or have a more youthful, natural or elegant looking smile.

THE IMPORTANCE OF A HEALTHY AND ATTRACTIVE SMILE

According to the American Academy of Cosmetic Dentistry (AACD), virtually all Americans (99.7 percent) believe a smile is an important social asset, while 96 percent of adults believe an attractive smile makes a person more appealing to members of the opposite sex.  Three-quarters (74 percent) of adults feel an unattractive smile can hurt a person’s chances for career success.

The demand for cosmetic dentistry has increased as the public becomes more educated about the power of healthy teeth and an attractive smile.  Within the last five years, teeth bleaching procedures have increased 300 percent and porcelain veneer procedures have increased 250 percent.

It is of the utmost importance to my staff and me to be at the forefront of this evolution, and to help transform the way people perceive the dental profession.

IMPROVING THE QUALITY OF THE DENTAL EXPERIENCE FOR PATIENTS

After some pretty horrifying experiences at the dentist’s office as a child – I can remember one instance where I actually ran and hid in terror – I decided in the seventh grade that I wanted to become a new kind of dentist.  I was determined to heal the anxiety and fear many people associate with dental work.

And, I have always had a love for art.  Several years into my dental career I realized there is a connection between art and dentistry.  Cosmetic Dentistry has been a natural fit for me in blending my two interests.

Over the next several years, we began exploring ways to further improve the dental experience.  As stated in a Wall Street Journal article, we helped to pioneer the Spa Dentistry concept which has become a popular trend throughout the world.  The Dental Day Spa helps those with high dental anxiety to have dentistry done in a safe and comfortable environment.  We pamper patients with massage therapy, aroma- and audio-therapy, aesthetician services, movies during dental treatment, catered lunches, computer access to the Internet and e-mail, even limousine service, to create a “WOW” experience.  The concept is becoming more popular today as practitioners realize the patient’s need to relax and feel comfortable while having dental procedures.

PATIENTS ALSO BENEFIT FROM STATE-OF-THE-ART DENTAL TECHNOLOGY

However, it’s also extremely important that we focus daily on maintaining the highest credentials, education and training possible.  As the dental profession grows, this should be Priority #1 for anyone seeking cosmetic dentistry services as well.  I am proud to be the first AACD Board Accredited cosmetic dentist on Oahu.  I spend a significant amount of time lecturing for dental associations and universities nationally and around the world (in Japan, Australia and Singapore, among others), and writing articles for dental trade publications to continue to share my knowledge with other dental professionals.

Not only does this help others in the field, but it helps us to keep our practice at the forefront of global technology, letting us employ world-class knowledge right here in Honolulu (for instance, we unveiled some of the latest technology from Australia).  Maintaining a global network has also allowed me to influence product development.  As an example, we worked with a manufacturer in Japan to develop bleach specifically for sensitive teeth, making the popular procedure available to many more people.

Like any profession, the cosmetic dental industry faces challenges.  One challenge is the word “cosmetic.”  It can mistakenly imply “all fluff and no substance.”  In actuality, people are either born with or acquire cosmetic dental problems as they go through life, and many of these problems are serious enough to affect health, bite, mouth comfort or self-esteem.  That in turn can interfere with career success, relationships and enjoyment of life.

In consideration of this challenge, it may be more accurate to use the terms “dental rejuvenation” or “restorative dentistry.”  With the tremendous technology employed in cosmetic dental procedures, facial rejuvenation can be achieved in making a person look 10 years younger in as little as two visits.  The end result to cosmetic dentistry, when done correctly, can be extremely natural and long lasting.  We balance health, science, function and esthetics, treating the whole patient so they can live their best life.  I believe this is a good formula for long-term success.

STRIVING FOR EXCELLENT QUALITY DENTISTRY WHILE PROVIDING A POSITIVE DENTAL EXPERIENCE

Every day I’m thrilled by the feedback my patients give us, which further inspires me to strive for excellent quality dentistry while creating a positive experience for patients.  We’ve had patients who haven’t been to a dentist in decades because of their anxiety, and we’ve been able to successfully and comfortably treat them, changing their whole outlook on dental care.  Just recently after a procedure, I asked a patient how it went for her.  She was so comfortable she had fallen asleep!  That’s really validating for me.

