In the news we hear about osteoporosis and bone loss in our body. Indeed this disorder, which affects 28 million Americans, is a health concern as we all get older and live longer. What we hear about less often is the bone loss in your mouth. According to the Academy of General Dentistry (AGD), osteoporosis also increases risk factors for tooth loss, bone loss and periodontal (gum) disease. Even those without osteoporosis need to be aware of the issues of tooth loss, periodontal disease and its affect on the bone levels. It is important to preserve the oral bone levels we have now so that ideal dental health can be achieved over our lifetime.

Preventing Bone Loss Keeps Your Smile Bright

The bone in your jaw is the actual foundation to your teeth and gums, and therefore essential to having a healthy smile. Decreased levels of bone may lead to insufficient support for teeth, resulting in shifting, loose or mobile teeth. At a certain point these teeth may be unable to be saved and must be extracted. Furthermore, missing teeth or bone loss may have consequences that are more far reaching than the ability to chew and the look of your smile. It can also affect your overall facial appearance as significant bone loss in the mouth may leave a concavity on your face in that area.

Many factors affect oral bone levels. A tooth merely having its root embedded in the bone stimulates the growth of bone and keeps it at an optimal height. If a tooth is extracted the bone may heal at a lower or sunken level and may even continue to recede. If the surrounding gums are affected by periodontal or gum disease, that may eventually contribute to gum tissue and bone loss. According to the American Dental Association (ADA), after age 35 about three out of four adults are affected by some form of gum disease. Periodontitis or advanced gum disease is the number one reason adults lose teeth.

Misconceptions Regarding Tooth Loss

Sometimes misinformation may lead people to make dental choices that negatively affect their oral bone level. Some people seem to be under the impression that if their tooth requires root canal therapy due to an infected or dead pulp, they have a choice of either having the root canal therapy or having the tooth pulled. The two choices have drastically different outcomes for your future dental health. A tooth which has had root canal therapy is still able to stimulate the growth of bone around the root; the result of a tooth extraction can lead to multiple tooth, gum and bone problems.

Another misconception is about the importance of their back teeth or molars. Some may decide they don’t have to take care of the back teeth or won’t miss them if they need to be extracted, as they can’t be seen as much as the front teeth. The molars function as the all-important chewing surfaces of our teeth, therefore absent molars may require a restriction to a softer food diet, which is undesirable to most people. In addition, as mentioned before, the bone in the area where teeth are missing may heal at a sunken level and continue to recede.

A third misconception is an ill-fitting denture can’t be fixed and must be accepted as is. There is a dangerous downward spiral linked to this belief. Maybe someone’s denture is not fitting as well for whatever reason, but they decide not to go back to their dentist to have it addressed. This poorly fitting denture will often accelerate bone loss leading to an even more poorly fitting denture and decreased bone heights.

Advances in Dentistry Help Keep Your Smile Beautiful

Fortunately, advances in restorative dentistry continue to address bone preservation. Dental implants over the past decades have revolutionized dentistry. Years ago restorations for missing teeth were limited because there was no method to anchor a crown or denture. Dental implants are titanium alloy screws that are inserted directly in the bone, allowing an extremely stable foundation on which to place a crown, bridge or denture. The implant stimulates normal bone growth similar to a natural tooth. Keep in mind that although dental implants help preserve bone, they also initially require sufficient bone levels to be able to be placed.

Preserving bone in every area of the mouth is so important that there is now state-of-the-art procedure that should be performed with any tooth extraction to maintain bone levels. If you do need to have a tooth extracted due to a severe tooth fracture or another reason, a “bone graft” can be inserted in the place of the missing tooth. This bone graft may be from various sources such as human or synthetic bone. It allows the bone surrounding the extraction site to heal at the highest position. Otherwise there may be 30 to 40% additional loss with the bone healing in a sunken position. Over time, without any such treatment, the bone will tend to recede away from the gums.

If someone has extensive bone loss but still wants to have implants placed, there are bone replacement surgeries available. Some of these bone regeneration surgeries can be complex, invasive and expensive procedures where bone is obtained from a hip surgery by an orthopedic surgeon then grafted to the jaw bone and left to heal and grow. It is much easier and simpler to prevent bone loss in the first place.

