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360 Ortho, Marketing, and More with Shigeyuki Okuda : Dentistry Uncensored with Howard Farran

360 Ortho, Marketing, and More with Shigeyuki Okuda : Dentistry Uncensored with Howard Farran

4/11/2016 5:34:16 AM   |   Comments: 0   |   Views: 257

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Howard sat down in Tokyo to interview orthodontist Dr. Shigeyuki Okuda and his two dental hygienists Dh. Mariko Sato and Dh. Teruyo Mitsuoka. 

Howard:

It is just a huge honor to be in Tokyo Japan. Tokyo is so huge I didn't know if I was still in it. From the airport to here was probably an hour and a half train ride going very fast. You are an Orthodontist. Tell us your name?

 

Okuda:

My name is Dr. Shigeyuki Okuda.

 

Howard:

These are your two dental hygienist? What is your name?

 

Mitsuoka:

My name Teruyo Mitsuoka.

 

Sato:

My name is Mariko Sato.

 

Howard:

You are an orthodontist? These are three of you, with two chairs. I find it very interesting because you have two hygienist and can clean the teeth whereas in the United States that's not legal and the orthodontist can only do the braces and there is a dentist, there is an orthodontist, I believe he is in Arkansas, do you remember his name Ryan? He is actually suing the government because they are not allowed to do cleanings.

 

 

Tell us your journey. You actually have roots in the United States and that's why you speak English so we can talk to you. Tell us your story here.

 

Okuda:

In high school I was an exchange student and I spent a year in Pennsylvania. I was in the senior grade. Also I had a good experience to attend the prom party. I had a date there.

 

Howard:

You had a date there?

 

Okuda:

Right. I came back to Tokyo and I enjoyed my Dental College. After that I decided to move over to Hokkaido University and join their orthodontic residency there. Then I came back.

 

Howard:

So you were in Pittsburgh Pennsylvania for one year?

 

Okuda:

One year, right.

 

Howard:

Did they turn you into a Pittsburgh Steelers Football fan in one year?

 

Okuda:

No.

 

Howard:

What is your favorite sport in Japan?

 

Okuda:

Baseball is very popular but lately the soccer, the football is much more popular for the young generation.

 

Howard:

So did Pittsburgh make you a Pittsburgh Pirates baseball fan?

 

Okuda:

Mm-hmm (affirmative).

 

Howard:

Tell us, you are talking to mostly Americans. I think 3/4ths ... I think 83% of our show is United States and the rest are from around the world. Most of them aren't as lucky as me to get to visit Tokyo Japan. Tell us what it's like being an Orthodontist in Japan?

 

Okuda:

To be an orthodontist? After graduating dental college basically we have to attend the residency at least 2 years. Maybe 5 years in general. Then after that probably we get qualified orthodontist by Japan Orthodontic Society, JOS. Then most of the doctors will open their clinic or working in a hospital like that.

 

Howard:

What are your office hours? How many days a week?

 

Okuda:

It starts from 11 to 8 at night.

 

Howard:

How many days a week?

 

Okuda:

Basically 5 days a week.

 

Howard:

So you work 11 to 8. Why so late? Why not ... So 11am to 8pm?

 

Okuda:

Oh you feel that's late? 8pm is late?

 

Howard:

11am to 8pm Monday through Friday. You don't work Saturday and Sunday?

 

Okuda:

Thursday and Sunday is basically we are closed.

 

Howard:

Which days?

 

Okuda:

Sunday and Thursday.

 

Howard:

So you are closed Thursday?

 

Okuda:

On Sunday too. The most popular and crowded day is on Saturday.

 

Howard:

When does the average Japanese person work at work? Is it 8 am to 5pm? You come in late and stay open evening so they can come in after work?

 

Okuda:

That's right.

 

Howard:

What are the hours of the average worker at Japan? 8am to 5pm?

 

Okuda:

Mm-hmm (affirmative). Yeah, 5 yeah.

 

Howard:

You like to stay 3 hours after work for to be convenient?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

What do braces cost in Japan?

 

Okuda:

It depends on the clinic.

 

Howard:

On average?

 

Okuda:

On average ... 800,000 probably.

 

Howard:

What would that be in US? Braces cost 800,000 yen. What is the Yen to the US Dollar? Is it 1/10?

 

Okuda:

Probably around that.

 

Howard:

What would that be dived by 110 ... You are doing a lot of Lingual braces?

 

Okuda:

Yeah. Lingual braces are very popular here.

 

Howard:

What percent of your braces are on the lingual versus the buckle?

 

Okuda:

Over 60%.

 

Howard:

60% lingual. Wow. Why do you think it's more common in Japan to go lingual than labial?

 

Okuda:

It's based on the cultural things. Asian people I think are one of culture and they don't want to show their teeth.

 

Howard:

They don't want to show that they have braces?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

Why do you think lingual braces is more popular than say clear aligners like Invisoline?

 

Okuda:

It's a word Japanese crowdings. That just means so much crowding. We can't treat it with Invisoline. It's too hard for the treatment.

 

Howard:

You are saying that Invisoline is hard to treat a standard case in Japan. Do Japanese have more unique types of crowding than say people from Ireland. I'm Irish. Is Japanese more class 3, more prognathic, what is the average orthodontic case.

 

Okuda:

Not prognathic but, it depends on the person but the base bone could be much more smaller than the total amount of the tooth size probably. Most of my patient are extraction cases.

 

Howard:

What percent are extraction cases?

