Realizing a Vision of Service and Success

2006 Winner Wynn H. Okuda, DMD Owner Dental Day Spa of Hawaii Honolulu, Hawaii Phone: 808.734.1099 Web site: www.cosmeticdentistryhawaii.com

The Cosmetic Practice of the Year Award raises awareness of the importance of cosmetic dentistry and recognizes the professionals whose cosmetic practices achieve excellence. Ascend Dental Media and Levin Group, sponsors of the 5th Annual Cosmetic Practice of the Year Award, believe a truly successful cosmetic practice is based on a philosophy of comprehensive patient care, clinical and management excellence, effective leadership, innovation, and commitment to the dental community.

"As cosmetic dentistry continues to experience rapid growth, it becomes even more vital to recognize excellence in this expanding field," said Roger Levin, DDS, chairman and CEO of Levin Group, a founding sponsor of the Cosmetic Practice of the Year Award program. "The dentists who receive this honor exemplify success in building a cosmetic practice."

The 2006 Cosmetic Practice of the Year Award winner incorporates those successful components into his practice. Wynn H. Okuda, DMD, whose Dental Day Spa is located in Honolulu, Hawaii, believes his success story and receiving the Cosmetic Practice of the Year Award proves that anything is possible.

As a child, Okuda feared his dentist and dental office visits, a situation exacerbated by the fact that his dentist was his next-door neighbor. Raised in an immigrant family, he was barely able to afford dental school. Throughout his 19-year career since graduating in 1988 from Oregon Health Science University, Okuda has pursued ways to make the visit to the dentist more comfortable and welcoming.

In Dr. Okuda's office, the marble reception desk creates a grand first impression.

In 1992, as a general dentist, he had a revelation to combine his background in art with his clinical skills in dentistry. This idea continued to inspire him as he transitioned himself and his practice from general dentistry to cosmetic dentistry, and it fueled and energized him for the hard work that followed. He traveled extensively to learn as much as possible. He attended conferences, specialized courses, and over-the-shoulder experiences. He completed the accreditation process for the American Academy of Cosmetic Dentistry (AACD) and graduated from the Misch International Implant Institute, among other intensive programs.

"This award validates all the detail and hard work that is put into our cosmetic dental treatment," said Okuda after being notified of his award. "Our practice strives to always provide the very best care and service to our patients, and it is an honor for us to be recognized for what we do to make our patients smile."

He admits it was risky to make such a change back then, especially in Hawaii, considering that insurance reimbursement focused on nonelective services. What's more, procedures and treatment planning were performed differently than in fee-for-service practices. Okuda recalls that with 96% of all dentists in Hawaii participating with preferred provider organization insurance plans, his move from general to cosmetic dentistry was and still is considered a tremendous challenge from a business point of view.

A Vision Realized

Over time, however, Okuda assembled a clinical and business team that skillfully performs at high levels, thereby enabling the practice to thrive. Today, his Dental Day Spa of Hawaii—which he opened in 2002 as the realization of his vision of a comfortable and welcoming dental practice— consists of himself, the only dentist in the practice; 2 hygienists who each work 1 day a week; and 4 operatories.

In terms of décor, the main objective of the Dental Day Spa was to create an elegant yet highly functional dental office with a spa appearance. Calming colors, soothing aromas, a pleasing design, and tranquil sounds peacefully alleviate patient apprehensions, creating a relaxing environment. The hallways and rooms are wider than normal to give a sense of openness and spaciousness and reduce stress.

The hand-painted Hawaiian skydome illuminates the spacious corridor.

Although certain features at Okuda's Dental Day Spa seem esthetic, they were in fact intentionally placed. For example, to help eliminate fear and anxiety, there is no door between the reception area and the dental treatment area. In other words, there is no division between the "safe" and "unsafe" places. As patients cross the threshold from the reception area, distractions help create a spa experience: a sky dome with changing lights to mimic a Hawaiian sunset, marble floors, faux painting finishes, a refreshment area with hot and cold beverages, and a consultation room. There is also a VIP room to pamper and give privacy to high-profile patients.

Other amenities in Okuda's practice are designed with a flair for elegance and comfort. To help patients relax, feel comfortable, and at-home, there are such offerings as internet service, massage services for all patients, special eyeglasses for watching movies, blankets, and lavender pillows. Additionally, all day-long patients are offered limousine service and in-house catered dining.

"We never compromise the product and service we provide and do not take for granted the trust and confidence our patients have in our practice," Okuda explains of the characteristics that exemplify his practice. "Providing excellence in esthetic results and having our patients leave each visit feeling rested, rejuvenated, and overjoyed is what we strive to achieve."