If you have any dental concerns mentioned in this article, such as missing teeth or an ill-fitting denture, discuss them with your restorative dentist on a timely basis. Not doing anything puts you at a disadvantage, as you may miss treatment or preventive opportunities. Natural teeth and implants must be able to have a firm foundation in the bone. By taking steps to preserve the bone levels in your mouth, you are making great strides in preserving your smile for your 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!

“Sometimes your joy is the source of your smile, but sometimes your smile can be the source of your joy.” — Thich Nhat Hanh

You’re Beautiful When You Smile – Don’t Worry, Be Happy

I know we’ve all had days where things aren’t going right. Maybe we get a flat tire, or are running behind schedule all day, or forget to do something important. And then someone, maybe a cashier or someone in the elevator, unexpectedly brightens our day with their warm smile…. and the day doesn’t seem as bad. There’s something wonderful about a smile. We all value a smile to say so much more than words. A smile is optimism, hope, strength, warmth, positivity, beautiful. And more.

We show our appreciation of the smile in the celebrities, models, and actors we admire. Stars like Julia Roberts, Tom Cruise, Sandra Bullock, and Brad Pitt have smiles that radiate and light up rooms.

Our appreciation for smiles also carries over in the advertising corporations create. They know the importance of a smile, and want to be associated with it. McDonald’s says “We love to see you smile,” Little Debbie cakes say “Unwrap a smile,” and there’s a car commercial that shows smiles and kindness are contagious.

Your Beautiful Smile Conveys Many Emotions

So are smiles fundamental in our lives? Often my patients hear compliments on their smiles from strangers who will go out of their way to tell them, “What a great smile you have!” This further shows human appreciation for a nice smile. And obviously it’s not just any facial expression that’s appreciated, because I’ve never heard anyone comment to another, “That’s a great frown!” or “What a nice grimace!”

What if we choose not to smile at anyone, ever? Is that so horrible? Do you remember several years ago, a 5-year-old girl by the name of Lauren Deveney of Virginia who couldn’t smile due to a medical condition called Mobius syndrome? She was not able to smile nor blink because she was born without the active nerves needed to make facial expressions. It made national news because we all felt it would be a tragedy if this little girl was unable to show her happiness and pleasure to her family and to the world. And we were relieved when we learned that she could be helped through surgery.

Scientists probably felt relieved, too, as studies have shown that a smile is a two-way communication from yourself. A smile can convey confidence, acceptance, joy, and pleasure to another human. But what’s also true is when we make ourselves smile, we send a message to our brain to be happier, lighthearted. These positive emotions let us feel better about ourselves, and from what I’ve found through examples of my patients, do better in life.

A Beautiful Smile is Essential in Communicating with Others

This non-verbal communication is among the most essential in our daily lives. Did you know that we are able to detect a smile in another human from 300 feet away, which is about the distance of one football field! Hard to believe? Well, even though you may not be able to see broccoli in their teeth, you certainly are able to know a person is smiling from that far distance.

Our smiles do communicate so much. They can say without a word how much confidence we have in ourselves, our acceptance of someone else, our heartfelt appreciation of what others do for us, or our interest in dating someone. It’s such a pinnacle part of communication and extremely hard to think about life without a smile. Just imagine how much greater we’ll be able to perform at our professional lives because of smiling.

Is just any type of smile okay, or are some better than others? Apparently there are 18 different smiles which express emotions, from pure joy to mild amusement to beaming pride. Two smiles in particular look different to us, because of the emotion behind it. A natural, spontaneous, true smile of enjoyment shows from the sparkling of our eyes down to the flashing of our pearly whites. This is because the contraction of the Zygomaticus muscles run from our eyes, across our cheeks, to the corners of our mouths. Thus the old adage, “A sincere smile is visible in the eyes.”

Contrast this with a “conscious smile” or a false smile, where someone may not feel true gladness or joy, but needs to smile anyway. This smile may look similar in the lips and the teeth, but doesn’t quite reach the eyes. It may look slightly asymmetrical or lopsided, as the person is not truly glad to see you and just faking the smile. Perhaps this is the basis for the saying, “Never trust someone with a crooked smile.”

