Following is an interview with Dr. Wynn Okuda, the president of the American Academy of Cosmetic Dentistry (AACD) and the founder of the "Give Back A Smile Program," a charitable foundation of the AACD which helps survivors of domestic violence throughout the nation to restore their smiles and lives. In addition to running his Dental Day Spa practice in Honolulu, he is an accomplished author and lecturer on the subjects of cosmetic dentistry and bleaching/whitening. He recently took a few moments from his hectic schedule to talk to Dental Equipment & Materials about the present and future of bleaching/whitening.
DE&M: What do you see as the main factors behind the whitening/bleaching boom?
Okuda: One of the things that has increased excitement in whitening is the media blitz on the subject. People are very interested in rejuvenation and looking younger. Consumers want to learn more about that, and the media has come to the AACD to learn about the subject in order to educate their readers and viewers. Whether it is the readers of Better Homes & Gardens, Shape Magazine, NBC, CNN, or many other media entities, people feel empowered with the possibilities offered by whitening/bleaching and cosmetic dentistry.
DE&M: One of the main areas seen in the media blitz are products which offer to whiten teeth without
Okuda: It does concern me that people can whiten their teeth without seeing a dentist. Do they have cavities? Do they have periodontal disease? There could be lots of hidden problems that they might not discover until they purchase these products and introduce chemicals onto their teeth. This could cause potential problems for the patient and turn what they thought was going to be a $50 whitening opportunity into a very costly restorative procedure. Another concern is the fact that existing anterior cosmetic dental work does not bleach as the tooth. People may end up having anterior restorative work that no longer blends with their newly bleached teeth. The AACD has worked hard to educate dentists on blending color and contour of veneers and crowns to natural dentition and making sure that, at the end of any cosmetic procedure, the patient's teeth look natural. Without a dentist, there's no guarantee that will happen.
DE&M: How well has the dental community met the demand for whitening procedures?
Okuda: Companies like Ultradent and Discus Dental have done a tremendous job of coming out with products that control issues such as sensitivity. Bleaching has become a very safe procedure thanks to these types of companies. There are also many educators out there who are spreading the message of ways to deliver safe procedures that will create good treatment outcome.
DE&M: A recent study said that 88 percent of AACD members reported that at-home custom-fitted whiten
Okuda: The biggest reason for its success is simplicity. The dentist needs to only invest a minimal amount of time because the staff can make the bleach trays. In comparison to power bleach, the cost to the patient is relatively low. There is also a control factor with take-home whitening. Every morning, a person can look in the mirror and monitor the progress of the bleaching that is taking place. Therefore, the level of whitening can be controlled. Every individual comes to a point when he or she says, "That's white enough." People don't necessarily want to have extremely white teeth, and the take-home option gives them this control.
DE&M: In-office power whitening has also become very popular in today's busy world. What are the
Okuda: There are a lot of good benefits, but I think the most important one is instant gratification. People are extremely busy and want things now. They feel empowered knowing they can go into the dentist and come out with a different shade of teeth. There are also people who are not comfortable with administering the whitening procedure themselves. They feel that letting a professional do the job is much better.
DE&M: What types of whitening procedures do you offer in your practice?
Okuda: I offer both take-home and in-office. I have a mixture of patients, some who want things done now and some who want to take things slowly. Offering both procedures is a plus because it allows me to reach more patients. I offer Discus Zoom! for power bleaching and Ultradent's Opalescence and Discus Dental's Nite-White/Day White for take-home.
DE&M: How important is communication in the whitening process?
Okuda: The most important thing a dentist can do is determine the patient's expectations prior to the start of treatment. I spend a lot of time consulting with the patient, and find it is critical to my success. Patients need to know what options are out there, and they also need to know if bleaching may or may not meet their expectations. Patients have expectations about the end result. If those expectations are met, they are going to say a lot of positive things about cosmetic dentistry. However, patients have to understand that there are limitations of bleaching. In my experience, I have found that teeth heavily stained by tetracycline will revert and relapse a significant number of times after bleaching. Ultimately, these people have to go to other cosmetic dental procedures such as composite or porcelain veneers. There are times I will recommend going straight to veneers knowing whitening will not meet their expectations.
DE&M: Your practice has a "spa dentistry" theme. Do you think the atmosphere of the office makes it
Okuda: The atmosphere plays a huge role. We have talked for so long about five-star service and five-star products; now we need to create an environment for those ideas. Beyond the pampering services, spa dentistry encourages patients to experience the wonderful things dentistry has to offer. Look at Starbuck's. They have made getting coffee an experience. When patients come into my Day Spa, I want to do everything I can for them to have a positive experience, including having them leave with a beautiful smile. The attitudes of the patient will change when he or she is in the middle of a positive experience.
DE&M: In your experience, what are the most unrealistic expectations patients have about whitening s
Okuda: Expectations are the biggest area we deal with when it comes to whitening. In my 15 years in dentistry, I have tried to predict what could go wrong before it does. Education for the dentist is the key to overcoming most problems. We may all know how to make a bleach tray and fill it, but the knowledge behind certain cosmetic dental procedures is important for doctors to acquire. If you can help to decrease problems down the road, you will help eliminate unrealistic expectations.
DE&M: What final thoughts would you like to leave with our readers?
Okuda: Creating a win-win situation is important for everyone involved, and having the dentist as the leader is the key to that. Because there is so much interest in bleaching and whitening by the general public, there is great opportunity for dentists and their staff to educate patients. It's important to reinforce to everyone the necessity to seek dental professional advice before bleaching. Cosmetic dentistry is perceived positively by the public. If we are able to advise patients on options and consequences before they try something on their own, then the profession has the best chance for optimal results.
For more information on Dr. Okuda, log on to www.wokuda.com. He can be reached by e-mail at [email protected]. To learn more about cosmetic dentistry from A to Z, and the latest developments in cosmetic dentistry, it is a must to attend the AACD Annual Scientific Session. The 2004 session will be in Vancouver. For more information, log onto www.aacd.com.