Proper diagnosis, treatment planning, case work-up and the use of a dental laboratory that is skilled in fabricating beautiful, life-like restorations are all necessary for a proper outcome.  Good communication between the patient & doctor as well as the doctor & lab are also essential to convey the information, goals and desires for the final restorations.  Color, shape, contour, allignment and surface characteristics of the teeth are just a few of the artistic nuances that need to be considered.  Then there is the functional aspect to consider.  The beautiful new teeth have to function well and properly so the patient can eat and not have any problems or pain.

I have had many patients come to me here in Kailua-Kona, Hawaii, unhappy with the cosmetic dentistry they had done by another dentist.  They either tried to save money or were offered a “deal” to have it done at a reduced cost.  Just like cars, you can buy a Geo Metro or you can buy a Mercedes Benz.  Both will get you from point A to point B, but they are far from equal.  High quality dentistry, especially cosmetic dentistry, is a large investment.  The skill and experience of the dentist and dental lab, the proper materials and techniques are all factors in the cost of treatment.  When dealing with something as important as your teeth and smile, do you want the Mercedes or the Metro?

Here, on the left, is a smile design done by a “cosmetic dentist” in Kona, Hawaii.  Note the poor shape and allignment and the fact that they look fake and opaque.  They are also causing problems with the gums. 

On the right, is a smile design that I did.  Notice the life-like translucency at the edges, the subtle textures and contours that break up and reflect light to make them look natural and the beautiful shape and allignment.  The gums and teeth are healthy and functioning in harmony.  Which smile design would you rather have?

Unattractive Porcelain VeneersBeautiful, Life-like Porcelain Veneers

I had the opportunity to treat a wonderful woman who was extremely embarrassed with her teeth and smile and had a bad history with her previous dentists.  She is quiet and reserved but is very kind and warm.  Unfortunately, she had neglected her teeth to the point where they were in pretty bad shape and she would not smile.  This affected her self image and confidence.

We were able to get her mouth back into good health and provide her with a beautiful smile that she is very proud of and happy with.  I would like to share her kind words because they say it all.  Since she is a bit shy, she wrote her feelings down and gave the letter to us rather than express them verbally.

She wrote:  “Dear Dr. Yokoyama & Staff,  I would like to express my appreciation to you and your wonderful staff in truly making me feel confident by your kindness, honesty and feeling of warmth.  You have a tremendously hard working staff that truly shares the spirit of aloha.  Thank you for all of your assistance you’ve done for me and please let your staff know how much I appreciate all of you.  I truly would recommend you to my many friends along with expressing my feelings of your staff members.  It’s people like you and your staff that makes a difference in your lives.  Please share this letter of appreciation with your staff and give them my aloha.”

It’s patients like this, who appreciate the hard work, dedication and expertise that we strive to provide every day that make it all worth while.  Helping them and caring for them is why I became a dentist and why I love my job.

Last week I got to visit my daughter’s kindergarten class on their “Dental Day”.  I had a lot of fun and was able to talk to the whole grade (over 100 students).  Although it has nothing to do with cosmetic dentistry and I don’t see many children in my practice, it’s a great feeling to give something to the community.  Next month I will help with the local children’s clinic to do dental screenings for the elementary school.

The thank yous and hugs from the kids made it all worth while and the teachers really appreciated it.  Plus, my daughter was soooo excited to have Daddy visit her school.  What a great day!  Hope I get invited back next year.

I’m extremely saddened by the loss of two of my patients who have been with me for a long time.  The first, passed away last month and was with me for 14 years.  The second, just moved away, she was with me for 13 years.  Both became more than patients, they were friends.

I got into dentistry for the opportunity to help people and care for their health.  After years of pursuing excellence in both cosmetic dentistry and full mouth rehabilitation I have experienced the joy of transforming people’s lives.  There is no better feeling in dentistry than to facilitate that change and provide a smile that changes a person’s life.  Both of these friends experienced that with me.  I was able to match their smiles with their vibrant, upbeat personalities.  To have the privilege of providing that for your friends is truly amazing.

I will miss both of these people tremendously.  They were the type of people you looked forward to seeing on your schedule and were always interested in what was going on in our lives.  Close relationships, wherever they are formed (even in the dental office) add meaning to our lives and is one of the true joys of practicing dentistry.  I feel honored to have known Mike and Shannon and will always consider them friends.