My Challenge to You

So keep this in mind as you smile at friends, co-workers, new acquaintances, prospective clients or dating partners. The warmth of your smile can be perceived by others, whether you think so or not.

I challenge you this month to see how many people you can make smile. Smiles are meant to be shared. Remember, you are given an unlimited supply of smiles, to last a lifetime. If you are unhappy with your smile, don’t despair as current cosmetic dental procedures can help you find even more reasons to smile. So smile beautifully and let’s spread Aloha around throughout the year! You really do have a beautiful smile! And remember, the beauty is not only in your smile, but also in you.

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.

When you go to see your physician or cosmetic dentist, it’s quite common to be asked which medications you are taking. I’m sure you’re used to writing down the prescription or other over-the-counter medications you regularly take. Did you know that you should also inform your physician or dentist about the herbal supplements you are taking? Many people feel that herbal supplements are as safe and non-threatening as a Flintstone Vitamin. However, especially if you are going to have surgery or another invasive procedure performed or if you take prescription medications, it’s important to tell your physician or dentist about them.

Herbal supplements include Echinacea, which people may take to prevent colds, Black Cohosh for post-menopausal symptoms, Feverfew to prevent migraines, Saw Palmetto for prostate health, Garlic for lowering blood pressure and cholesterol, Ginkgo for improving memory, St. John’s Wort for depression and so many more.

Why Tell Your Cosmetic Dentist?

Why is it that many patients do not disclose their taking herbal supplements? Because of the relative unproven effectiveness of herbal supplements compared with prescription or over-the-counter medications, some patients think their health professional may voice disapproval or question their actions. Other patients may think these supplements would not cause any harm nor affect their body like medications would. Still others may only take supplements occasionally, such as when they may be vulnerable to catching a cold.

Regardless of your perceptions, it’s important to inform your physician or dentist about these herbal supplements, and their dosage and frequency, for your optimal health. You may need to stop taking certain supplements from one to three weeks before surgery. For dental treatment, procedures include implant, oral and gum surgeries.

Some Herbals Don’t Mix Well with Cosmetic Surgery

According to the Mayo Clinic, these common herbal supplements can interfere with surgery:

Danshen – May cause bleeding.
Dong Quai – May cause bleeding.
Echinacea – May interfere with immune functioning, may alter effectiveness of immunosuppressant drugs given after transplant surgery.
Ephedra (ma huang) – May cause abnormal heartbeat, may cause extreme high blood pressure and coma if combined with certain anti-depressants and anesthesia.
Feverfew – May cause bleeding.
Garlic – May cause bleeding, may interfere with normal blood clotting.
Ginger – May cause bleeding.
Ginkgo – May cause bleeding.
Ginseng – May cause bleeding, may cause rapid heartbeat, may cause high blood pressure.
Goldenseal – May cause or worsen high blood pressure.
Kava – May increase sedative effects of anesthesia.
Licorice – May increase blood pressure.
Senna – May cause electrolyte imbalance.
St. John’s Wort – May increase or decrease the effects of some drugs used during and after surgery.
Valerian – May interfere with the effects of anesthesia.

The Mayo Clinic also recommends not mixing herbal supplements with prescription and over-the-counter medication. They advise caution in taking herbal supplements if any of the following types of medications are being used: Blood pressure medications, blood thinners (anti-coagulants, anti-platelet agents, non-steroidal anti-inflammatory drugs – NSAIDs – such as aspirin, ibuprofen or naproxen), diabetes medications, drugs that affect the liver, heart medications, monoamine oxidase inhibitors (MAOIs).

In addition, the Mayo Clinic lists herbal supplements that may cause harmful side effects if used with certain medications: Black Cohosh, Dong Quai, Ephedra, Feverfew, Garlic, Ginkgo, Ginseng, Goldenseal, Kava, Milk Thistle, Scotch Broom, St. John’s Wort.

Keep in mind that even though herbal supplements are labeled “natural,” they do have active ingredients that have the potential to cause complications after surgery or affect anesthesia, and may interact with other medications. Be sure to keep your health professional informed of which herbal supplements you take.

