COURTESY OF WYNN OKUDA
Crooked and discolored teeth were corrected with porcelain restorations by Dr. Wynn Okuda in two office visits.
So white!
Clean, straight teeth
are latest cosmetic craze
IT WAS JUST a matter of time. We worked on our flabby abs in the '80s; we sculpted our noses and plumped our lips in the '90s; we started the '00s with a Botox party; and now we're obsessing about our teeth. Everyone wants a brighter smile.
We are living in "a look good, feel good now" society, according to BriteSmile CEO John Reed, who says procedures such as liposuction, breast implants and face lifts -- once the province of the rich and famous -- are all routinely performed today, not just to correct genetic blunders, but to address perceived problems and increase individuals' self-esteem and self-worth.
To see just how far we've come, he said, "In the '50s and '60s, it was common to have bad breath. Today, bad breath is unacceptable.
Cosmetic
procedures
(in highest demand
by age group)Under 20:
1. Whitening
2. Orthodontics
3. Composites
20 to 50:
1. Whitening
2. Veneers
3. Composites
Over 50:
1. Crowns and bridges
2. Whitening
3. VeneersSTATISTICS FROM THE AMERICAN ACADEMY OF COSMETIC DENTISTS
"In a global competitive society, appearance has become much more important," he said, sharing his belief that one day it will be socially unacceptable to have yellow teeth.
His views seems to be confirmed by a survey of American adults conducted by the American Academy of Cosmetic Dentistry. According to the survey, 74 percent of respondents believe an unattractive smile could hurt a person's chance for career success, and 92 percent feel that an attractive smile is an important social asset.
"The pressure is growing, whether overt or subliminal, to look and feel better," Reed said.
It's gotten to a point where one of dentist Jonathan Okabe's patients was a blind man asking to have his teeth whitened.
The cost of keeping up with the competition starts at about $3 for a tube of whitening toothpaste, to $350 to $500 for BriteSmile services.
Commercial products such as Crest Whitestrips work in getting teeth a few shades lighter after wearing the product for about 14 hours divided over a long period of time, but Reed said whitening toothpastes can be problematic. He said most whitening toothpastes are silica- or sand-based and remove stains with abrasive action. Such products may work in the short term, but he said, "When overdone it's not safe."
Tray-based whitening kits can be obtained at dental offices, but Reed said the problem with self-treatment is, "People don't go through with all of the hours needed to complete the treatment. Either they experience sensitivity or are inconvenienced," he said. Also, peroxide in the product can damage gums if used incorrectly.
According to Reed, a professional teeth-whitening treatment won't harm enamel, composites or dental work. It typically takes one hour.
The whitening procedure can erase coffee, tea, soda and red wine stains, getting teeth a measurable nine shades lighter. The procedure can also lighten yellow teeth or teeth darkened due to aging, as well as diminish signs of cigarette and tobacco stains.
Cracked teeth, cavities and gum disease must be addressed before whitening treatments can be performed. Then expect those teeth to stay white about five years, according to Reed, before nature or eating dye-filled foods takes its toll. You may never look at spaghetti sauce or a rainbow shave ice the same way again.
TEETH WHITENING, also known as bleaching, has increased by more than 300 percent over the past five years, according to American Academy of Cosmetic Dentistry. But whitening is just one aspect of the new dental makeover.
Bonding, a procedure used to repair chips and cracks, has increased by more than 100 percent over the same time period. The use of veneers, custom-made moldings that cover teeth deemed too unsightly to be seen, have increased by more than 250 percent.
As a result, more are willing to flaunt their enhanced teeth. Local celebrities who have chosen to improve their smiles include KHON's Trini Kaopuiki, former Miss Hawaii Erika Kauffman, Michael W. Perry, Larry Price and reigning Miss Hawaii Melanie Kanoe Gibson.
According to Okabe, a practicing dentist for 25 years, smile makeovers are like art. "It's like starting with a white canvas and you can paint anything."
His skills were tested when a fan of goth music wanted her eye teeth lengthened to look like vampire fangs. He obliged by using porcelain veneers to add 2 millimeters to her teeth, shaping them into points.
But that is an extreme case. Okabe said most dentists intend results to look natural, although they want to comply with patients' wishes.
The focus on teeth has been assisted by improved technology. "Porcelain products weren't that good in the beginning," said Okabe, who says the quality of materials such as porcelains and composite resins has improved to give teeth a more lifelike look.
Costs of cosmetic procedures vary depending on the condition of the teeth, how extensive the treatment is and the type of cosmetic procedure. Options are endless. Stained or discolored teeth may be corrected with in-office or at-home whitening systems. Missing teeth can be fixed with bridges or dental implants. Chipped, cracked or worn teeth can be restored with laminates or veneers. Even old, unsightly fillings can now be replaced with more aesthetically pleasing materials such as resins, porcelain fillings or crowns.
Dentists can even provide pictures of "smile designs" to help people get the right look, whether it's a movie star grin full of perfect teeth or natural girl or boy next door.
Okabe said people often fear pain or how they will look with their new smile. That's when computerized video imaging comes in, providing a preview of an individual's new smile. "Results actually change a person's disposition and how they feel about themselves," he said. "A lot of cosmetic dentistry is about a person's self-value."
Whereas people of earlier generations may have lost many of their teeth, Okabe said, "The progression in our country is for people to keep their teeth (for a lifetime)."
The number of denture wearers has been cut in half since 1995, a statistic he attributes to better care, more knowledge and availability of dental insurance. The downside has been that natural, aging teeth may not be as pretty as man-made sets, fueling the awareness and need for cosmetic dentistry.