Successful Business and Clinical Systems

With approximately 400 active patients in his practice, cosmetic cases account for an estimated 80% of his revenue. Since opening his Dental Day Spa, Okuda and his staff have seen an increase in patients from around the world that now account for 40% of his patient base. This diversification of the local patient base provides tremendous financial stability to the practice, particularly during times of local and national economic downturns. Interestingly, since its opening, collections have increased by 33% and continue to rise annually.

New patient education is of paramount importance to Okuda and his staff from the very first call. Their goal is for prospective patients to feel empowered with knowledge so that they are able to make informed choices about their dental health. For this reason, each patient is offered a complimentary consultation to further assess their situation and needs in detail. He or she also is sent an informational portfolio about Okuda's Dental Day Spa that includes articles written by Okuda that pertain to the patient's specific dental concerns, as well as general information about what materials and techniques are used in the practice. Also placed in the new patient packet is a DVD to help educate the patient about the practice before arriving, as well as a brochure that conveys the philosophy of the Dental Day Spa.

Then, during the initial appointment, a comprehensive examination is performed and diagnostic records are taken. Various digital intraoral cameras are used to educate the patient about his or her preliminary diagnosis. Next, the patient returns for thorough patient education and consultation about his or her definitive diagnosis and the proposed treatment plan before any treatment is initiated. During this initial phase, Okuda and his staff spend a great deal of time educating the patient about his or her dental problems and the appropriate solutions, customizing each treatment plan to the patient's individual needs.

The office has 5 operatories, including a spa/massage treatment room.

Noted one of the judges for the 2006 Cosmetic Practice of the Year, "Okuda's commitment to being the best by immersing himself over the years in continuing education and advanced training is obvious in the case photos submitted." This judge went on to comment that the production generated in this solo practice can only be accomplished by a well-led team and dedicated team members.

Not surprisingly, the systems implemented within the Dental Day Spa allow Okuda to deliver predictable and consistent clinical excellence, as well as efficient profitability. These include the careful integration of clinical and business technologies, such as intraoral cameras (Digital Doc LLC, El Dorado Hills, Calif, www.digi-doc.com), digital radiography (Planmeca USA Inc, Roselle, Ill, www.planmeca.com), digital imaging (Dentrix Clarity/formerly Viper-Soft, Henry Schein, Inc, Melville, NY, www.henryschein.com), patient recare reminders (Smile Reminder, Lehi, Utah, www.smilereminder.com), computed tomography (CT) scans, and computerized preimplant planning (SimPlant, Materialise Dental Inc, Glen Burnie, Md, www.materialise.com), among others.

But Okuda admits that despite the fact that his practice was healthy and didn't have any major problems, he realized that by working with a practice management consultant (Levin Group), he "didn't know what he didn't know." By putting systems in place to enhance efficiency and provide insight into various components of the practice—specifically finances and overhead—the profitability of the Dental Day Spa has increased at a record rate. What's more, Okuda says he is now more in control of his practice.

"The most effective way to grow a cosmetic practice is to treat it as if you have a practice within a practice," remarks Levin. "A practice needs to manage its cosmetic dentistry in an entirely different manner than its needs-based dentistry. Everything from marketing your cosmetic service mix, training staff, presenting cases, and communicating with patients requires its own set of systems and strategies to be successful."

In that regard, Okuda also credits Levin Group with helping him and his staff improve their intraoffice communication skills and their communication with patients. By developing scripts and discussing creative ways to build the practice, staff meetings and the workplace overall have become increasingly fun and energetic. Having everyone work efficiently and effectively has helped Okuda and his team increase productivity and decrease stress.

Noted another judge for this year's award, "Dr. Okuda has a well-established practice in esthetic dentistry, one for which an extreme effort to market the practice is given."

Those efforts include such internal marketing activities as offering each patient a makeover and professional photographs with his or her new smile, a referral rewards program for all patients through which they receive gifts for each referral, a quarterly newsletter about different services, and holiday cards that include news about staff. External marketing efforts include a prolific Web site to educate patients and the public about the latest in cosmetic dental procedures, television advertising, print advertising, and public relations activities that result in reported coverage in local and national media. For example, in 2002, Okuda and his staff were fortunate to be interviewed by The Wall Street Journal as one of 5 dental offices that innovated the spa dentistry concept.

Satisfaction from Giving Back

Dr. Okuda's staff (pictured, left to right): Debbie Kaiser-Reed, Clinical Assistant; Julie Brum, Practice Manager; Dr. Wynn Okuda; Barbara Shirland, Massage Therapist/Esthetician; Pam Kutaka, Clinical Assistant. (Not pictured: Barbara Brennan, Registered Dental Hygienist; Cheryl Nadamoto, Registered Dental Hygienist; Keiko Katoku, Massage Therapist; Irene Okuda, Office Assistant.)