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.

Imagine walking through elegant French doors to find Impressionistic oil paintings, soothing music, calming colors, neo-Victorian design, open spaces, relaxing smells, beautiful floral arrangements, healing massages, an intriguing skydome, a quenching refreshment center, and entertaining movies.

If you had to guess, where would you say you were? A resort? An art gallery? A spa? How about a dental office? What?…how can that be?

Introducing the Dental Day Spa

You probably never thought you’d hear “Dental” and “Spa” in the same sentence unless it was, “I’d rather be at a spa than be at a dental appointment.” But that’s the past. Welcome to the 21st Century, where the spa IS the dental office, and where the boundaries of a spa and dental appointment become blurred.

I would like to hope the Dental Day Spa concept will be the future of dentistry. Having been a child who feared and hated dental appointments, I’ve always pursued solutions throughout my dental career that would make visits to the dentist more comfortable and relaxing. I already knew how things such as building trust, having a good relationship and providing effective communication formed the foundation of a great dental appointment for anxious patients. The next step was to bring together a superior product and Five-Star Service. But I suspected there was more that could be done.

It was while my dental practice was located in a previous office that I became aware of and researched the effects of environment and design on the anxious dental patient. I learned that such aspects as open spaces or wider corridors allowed people to feel at ease, although it may be subconscious to them. In contrast, narrow hallways and tighter spaces may lead to feelings of claustrophobia, being threatened or trapped. In addition, sounds such as falling water or soothing music have a calming effect. Color and pleasing sights also contribute to overall positive emotions. With the assistance of talented and experienced local architect Stan Hesse, the blending of high design and functionality resulted in the innovative Dental Day Spa.

Beautiful Smile Created in Beautiful Surroundings

If a dental office were created that didn’t look like a dental office, perhaps it could help to trick your mind that you were at a spa or resort and not seeing the dentist. The calming atmosphere would create a unique experience that was pleasing to the senses.

I took this concept even further by offering pampering services, such as full body massages and reflexology, which are definitely new to the dental office. The concept of melding product or service with atmosphere and emotion is not new. Starbucks is a prime example of this. Starbucks started in Seattle, Washington as a small coffee shop and retail outlet. It took an outsider who was inspired by coffee shops in Italy to marry a cup of coffee with conversation, comfort and community. The owners didn’t want to change their original idea. But progressive thinking prevailed, and now no matter where you go in the world, even in Japan, Singapore, and the Austin Powers movies, Starbucks is there bringing people together with regular, decaf or anyway you want it.

Why some people have phobias is usually a result of many factors, such as childhood experiences, reinforcement of fear by parents and the media, and ongoing experiences they feel are insensitive to their needs. Certain phobias, like the fear of heights or spiders, can be voluntarily avoided throughout one’s lifetime. But voluntarily avoiding dental care can lead to unfortunate consequences.

Keep Your Beautiful Smile by Keeping Your Dental Appointments

There are quite a few patients that completely avoid dental care because of fear and extreme anxiety. With environments and services changing to meet their concerns, they now have fewer reasons to avoid the dentist. They can finally find a dental office where they can feel comfortable and at home.

The main goal of helping people to have more comfortable, positive dental appointments is to assure optimal dental health for them now and through the years. If someone feels at ease about visiting the dental office, they will be more likely to stay current on their dental cleanings, examinations, and treatment. This is essential, as it is at these timely, regular visits that preventive measures for conditions such as gum disease (periodontitis)  can be taken, and concerns addressed early. The number one cause of tooth loss in older adults is advanced periodontitis, so staying up-to-date with preventive appointments will help keep teeth and smiles healthy for a 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.

Wouldn’t it be great if, when you needed a body part or organ, you just go to the doctor to grow it? Does that sound like a show on the Sci-Fi channel? Well, it’s science non-fiction when it comes to growing bone in your jaw and elsewhere. And for patients with otherwise limited options in having dental implants and the ability to chew, it may seem too good to be true.