I have a vested interest in maintaining impeccable standards in cosmetic dentistry.  One of the most effective tools is public education.  The more people know, the better equipped they are to seek out and demand excellence.  I advise anyone interested in having cosmetic dental work done to first ask friends, relatives and co-workers for recommendations.  Research credentials and accreditation online.  Make an appointment for a consultation before any work is done.  Look at Before and After photos of work personally done by the dentist.

This sets the stage for Patient and Dentist to work together for the best possible results.  That’s the essence of good dentistry.

So there you are, minding your own business and drinking your usual, a Grande Mocha Decaf Iced Frappuccino.  Then all of a sudden, “Ouch!”  Your tooth feels really sensitive.  So you drink and chew on the other side of your mouth, hoping the sensitivity doesn’t return.  What does this mean?  Should you call your dentist?  Should you just get toothpaste for sensitivity and consider yourself healed?

The Academy of General Dentistry (AGD) states that sensitive teeth are one of the most common complaints at the dental office, and at least 45 million adults suffer at some time from it.  A tooth is normally protected from sensitivity by a layer of hard enamel on its surface, or by gums over its root.  Tooth sensitivity occurs when the enamel is worn away or gums recede, causing the dentin to be exposed.  The microscopic, nerve-filled tube-like structures within each tooth (“tubules”) are exposed to temperature and air, and a feeling of sensitivity results.

Tooth sensitivity may occur when your teeth come in contact with cold, hot, sweet or sour substances.  In addition, pain when chewing, tooth brushing, or even sensitivity to breathing air may have more underlying causes that can be problematic.  Many people try their best to ignore this sensitivity, and just chew on the opposite side.  It’s important to let your dentist know of these symptoms so he or she may assess your situation and prevent a potential problem from becoming progressively worse.

POSSIBLE CAUSES FOR TEETH TO BECOME SENSITIVE

There are various reasons why a tooth feels sensitive.  One cause of tooth sensitivity may be due to vigorous tooth brushing.  Using a hard bristled brush or applying too much pressure when brushing may result in the gradual wearing down of tooth enamel.  Always use a soft bristled brush.  Save the hard bristled ones for scrubbing the sink.  Use gentle pressure and circular movements on your teeth.  Furthermore, although tartar control toothpaste may work well for some, it may be too abrasive for others.  Talk with your dentist or hygienist about your special needs.

Another cause of sensitivity could be a tooth fracture or crack, or even a fracture or crack in a restoration.  Sensitivity could also be a sign that a cavity has developed.  In addition, gum disease or bite-related problems may cause your gums to recede and expose the root surface.  In these situations, various dental procedures such as a restoration (filling or a crown), may be needed to correct the problem.

In addition, with an increase of stress in our daily lives, there has been an increase in “bruxism,” or the grinding of teeth.  Teeth grinding over a period of time can cause the wearing away of enamel on the biting surfaces of teeth.  When bruxism occurs during sleep, a person is unaware of the damage that is chronically occurring night after night.  After prolonged grinding, this may lead to severe pain in all affected teeth.  For these situations, your dentist may recommend a preventive approach to correcting these problems.

SOME SOLUTIONS THAT CAN HELP RELIEVE TEETH SENSITIVITY

One solution may include the use of a “bite splint” or a “nightguard.”  This can be similar to the mouth guards that athletes wear when playing contact sports.  This custom-made acrylic resin guard is used as a shield between the upper and lower teeth.  Therefore, as you grind your teeth in your sleep, this bite splint will help protect your teeth.  This is especially important to wear when delicate restorations, such as veneers, are present.

Finally, toothpastes for sensitive teeth may help to relieve the pain, but are not the solution for everyone.  What toothpaste for sensitive teeth does is coat the exposed dentin tubules to minimize its nerve exposure.  Another solution your dentist may suggest is an in-office treatment, such as a desensitizing gel to apply to your teeth.

TALK WITH YOUR DENTIST OR HYGIENIST ABOUT TREATMENT OPTIONS

So the next time you’re drinking that Frappuccino and your teeth feel sensitive, don’t just turn the other cheek!  It’s wise to mention your sensitivity to your dental hygienist or dentist, so they can determine exactly what’s going on and discuss with you the different treatment options available.  Many people just want to ignore tooth sensitivity; however, it’s always better to be informed and be proactive about your dental health.