While building his practice's success, it was important for Okuda, an active member of the AACD and past president (2002/2003), to give back to his community. In 1997, he and his practice manager developed a program to help the survivors of domestic violence who had sustained dental injuries. Founded in 1999 through the AACD, the "Give Back a Smile" program provides annually more than $1 million in free cosmetic dentistry nationwide to survivors of domestic violence.

"Balancing my life by giving back to charity is a tremendous fulfillment of my professional life," Okuda noted on his Cosmetic Practice of the Year application.

Conclusion

According to Okuda, he and his staff strive to create the best environment, exceptional esthetic results, and an incredibly positive experience for their patients. But equally important is sharing his knowledge and passing information on to help elevate other practices to a higher level, whether through lecturing, writing articles, or allowing other dentists to visit his practice. In fact, a third judge for this year's competition commented that "Okuda's willingness to share his knowledge and philosophy of dentistry was easily seen, and his integration of technology and his personal artistic skill are visible in his office and advertisements."

Okuda is the esthetic expert on the National Dental Expert Advisory Board of the Academy of General Dentistry (AGD), an Executive Council member of the International Federation of Esthetic Dentistry, and an active member of the International Congress of Oral Implantologists and the International College of Dentists. In recent years, he has lectured on cosmetic dentistry at the Chicago Midwinter meeting, the AGD Annual Meeting, the AACD Annual Conference, and the Annual Adhesion Dentistry Seminar. In addition, Okuda serves on the editorial boards of several dental publications.

"I would advise other dentists to set a vision for excellence and religiously follow it as a team," encourages Okuda. "Then, surround yourselves with staff that see your vision and allow you to have the freedom you need to provide better service to your patients. Finally, continue to come up with new and innovative ways to give your patients the best dental experience every time they step into your practice." Okuda also emphasizes that it's important to seek out the best in quality cosmetic dental education, noting that AACD's Annual Meeting provides high-quality education in cosmetic dentistry for both dentists and their staff.

1st Runner-Up — David Eshom, DDS

David Eshom, DDS Private Practice San Diego, California Phone: 858.455.9151 Web site: www.eshomdds.com

For the Benefit of Their Patients and Themselves
The Cosmetic Practice of the Year program provides dentists throughout the United States with the opportunity to present their exceptional practices to a panel of well-respected industry judges. Each year, a winner is selected, along with 2 other finalists.

This year's 1st Runner-Up is the San Diego, California, dental practice of David S. Eshom, DDS. Currently undergoing the American Academy of Cosmetic Dentistry (AACD) accreditation process, Eshom is a 1985 graduate of the University of the Pacific School of Dentistry and has been a practicing dentist for 22 years.

"I am honored and proud of my team and our efforts. We have worked incessantly for 20 years on improving ourselves clinically, in service and teamwork," shared Eshom after learning of his 1st Runner-Up recognition. "This recognition confirms we are doing the right thing and inspires us to continue to improve for the benefit of our patients and ourselves."

As a general dentist who emphasizes dental health and beauty for his patients, Eshom designed his dental practice to please his patients and make them more comfortable. In fact, when walking through the door, patients are soothed with the sound of a 6-foot water feature, and team members welcome them with bottled water. The front area is well-appointed and small; Eshom believes that no patients are to wait for an appointment, so there is no need for a large waiting room.

Rather, a member of Eshom's well-trained staff personally escorts each patient to a treatment suite, where he or she is asked if a hand paraffin wax is desired during the appointment. Overhead, a 19-inch monitor is ready for the patient to comfortably view a DVD or favorite program while the treatment is performed. Among the state-of-the-art dental equipment and technology that Eshom uses are lasers for patient comfort and minimally invasive care; digital radiography; digital photography and computer imaging; and ultrasoft, comfortable leather treatment chairs.

The new patient encounter and the diagnostic sequence are significant to the overall treatment experience in Eshom's practice. Believing in a one-patient-at-a-time approach, each patient is interviewed by a staff member and a medical/dental history is taken. Then, the patient is escorted to an operatory, where he or she meets Eshom and his or her history and concerns are reviewed, as well as anything else the patient would like to address. Digital radiographs and photographs are taken. With these clearly visible to the patient on dualscreen monitors, Eshom takes the opportunity to provide the patient a tour of his or her mouth as any concerns, health-related issues, or problems are discussed. Priority is given to eliminating dental disease, as well as answering questions.