In the past, the only option for crooked teeth was braces, but products such as Invisalign (a graduating series of removable aligners) and veneers make it possible to correct some of these problems without a year of orthodontist visits. Some procedures can be completed in just a couple of visits.
Cecile Sebastian enhanced her practice by using neuromuscular dentistry, which gives a more thorough overview of the entire jaw. A machine is used to measure muscle activity and help find the most relaxed position for the jaws.
DENNIS ODA / DODA@STARBULLETIN.COM
Cecile Sebastian, left, and assistant Shalimar Aleta demonstrate how to hook up their neuromuscular gear on Ruth Failma to determine the alignment of her jaw.
"Cosmetic dentistry is great, but dentists must still look at the overall function of the entire mouth. The teeth in front will be pretty, but the ones in back may not be functioning properly," she said.
If teeth can't come together properly, some people may use their tongue to create a seal in order to swallow. Once neuromuscular tests are done, a dentist can decide if the jaw position needs to be adjusted to be more optimal, she said.
"Back teeth need to be in the proper position," she said, to prevent any number of problems, including headaches, clicking and popping joints, nerve damage, ringing in the ears, a locking jaw, muscle pain and broken teeth.
"The procedure is painless and noninvasive," said Sebastian, who compared the process to having an ultrasound wand rubbed over your body.
Preventive dentistry means parents might also want to keep an eye on children with allergies, who have trouble breathing through their noses. "Mouth breathing causes the tongue to lift up, which can create a deep overbite," Sebastian said. "Pediatricians may not be aware of the correlation of dental development and upper respiratory obstruction.
"The experience can be life-changing. We can take a patient's pain away, and it makes our job so much more fun."
CRAIG T. KOJIMA / CKOJIMA@ STARBULLETIN.COM
Wynn Okuda says the serene environment of his dental day spa eases patients' anxiety over a trip to the dentist.
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Choosing a cosmetic dentist
Here are tips from the American Academy of Cosmetic Dentistry on choosing a qualified cosmetic dentist:>> Set up an appointment with the dentist to discuss how you feel about your smile and the changes you want to make.
>> Ask to see before-and-after photos of previous patients.
>> Ask how the dentist keeps up with medical advances.
>> Observe the office's overall atmosphere and cleanliness, as well as how modern equipment and furnishings appear.
>> The dentist should recommend a comprehensive examination before any treatment begins. The dentist should be able to assess all aspects of your dental health, such as gum disease, tooth decay, overall oral function, and the longevity of the completed cosmetic treatment.
>> Once the examination is done and treatment options discussed, you can talk about the length of time treatment will take, the outcome of work done, and payment options.
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Aromas, murals and
a massage set relaxed toneBack when I was a kid, a visit to the dentist was something most people tried to avoid. A dose of pain and misery was inevitable.
Wynn Okuda knows the feeling well. "My dentist lived next door to us. My mom would just drag me over there and put me in the chair."
Today, Okuda is a dentist himself, specializing in cosmetic dentistry. Remembering his old fears, he concluded that a dental day spa is just what patients need to ease their anxiety.
His goal has always been to establish a practice known for treating people as "more than just teeth."
At the spa, medical smells are neutralized through use of aromatherapy, and the sounds of drills are drowned out as patients watch their favorite DVDs through movie goggles or relax to the sound of music played through headphones. "We don't want patients to be counting the holes in the ceiling," he laughed.
"The sights and sounds in dentistry trigger a lot of fears," said Okuda, who also wanted to reduce the cold feeling of a stark white dental office. His offices make use of warm woods and a ceiling mural of a cloud-filled blue sky.
DENNIS ODA / DODA@STARBULLETIN.COM
Heather Akita dons a pair of movie goggles in Cecile Sebastian's office. Watching DVDs distracts patients from dental work being done.
And he's chosen not to don the traditional lab coat.
The spacious, tranquil office contains a beverage station and a place to get a facial or paraffin wax treatments. Barbara Shirland, a registered nurse and licensed massage therapist, is also on site to ease patients' tensions. She might whisk them away for a massage in the midst of their treatment.
"Patients get knots from sitting in the chair for long periods of time," Okuda explains.
Shirland also works on patients' feet during their treatment, even if it involves only a simple filling.
"When they first sit down in the chair, they're anxious," she said, but pretty soon, their eyes are closed and their breathing slows. "It really provides a physical distraction."
Massage also releases the body's natural endorphins, so fewer drugs are used, said Okuda.
CRAIG T. KOJIMA / CKOJIMA@STARBULLETIN.COM
Wynn Okuda's practice includes massage as a relaxing component of a trip to his cosmetic dentistry office.
He believes that cosmetic dentistry at its finest blends science with the artistic abilities of the dentist. This philosophy has led him to become the official cosmetic dentist to the Miss Hawaii USA and Miss Hawaii Teen USA Pageants. He has also performed cosmetic dentistry on celebrities such as "Baywatch Hawaii's" Stacy Kamano.
"Normal" patients can have the star treatment as well, as Okuda can arrange for them to picked up in a limousine and transported to the spa.
He's a strong believer in the need to have positive experiences, especially when spending the day at a dentist's office.
Dentistry in this century will be "all about pampering," he said.
Wynn Okuda is the founder of the "Give Back a Smile Program," a charitable foundation of the Academy of Cosmetic Dentistry, which helps survivors of domestic violence throughout the nation to restore their smiles and lives. He has assembled nearly 1,000 dentists nationwide to help fight against domestic violence. Call 800-773-GBAS (4227) or e-mail givebackasmile@aacd.com for more information.
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