WYNN H. OKUDA, DMD is a world renowned Cosmetic Dentist, board-accredited by the American Academy of Cosmetic Dentistry (AACD).  Dr. Wynn Okuda’s Dental Day Spa of Hawaii provides outstanding esthetic and implant dentistry to patients in a relaxed, spa setting.  Here he answers your questions regarding the latest cosmetic dental procedures and their impact on people’s lives.

QUESTION:  ARE MEN SPENDING MORE TIME IN YOUR DENTAL CHAIR THAN WOMEN?

DR. OKUDA:  I would say at least equal time in the dental chair. Men in my practice are working high stress jobs and these stresses are taking its toll on their teeth.  One issue that men have is they feel their teeth are getting smaller and looking older.  As teeth age they get darker and the more stress, the more grinding and clenching, causing the shortening of teeth.  Porcelain veneers fixes this issue for a close to perfect smile.

QUESTION:  WHAT DO WOMEN REQUEST MOST WHEN THEY SCHEDULE A CONSULTATION WITH YOU?

DR. OKUDA:  Most women want their smile to look rejuvenated. Having a youthful smile creates a youthful appearance.  Oftentimes, patients who thought they wanted a facelift come in and restore their smiles, then realize they no longer need the facelift.  Smile rejuvenation makes you look and feel younger…doesn’t everyone want that?

QUESTION:  HOW IS IT POSSIBLE TO COMPLETE A FULL MOUTH RESTORATION IN JUST 2 DAYS?

DR. OKUDA:  I created the Accelerated Cosmetic Treatment (ACT). In today’s hectic world, patients are too busy to be coming back and forth to the dentist, month after month. My ACT process allows me to provide long lasting, healthy results in as little as 2 visits.  It’s like winding the clock back to a time when your teeth looked and felt a lot younger.  This technique not only gives you a great smile, but also gives you health and function.

QUESTION:  WHY WOULD A PERSON NEED A FULL MOUTH RECONSTRUCTION?

DR. OKUDA:  Both men and women are much harder on their teeth today than they were 30 years ago.  We are also living longer now and our lifestyles are outliving our teeth.  We need to rejuvenate our mouths so we can have healthy teeth throughout our lifetime.  Removing decay and rebuilding the tooth structure to a more youthful appearance is key to having a happy and healthy retirement.

QUESTION:  HOW DO YOU SEE YOUR PATIENTS’ LIVES CHANGED AFTER YOUR PROCEDURES?

DR. OKUDA:  It’s an amazing transformation that occurs in the first all-day visit.  Immediately patients can see what their permanent teeth will look like.  The physical changes to their face and smile are very dramatic but more importantly, as their inner smile begins to show through, patients lead a fuller, happier, and more successful life.

Network television programs such as “Extreme Makeover” and “The Swan” have brought into the general public’s eye various dental-related problems that cosmetic dentists can address. The viewing audience is always so amazed at the changes even just the smile can make to the person’s overall appearance.

In talking with my friend and colleague Dr. Bill Dorfman, the cosmetic dentist for the ABC Television Show “Extreme Makeover”, we agree that one of the great outcomes of these television programs is the awareness raised of different possibilities in cosmetic dentistry and cosmetic surgery. Increased awareness means that people are empowered with updated information on what can be done, and therefore can ask better questions and make better informed decisions for themselves. Because of these programs I often am asked related questions about what is possible in cosmetic dentistry.

Your Smile Can Be Beautiful

I know it sounds like candy a child would buy at a crack seed store, but what I am referring to as the “gummy smile” is when a disproportionate amount of gums show when a person laughs or smiles when comparing gums and teeth. The result is a smile that seems to resemble one of a young child. And although many people want a youthful smile, having one of a 10-year-old is not what anyone has in mind. In the gummy smile, not only do the gums look too prominent, but also the teeth look too small, too square, or like baby teeth. In dental research and literature there is actually a mathematical ratio called “The Golden Proportion” which specifies what the proportion of gums to teeth should be (in consideration of the entire face) for optimal facial esthetics.

Generally the gummy smile is the result of genetics, which is to say you are predisposed to how much gums show when you smile. Normally, as permanent teeth emerge, gums are supposed to naturally pull back. For most people their gums will pull back to a level that looks normal, natural and esthetic. For others this normal gum process stops prematurely, leaving the tooth looking shorter than it should. Another situation that contributes to a gummy smile problem is when someone is born with an enlarged or long upper jaw. The excess bone creates a severe gummy appearance.