What is Bone Grafting? Bone grafting is a surgical procedure that adds bone to a deficient site, where it will fuse to the existing bone over time. This added bone may either be autograft (a self donation from the patient), allograft (cadaver bone from a bone bank) or synthetic (from a man-made material). Generally the grafting material tends to be a mixture of these types, as dictated by each patient’s specific needs. The time it takes for the bone to fuse may be 4 – 12 months, depending on the patient’s age, medical and dental health, and oral care and lifestyle habits.

Why Might Bone Grafting Be Needed to Create Beautiful Smiles?

Bone has a tendency to resorb or decrease where there is a missing tooth, when it is affected by disease such as periodontitis, or just with age. When teeth are present they stimulate bone growth, so the bone can stay at a healthy level. However, if teeth are missing, there is no stimulation present, so the bone level will drop.

In the case of periodontitis, or advanced gum disease, the infected and irritated gums after time will start to cause the bone to resorb or “melt” away from the tooth. The bone will continue to do this until the point where the tooth is mobile and eventually lost. Without the proper support of bone around each tooth, not only does this offset the health and function of your teeth, but it also affects the appearance of your smile. The defects that can result due to bone loss can cause a smile to look deformed. With bone correction prior to a “smile restoration” a natural appearance can be regained.

When is it performed? When using dental implants to replace missing teeth, bone grafting needs to be performed prior to implant placement to augment insufficient bone. This is an essential procedure to increase the success of any dental implant. There are various grafting procedures which can build up the jaw bone in height, width or thickness as necessary. Also, if the lack of bone affects the appearance of your smile, a bone graft can allow a more esthetic, natural end result. Finally, when a tooth needs to be extracted a bone graft is added to prevent future bone loss at the site.

Can Anyone Have This Type of Smile Makeover?

Who is a candidate? Not everyone is an ideal candidate for bone grafting. For example, one needs to be in overall good health and dental health, to ensure the best results. Furthermore, a bone graft can only add on a limited amount of bone. For patients who have been undergoing bone loss for years, it may not be possible to add what is sufficient for implant or esthetic needs. However, to find out if bone grafting can benefit you, ask your dentist.

Beyond the obvious function of bone for tooth support, your underlying bone plays a multitude of roles in preserving your natural smile for a lifetime. Continued research in dental and medical technology has allowed patients to take advantage of bone grafting techniques, for a better quality of life.

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.

In a recent Forbes magazine article, executive smile makeovers were featured. It mentioned that CEOs may not be worried about their wrinkles, but rather are more concerned about their “not so pearly whites”. “Executive Esthetic Dentistry” is cosmetic dentistry for high level executives, but differs somewhat from cosmetic dentistry that let’s say a model or actor would want.

Although Executive Esthetic Dentistry is not necessarily a new trend, it probably does get more attention in the media these days along with other cosmetic surgery procedures. And it may make some people perplexed. They can understand someone wanting a professional makeover when they are working their way up the ranks, but once they get there? In the Forbes article, Cendant’s Henry Silverman said, “I was going on TV a lot, and I didn’t like the way my teeth looked.” Having it, he confides, “gives you a sense of self-confidence, which never hurts.”

Executives, too, want to have a natural smile that takes years off their appearance. As business is becoming more competitive worldwide, even business people in Japan are starting to turn to cosmetic dentistry. Although each individual is different, the Executive Esthetic Smile tends to have certain traits.

Although many executives may enjoy the spotlight, they tend to prefer a more conservative approach to the smile. Whereas someone who is a model or actor would be more likely to want their teeth to be more perfect looking or a brighter white, executives may lean towards a something more subtle. There are exceptions, but the tendency is away from a Hollywood-white smile.

Younger, Healthier Smile, Rather Than Brilliant or Dazzling

The look that executives tend to feel comfortable with is a natural, youthful and healthy look. It’s a rejuvenation of their current smile. Perhaps the shapes and sizes of the teeth will stay similar, or perhaps slight alterations for a more enhanced look. They don’t necessarily want to call too much attention to their smile. But the overall effect will be to make the smile look 10 – 15 years younger, to brighten their appearance and to look more professional in front of prospective clients.