A few days ago I got a compliment from a patient who is a former dental assistant.  She appreciated the “beautiful job I did on carving the occlusalanatomy on her composite.  It looks like a natural tooth!”  Those were her words.  She always inspects my work closely and knows a lot about dentistry so I felt good about the compliment.

I have been using a composite that blends in so well with natural tooth structure that one shade matches almost every tooth from very white to very yellow and it magically disappears so you can’t tell what is filling and what is tooth.  I also spend extra time carving grooves and “anatomy” into the fillings.  Sculpting fillings to look like teeth was the one thing I loved about old silver amalgams and the only thing I miss about doing them.  This technique has allowed me to become a “tooth artist” again and provides cosmetic dentistry for even back teeth.  It’s nice when patients actually notice the extra effort I put in.

I have been honored again this year by Honolulu Magazine as one of Hawaii’s top dentists.  I am very proud to be placed on this list as it is voted on by other dentists in the state.  Being recognized by my peers for my efforts at providing top quality dentistry to my patients in Kona, Hawaii, and my passion for cosmetic dentistry is a wonderful feeling.  This year there were 6 general dentists from the Big island (4 from Kailua-Kona) chosen.

Although I don’t like to “blow my own horn” I just wanted to express my elation and hope to continue to exceed both patient and peer expectations.  I promise to continue to strive for excellence in both the dentistry I provide as well as the service we give our patients in our office.

I just returned from a weekend in Hana, Maui where I celebrated my 10th anniversary with my wife and another couple.  We enjoyed the beautiful surroundings and quiet time without children in a beautiful oceanfront home in the middle of paradise.  While staying at our vacation rental, a two story home with large yard and grand picture windows overlooking the ocean, I imagined how beautiful it must have been when it was first built.  The ocean and salt air takes it’s toll on everything and, although is was still a beautiful home, it needed a lot of work.

Maintenance is so vital with any large investment like a home, especially when it takes a beating from a harsh environment.  The same is true for our mouths and teeth.  Teeth are a vital component to our digestive system and we put a lot of stress on them over the years.  If we are lucky, we will have them for 70+ years and expect them to look good and function well for that duration.  Would you expect that from a car or big screen tv?  Yet there are so many people who are not willing to invest the time, effort or money into maintaining their dental health.  There are many levels of maintenance which could be as extensive as a total full mouth restoration (think of a remodel on a house) or as simple as twice a year cleanings & check-ups.

My point is, invest in your teeth.  They help us to enjoy wonderful foods, make us look good and feel good when we smile and, if we maintain them, will last a lifetime.  How many other things that we spend our money on can have that impact on our lives for such a long period of time?  It is true, you can live and function without teeth but what quality of life is that?  Ask anyone who doesn’t have their teeth and I’ll bet every one of them would want them back if they could.  The investment you make to keep your teeth healthy and make your smile beautiful is one of the best investments in yourselves that you can make.

I just saw a patient who had some dental work done in Thailand.  A few fillings and one veneer on a front tooth.  She was in pain and in tears because of her experience.  She thoughtshe was going to have some conservative bonding and old fillings replaced but before she knew it her teeth were being excessively ground down.  Now her teeth hurt and the veneer looks horrible.  She is very self-conscious about it now.  She reports that it was a perfectly healthy tooth and she liked the general shape and alignment of it.  She just wanted to have it blend in with her other front teeth and fill in a little gap.  From looking at her pre-op x-rays it looked like everything was in good alignment and the tooth had no restorations on it.  Unfortunately, it looks like it was grossly ground down to accomplish these goals.

I have seen some good dentistry come out of other countries where people go to get “cheap dentistry” done (places like Thailand & Mexico) but, mostly, I have seen a lot of bad work that has had to be replaced.  I feel bad for these people and urge any of you who may be thinking of it, to avoid getting treatment in these areas.  It is not worth putting your health at risk.

As we close out 2009 it’s a good time to reflect on the past year and look forward to the new one.  It  was a pretty hard year for a lot of people in Kailua-Kona, Hawaii this year.  Lots of layoffs and lost jobs, but how much can you complain when you live in Hawaii.

I am blessed with a wonderful wife, two beautiful girls and a hard working, devoted team.  We are looking forward to a bright and prosperous 2010 and wish all of our friends, family and patients the same.