How Veneers Can Help Make Your Smile Beautiful

A gummy smile can be treated mainly in two ways. For less severe to moderate gum disproportion, the treatment is a gum-lift followed by porcelain veneers. A gum-lift is where excess gum tissue is artistically sculpted to a new more proportionate height. Gum tissue heals quickly, provided proper home care is done. Then porcelain veneers may be placed over to create a beautiful smile. Veneers serve to not only protect the newly exposed tooth surface, which may not have a complete enamel covering, but they can also change the shape, color and size of the tooth to match the patient’s face. Depending on the complexity and the amount of gum-sculpting needed to reduce the gumminess, slight bone removal may be recommended. A thorough examination and x-rays are required first to ensure a patient is a good candidate for a gum-lift.

For more severe disproportion, possible treatment may be the actual breaking and repositioning of the upper jaw. Healing time may be a minimum of six weeks, where the jaw is wired shut and nutrients are taken in liquid form. Due to the radical nature of this procedure, this remedy is not really appealing to most people. However, the gum-lift procedure has been successful in correcting many of these complex problems. This used to be the only way the gummy smile was addressed years ago. About 12 years ago a current patient of mine was told by a more conservative dentist that this jaw surgery was the only way to improve her gummy smile. She decided to not do it at the time as she thought the surgery was too invasive. Fortunately her waiting paid off, and she was pleased to have her smile corrected with the simpler gum-lift, teeth whitening and porcelain veneers just before her wedding.

There are situations when a person may have more than one dental-related problem occurring at the same time. For example, there was a patient that not only had a gummy smile and small-appearing teeth, but also had an asymmetrical muscle pull of the cheeks where more gums and teeth showed on one side when she smiled. The ideal remedy would have been to surgically address the cheek muscles for an even pull. However the patient was not interested in such a surgery. Still, a gum-lift and veneers helped significantly to balance the appearance of her lopsided smile.

Questions & Answers

(1) Q: Does a gum-lift affect the strength of a tooth?

A: No, it does not.

(2) Q: Does it hurt to have a gum-lift done?

A: First, it is performed under local anesthesia, so no pain is felt during the procedure. Within days the gums heal themselves, using a special home care regimen.

(3) Q: Do gums grow back?

A: In the vast majority of people, no, but there are rare occurrences where it does happen.

Finally, it is important to have a gum-lift done by a cosmetic dentist who routinely performs them. Because gum-sculpting is irreversible, it must be done correctly. As with anything in cosmetic dentistry, it’s important for the dentist to have an artistic eye when performing the gum-lift so the worst case scenario doesn’t happen where gums are sculpted crooked or too high. It’s best to ask a cosmetic dentist to show before and after photos of the actual dental procedures he or she has done.

Dentistry has come a long way in how the gummy smile can be treated. Patients are able to greatly benefit when a procedure can now be performed with a much simpler recovery than what was done in the past. And it’s rewarding for dental professionals also to provide more accessible opportunities that more people can take advantage of.

There seems to be a misconception floating around about dental restorations and the options available. Both my staff and I have met people who ask about these restorations. They say one reason they are apprehensive about having dental treatment is the severe amount of tooth removal during a dental restoration procedure. In particular they are referring to crowns. They say it makes them hesitate as they know that their tooth will be shaved down to a “peg” and they wonder if that’s necessary.

New Innovations in Cosmetic Dentistry Brings Brighter Smiles

Over the last few years dentistry has entered an exciting time for dental restorations, with continual new advances. A cosmetic and restorative dentist has various types of restorations they can utilize, depending on the patient’s specific need. In other words, the crown is not the only natural-colored restoration available. This means patients can now benefit from treatment that is as tooth conserving as possible, until the situation merits more invasive procedures. This contributes positively to a person’s long term dental health.

Does it matter if a more extensive restoration is placed, compared with a less extensive restoration? Definitely. For example, if you had a moderate-sized cavity on your tooth, wouldn’t it make sense to replace only that decayed and damaged area alone? Unfortunately, traditional dentistry does not necessarily allow for the least invasive procedures. On the other hand, the more conservative approach would be to remove the decay, prepare the tooth and place the smallest restoration possible. If eventually that same tooth were exposed to more decay, only then would more natural tooth be removed to eliminate the decay. Only in extreme situations, such as a severe, irreparable fracture or extensive bone loss, would a tooth perhaps need to be extracted. Therefore, the more conservative the approach taken now, the more options there are in the future.