For one thing, because of the age group of corporation presidents and CEOs, teeth bleaching alone tends to not be an effective solution. Reasons for this includes the build-up of stain over the years leaves the stain too engrained to be lightened enough with bleaching. Or perhaps existing restorations in the front teeth would also prevent a uniform color. Or even if their teeth were whitened through bleaching, they may still be unhappy with the overall look and shapes of their teeth.

Therefore executive restorations would most likely be performed using porcelain veneers or crowns, depending on the amount of healthy tooth available and desired end result. If teeth are missing, an implant may be needed to fortify the foundation under a crown or bridge for an increased biting strength. If teeth are worn down through years of grinding, then the restoration may rebuild the length of the tooth to its natural, previous length. And if old, failing restorations are being replaced, the new restoration will give the illusion of a natural tooth, not an old crown.

One local executive came to my office saying he was extremely dissatisfied with the look of his smile, and also suspected that years of avoiding the dentist had placed his overall dental health in jeopardy. His teeth had the appearance of being crooked and worn down, to the point where he was beginning to feel more self-conscious about his smile. Although he had attained the position of president within his corporation and certainly was a success in his professional life, he still felt held back by not being able to express himself comfortably. He did feel he could become a better communicator and seem more approachable if he could express himself with his smile.

Cosmetic Dentistry Success – Helps Patient’s Self-Esteem

After extensive gum therapy, this patient’s old restorations and decay were replaced with natural-appearing porcelain restorations. The results were amazing to him. Little by little, he found himself smiling more when meeting people, when talking, or taking photos. He was also happy with the youthful look it gave him. And most importantly, the treatment received allowed him to continue on a road of good oral health, allowing him to keep his natural teeth. He had self-confidence again, and a bright smile.

One of the best things about state-of-the-art dentistry is the ability for cosmetic dentists to custom make each individual smile to fit face shape, personality, age, gender, and profession. This is due to a combination of advancements in dentist technique and smile design, dental materials used, and laboratory expertise. For example, in my office we use a technique that allows patient input and feedback on the smile we are creating together. Patients can feel comfortable knowing their final smile is a collaboration of science, art and their ideas, too.

So regardless of if you’re an aspiring super model hoping for jobs in New York or a CEO who has already arrived in their penthouse office, cosmetic dentistry can create a smile makeover well suited to your wants and needs to upgrade both personal and professional life.

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.

With the ever growing popularity of teeth bleaching, I find that discolored, yellowed or darkened smiles still are one of the more prevalent smile complaints. There are many reasons for teeth not be a natural bright hue. Today’s cosmetic dentists have a variety of procedures to turn back the clock to a more youthful smile. This article continues a series featuring various types of problem situations and how these can be addressed. This month’s focus is the Makeover for the Darkened Smile.

Tooth Whitening Becomes Necessary Because……

Whether it is one discolored tooth or a uniformly yellowed or darkened smile, its easy to pick out when teeth are not as bright as they should be. The reasons why teeth become discolored are numerous. The first of the reasons are situations that someone is born with or develop in childhood. These include drug- or mineral-induced stains, genetic abnormalities or other congenital problems.

The second set of reasons are environmental causes. Realize that your 28 pearly whites have been bombarded for decades by everything you’ve eaten or drank almost all of your life. The guilty attackers include colas, teas, coffees, red wines, tobacco products and other stain-producing foods. Even with routine professional teeth cleanings, these stainers have a cumulative effect on your teeth’s overall whiteness.

A third reason is age-related. The older a tooth becomes the more it darkens or yellows. Yes, this is the unfortunate side of nature. A fourth reason is situational for specific teeth. Here are some examples: A tooth whose pulp is dead due to trauma, may become gray or blackened over time. Another example is teeth associated with old silver fillings or metal-containing restorations. Over time these restorations may irreversibly stain teeth internally or around the gumline.

The Solution? A Smile Makeover

In combating many of these common cosmetic dental problems, cosmetic dentists have various solutions at their command that can address all of the above. The types of treatments selected will vary, depending on each individual person’s problems and needs. Routinely, some discoloration may be due to just plaque or tartar build-up. Plaque and calculus can cause a yellowing stain on teeth, and if left untreated decay may result leaving a darker discoloration. Professional cleanings can assist in minimizing the stain build-up from the food stains mentioned above, such as red wines and tobacco.