One judge noted that he was impressed by Eshom's concern for his patient's final outcome beginning with his introduction: "I could feel that Dr. Eshom wanted the best outcome for his patients, not just his best 'production dollar day.'" This judge went on to say that "the effort Dr. Eshom put into the diagnosis and treatment planning, along with the high-technology equipment he uses, sets him apart."

The patient then is asked if he or she has any cosmetic concerns or questions, and only then does Eshom address cosmetic issues by showing the patient similar cases he has performed, demonstrating how the patient's smile could benefit. A complete visual examination with intraoral photographs is then taken, and the needs of the individual teeth are identified.

If the case is complicated and/or cosmetic, the patient is asked to return for a second consultation, at which time Eshom explains the procedure(s) that would be needed to appropriately enhance the patient's smile. During this consultation, Eshom uses computer imaging to prepare a digital "after" photograph of the patient's chosen smile and explains the exact process(es) he will use to attain it. He also highlights his training and that of his staff and the laboratory he uses as it relates to the intended procedure(s).

In pursuing excellence in their cosmetic practices, Eshom offers this advice to other dentists: "I would advise other dentists to be patient, yet persistent, in the pursuit of their ideal cosmetic practice. They must first improve themselves by attending classes and meetings, like those at the [AACD] Annual Conference. As they improve their cosmetic skills, they should work on their leadership skills so they can instill their passion in their team."—A.D.

2nd Runner-Up — Barry D. Bessler, DMD

Barry D. Bessler, DMD Sowles Trauring Dental Partners of Boston Boston, Massachusetts Phone: 617.259.1100 Web site: www.dentalpartnersofboston.com

Comprehensive and Esthetic Care
Through the Cosmetic Practice of the Year evaluation process, participating practices come to recognize and acknowledge their own accomplishments, as well as measure their results against some of the most successful practices in the country. This year, 2nd Runner-Up recognition was given to Barry D. Bessler, DMD, whose office is among the group practices of Sowles Trauring Dental Partners of Boston, Massachusetts. Bessler, a prosthodontist and 1998 graduate of Harvard School of Dental Medicine, believes that a breadth and depth of knowledge and skill across every facet of dentistry is what makes his practice stand out from others. One of this year's judges noted, "Bessler's practice demonstrated comprehensive integrated dental care with excellent esthetic outcomes." This judge continued, noting that the fact that the practice has a comprehensive number of consultants of various disciplines on hand makes it very convenient to gain chairside consultations when needed.

Sowles Trauring Dental Partners of Boston consists of 17 dentists representing 8 specialties, plus an additional 39 experienced dental technicians, hygienists, and staff who attend to every dental need. As a result, Bessler's practice can employ a dynamic team approach through which restorative dentists work together with outstanding specialists to provide patients with the best in comprehensive dental care. When a periodontist, prosthodontist, and generalist can consult together on a case, whether a single-tooth or complex implant case, the impact of the joint collaboration is very powerful for the dentist, but more importantly, for the patient.

"We are honored to be recognized," said Bessler upon receiving notification of his 2nd Runner-Up recognition. "Our goal is to provide excellent comprehensive care to patients, where a commitment to excellence is our standard."

Today, when the desire for a beautiful, more natural-looking smile is greater than ever, Bessler's practice offers a full range of cosmetic dentistry procedures, including teeth whitening in 3 operatories, custom-fitted clear tooth aligners (Invisalign, Align Technology Inc, Santa Clara, Calif, www.invisalign.com) by a renowned orthodontist, Lumineers (Den-Mat, Santa Maria, Calif, www.denmat.com), veneers, and dental implantology. Three implantologists on staff specialize in immediate function dental implants—including teeth-in-a-day and teeth-in-an-hour processes. In addition, Dental Partners of Boston also offers single-visit crowns fabricated in-office using CEREC 3D (Sirona Dental Systems, LLC, Charlotte, NC, www.sirona.com) while the patient waits.

Commented another judge, Bessler's Dental Partners of Boston "has services that can be of benefit to almost any patient." And to best ensure patient understanding of their conditions and treatment needs, Bessler's practice uses dynamic 3D presentations that incorporate animation, full-motion video, and before-and-after images that engage and educate them.

Bessler, a clinical instructor in prosthodontics at Tufts University School of Dental Medicine since 1999 who currently teaches at the postgraduate level, offers this fundamental advice to other dentists pursuing excellence in cosmetic dentistry: "Focus on patient care, use continuing education as a tool to sharpen your knowledge base and skills, and interact closely with nearby specialists. We have a lot to learn from each other. Always strive to learn more and do better."

—A.D.

—Allison DiMatteo
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