Years ago, the crown or “cap” was the only option when there was a large amount of decay on a tooth or if a larger filling needed to be replaced. The crown offered protection for the tooth, as well as the ability to withstand the powerful biting forces of your jaws. Unfortunately, to prepare a tooth to be fitted for a crown, the tooth must be drilled down on all five sides of the tooth, whether or not there was decay or destruction. In other words, the mere design of a crown required this extensive removal, even of healthy, unaffected natural tooth. Furthermore, prior to the invention of state-of-the-art natural restorations, the only way to have the strength and durability required was to have the crown’s core be reinforced by metal.

The goal in preparing a tooth for a restoration has evolved from whittling a tooth down to a “nub” to saving as much of a person’s natural tooth as possible. Through extensive research, over the last several years materials were developed that offered everything needed in a tooth-colored restorative material: strength, durability, no use of metal, and color that mimics the natural beauty of teeth. This allows restorations that are less invasive to be used when the situation permits. These tooth conserving restorations include “inlays” and “onlays” for posterior (back) teeth, and porcelain “veneers” for anterior (front) teeth. These restorations require precise laboratory fabrication. Certainly, crowns are still prescribed when the tooth destruction is severe. The state-of-the-art process of placement or “bonding” (curing) of these conservative restorations contribute to less tooth removal than crowns of years ago. Similar to these non-metallic materials, the materials now used for the traditional crowns also offer good strength and durability.

Why is it ideal to minimize natural tooth reduction? Of course, it’s best to keep as much of your own tooth structure, because the natural tooth is the optimal substance as far as strength, durability, and compatibility with surrounding gum and bone structure. Moreover, nothing can exactly replace the benefits of your natural teeth. When the dental professionals talk about the mission of keeping your teeth for life, this is where it all begins.

Minimize Tooth Decay to Keep Your Beautiful Smile

The primary objective is to minimize tooth decay and gum disease, and maintain good oral health. Preventive dental activities, such as brushing, flossing and professional cleanings and exams, play an important role. That’s why dental health education is strongly emphasized at your office visits. However, human nature and genetics also play a role in how your dental health will fare. This is where tailored regimens are prescribed to optimize each patient’s dental problems.

The secondary objective is to minimize natural tooth loss, once decay does set in. This philosophy of keeping as much of your healthy, natural teeth as possible will further ensure keeping teeth for a lifetime. For example, some people may think it’s an equal option to either extract a tooth or to have a root canal performed. However, by the simple existence of a natural tooth in the gums (even if the tooth had root canal therapy) stimulates the bone and gum growth necessary to maintain its healthy level. Without a tooth, the bone and gum level may drop, possibly affecting the bone and gum level of neighboring teeth. Also, the opposing tooth may drift and the adjacent teeth may tip into the empty position, which affects the way teeth come together when chewing. So what appears to some to be an equally satisfactory solution is in reality detrimental to a person’s dental health.

Thanks to advancements in dental technology, patients are now able to benefit from the range of restorations that minimize tooth removal according to each tooth’s specific needs. This in turn maximizes the preservation of natural tooth, to give everyone a fighting chance to keep their teeth for their lifetime.

Dr. Wynn Okuda is an award winning international leader in cosmetic dentistry. He is one of only 280 dentists in the world to be accredited by the American Academy of Cosmetic Dentistry (AACD). Dr. Okuda turned the dental profession on its head nearly a decade ago , replacing pain, fear, & discomfort with the Dental Day Spa system. His offices for cosmetic, restorative and implant dentistry are located in Honolulu, Hawaii.

Dr. Okuda has been featured in the New York Times, Wall Street Journal, Reader’s Digest, American Spa, Shape Magazine, Better Homes & Garden, Health & Fitness Sports Magazine, New Woman, and dozens more!

Dr. Okuda is the founder of “Give Back A Smile”, a charitable foundation of the AACD which helps survivors of domestic violence throughout the nation to restore their smiles and lives. He has assembled nearly 1,000 cosmetic dentists nationwide to help fight against domestic violence.