Professional cleanings, however, are not the answer to every type of darkened smile. In-office or home bleaching may address other mild types of discolored smiles. In particular bleaching tends to be more effective on staining caused by food, drink and tobacco and the yellowing of aging teeth. In-office bleaching allows you to “jump-start” the whitening process with a quicker end result. A gentle bleaching gel is placed on your teeth and a light source is applied. Depending on the degree of darkness and the lightening you want to attain, this procedure may achieve your desired lighter shade in one visit. Sometimes one appointment may not be enough, and follow-up appointments may be needed.

“Home bleaching” takes place outside of the dental office, either while you sleep or at your leisure. A custom-fitted, clear plastic tray is made in the dental office. 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 14 days. Home bleaching procedures allow more flexibility and control over the whiteness achieved.

You’ll find numerous other whitening kits at the neighborhood drug store or on infomercials. However my best advice would be to consult your dental professionals for what will work best for you. Unwanted side effects of these over-the-counter kits may include accelerated tooth-related and/or gum-related problems or having teeth of mismatched colors. Don’t fall victim to using the product that merely is most convenient and cheapest to obtain. Asking your dentist if you are a candidate for bleaching may save you from wasting money, time and heartache.

If the staining or discoloration is too dark or deep within the tooth for bleaching, then the next option would be veneers or non-metallic, tooth-colored restorations. Veneers are thin, yet durable shells of porcelain that are custom-made to fit over the front and biting surfaces of teeth, to permanently mask the discoloration. Non-metallic crowns would be used if there is extensive decay or breakdown of the tooth structure.

Great Progress Made in Recreating the Beautiful Smile

The great news is that certain darkened smile concerns that could not be addressed fully 10 or even 5 years ago can now be solved. One example of such a dental problem is drug-induced stains, such as tetracycline. This shows as a heavy discoloration of the teeth (gray or black) with or without stripes. Esthetically correcting such a strikingly noticeable smile has perplexed dental professionals for decades. Fortunately with advancements in dental materials and techniques along with infusing dental artistry, this dilemma can be addressed with consistency and beautifully natural results. A technique article I wrote that was published in the Journal of the American Dental Association discussed this complex problem, and uncovered a conservative solution that concludes in such a natural end result.

Q&A

Questions & Answers: Q: I have tried to bleach my teeth several times to whiten my dark teeth but within several weeks the darkness returned. I realize I now need porcelain veneers. How do I determine who is qualified to help me achieve the best natural results?

A: Great question! Undergoing any advanced cosmetic dentistry such as porcelain veneers is quite an investment. However, if done correctly the results can be fantastic. Recreating a natural-appearing smile takes artistry in developing the right color, contour, length and size of the veneers. This takes expertise on behalf of the cosmetic dentist as well as the dental laboratory being used. Not all dentists and labs are equal. Seek out a reputable cosmetic dentist professional and ask them to show you before and after photo examples of similar cases they have corrected.

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.

What started as a conversation between Dr. Okuda and his practice manager Julie Brum turned into a national charitable organization, through much hard work and big hearts. The Give Back A Smileâ„¢ Program helps eligible survivors of domestic violence by restoring their smile, self-esteem and their lives. Dr. Okuda presented this program to the American Academy of Cosmetic Dentistry (AACD) which wholeheartedly embraced the program. From this beginning, a charitable foundation was started to make his dream program become a reality.

As National Chairperson, Dr. Okuda spent countless hours creating the charitable foundation for the program. Miss America 1992 and former Miss Hawaii Carolyn Sapp graciously agreed to become the National Spokesperson for the program, because of her strong commitment and personal experience with this cause. The program was introduced in May 1999,and now over 1000 volunteer dentists nationwide participate. Thanks to these generous dentist volunteers, dental laboratories and corporations, the program continues to grow and reach more survivors. Per patient, thousands of dollars of cosmetic dental treatment is provided.

The National Coalition on Domestic Violence is a partner with the AACD, and can be reached toll-free at (800) 773-GBAS (4227) for more information, or visit the Give Back A Smile™ Website at www.aacd.com.”