The Neglected Smile
May 21, 2009
Dr. Wynn Okuda in The Wisdom Tooth

Wisdom Tooth

This month I want to address a dental situation that some choose to ignore and have for many years. It's the neglected smile. There are people who have not seen a dentist for 5, 10, 15 or more years. A neglected smile could happen to anyone, even to the most successful and responsible business people. The U.S. Surgeon General's Report on Oral Health stated that 33 percent of Americans have not visited their dentist in the past year. The serious reality is that professional and personal dental neglect is extremely detrimental to your oral health.

There are many reasons why a smile may have been neglected. It could be as simple as your dentist retired and another one wasn't found yet, or as complex as deep-seated dental fears and anxiety that makes going to the dentist the absolute last priority. 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.

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, focus on 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 is the major cause of adult tooth loss and affects about 75 percent of Americans throughout our lives. 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, a sticky, colorless layer of bacteria that forms on your teeth. If not removed thoroughly each day by brushing and flossing, it hardens into tartar or calculus, which irritates the gums and eventually leads 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, the restoration will help stop further damage to the tooth from that entry point. However, left untreated, bacteria will 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. Further, patients who don't visit the dentist regularly miss other essential examinations such as oral cancer screening.

There are many other negative consequences from neglecting 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 teeth discouraged them from smiling or speaking to avoid embarrassment and attention to their teeth. They talk about living 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 for 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 do better professionally. All of these people mention they regret not fixing their smile long ago.

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. If dental anxiety keeps you away from the dentist, keep in mind that new approaches such as massage therapy and other spa pamperings help reduce 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 go to your first appointment, take a friend or family member if it gives you assurance, or ensures that you go to the appointment. Be sure to tell the dental staff your concerns about dental treatment so they can take measures to address them or make you feel more relaxed.

It's never easy to leave your comfort zone and make big changes in your life. To take that first step, decide what's important for you. Focus on your goal of improved dental health, and you will be able to overcome any obstacle. It may be difficult to continue on your path, step by step, but you and your smile will emerge as winners.

Dr. Wynn Okuda is Past National President and Board Accredited Member of the American Academy of Cosmetic Dentistry. In November 2007, he was awarded "Cosmetic Practice of the Year," a national honor chosen by Contemporary Esthetics publication. Dr. Okuda has a private practice in cosmetic, implant and restorative dentistry in Kaimuki. Visit us at our website at

Article originally appeared on East Oahu Sun | Your Community Newspaper (
See website for complete article licensing information.