 

Okuda:

I never had to calculate that but probably over 70%.

 

Howard:

70%? Would it be four bicuspids?

 

Okuda:

No. It depends on the person. Sometimes 2 bicuspids.

 

Howard:

On the upper or lower?

 

Okuda:

Lower.

 

Howard:

Two bicuspids on the lower because they are a class 3?

 

Okuda:

No. Too much crowding.

 

Howard:

70% of your cases probably have 2 ...

 

Okuda:

2 and 2.

 

Howard:

4?

 

Okuda:

4 bicuspid extractions.

 

Howard:

70%?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

70% probably have 4 bicuspid extractions and then 30% would not have any extractions.

 

Okuda:

Yeah. Also Japanese people are very careful of their profiles.

 

Howard:

Is that the ...

 

Okuda:

Right.

 

Howard:

What do you call that.

 

Okuda:

The aesthetic line.

 

Howard:

Meaning that if you put your finger from your nose to your chin they don't want the lips to touch the finger?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

Which is interesting because in the United States everybody is trying to puff out their lips with Botox and dermal fillers.

 

Okuda:

Why that? Why?

 

Howard:

It's just culture. That's a big deal in Asia, isn't it. A big deal in Asia doesn't want that out where as in other cultures they are pumping their lips full with dermal fillers and trying to puff out their lips but in Asia they are trying to bring their lip back.

 

Okuda:

Right.

 

Howard:

When you do an extraction case it's just a lot harder to do with a removable aligner like Invisoline?

 

Okuda:

Yes.

 

Howard:

You just really need to band something up?

 

Okuda:

Mm-hmm (affirmative) Also if I use Invisoline or those [inaudible 00:08:51] with extraction cases probably the interior segment will bow. Bowing effect, have you ever heard of it? Bowing effect? The interior teeth are inclined to the extraction site.

 

Howard:

I see.

 

Okuda:

It's very hard to treat with the Invisoline for the Japanese extraction cases.

 

Howard:

You are an orthodontist and these two are both dental hygienist so are they only doing cleanings or do they also branding and bracket, what do all they do? Can they place the bracket and place wires?

 

Okuda:

Yeah they can replace wires, preparing for the bonding's.

 

Howard:

Prepare for the bonding.

 

Okuda:

Try to fit in the band too.

 

Howard:

Can they cement the band?

 

Okuda:

No, I do that.

 

Howard:

Can they glue on the bracket?

 

Okuda:

No.

 

Howard:

They just prepare?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

Do you have one for each chair and then you go back and forth?

 

Okuda:

Right.

 

Howard:

Yeah, nice. 70% are lingual braces so the other 30% are labial braces? Would those be clear brackets or what kind of ...

 

Okuda:

You can call it clear bracket. Like these.

 

Howard:

What would be the ... What company sells you the lingual?

 

Okuda:

I'm using the Harmony. This is [redactable 00:10:25], the American Orthodontics company.

 

Howard:

Harmony form what?

 

Okuda:

From American Orthodontics.

 

Howard:

I wonder what city they are in.

 

Okuda:

[inaudible 00:10:36] What state was it near Lake Missouri? Michigan. Michigan that's right. Michigan.

 

Howard:

Harmony, so it's called Harmony orthodontics?

 

Okuda:

And Harmony Systems.

 

Howard:

In Michigan. The reason I like the name is the listeners are always, when somebody uses a product and they want to try it they are always emailing me say the name of the brand or say the name of the website.

 

Okuda:

Harmony is already very popular in the States too.

 

Howard:

I wasn't aware of it, but I'm not an orthodontist, I'm a general dentist.

 

Okuda:

Two years ago I was invited to the Harmony International Meeting in [inaudible 00:11:20]

 

Howard:

In where? In Michigan?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

I wonder what city in Michigan that was, where the company was.

 

Okuda:

Yeah. I spent maybe four days-

 

Howard:

Did you go.

 

Okuda:

Yeah.

 

Howard:

Did you have fun?

 

Okuda:

Yeah. With my mentor Dr. Matsuno.

 

Howard:

He doesn't work here though?

 

Okuda:

Excuse me?

 

Howard:

Your mentor, he doesn't work here though?

 

Okuda:

No. He has his own clinic.

 

Howard:

Did you guys have fun?

 

Okuda:

Sure.

 

Howard:

Was it ... Where do you buy the clear brackets? Is that Harmony also?

 

Okuda:

No. I bought this from a different company.

 

Howard:

What company is that?

 

Okuda:

Dentron.

 

Howard:

Dentron?

 

Okuda:

Yes, Dentron.

 

Howard:

D-E-N-T-R-O-N.

 

Okuda:

Yeah, right.

 

Howard:

Where are they out of?

 

Okuda:

[Japanese 00:12:09] Dentron ... Ortho Organizer, that is an American company.

 

Howard:

Is that St. Luis?

 

Okuda:

Dentron is a Japanese company.

 

Howard:

From everything you read do you think Japanese ... Is Orthodontics as popular in-

 

Okuda:

It's getting popular.

 

Howard:

Is it as popular as it is in London or the United States or Singapore or, how would you compare it?

 

Okuda:

I'm sorry, I don't get it.

 

Howard:

How popular is Orthodontics?

 

Okuda:

In Japan?

 

Howard:

Yeah, in Japan.

 

Okuda:

My generation it was not so popular. I see a student with braces maybe two or three kids in your class. Now, our generation is becoming parents, they really care for their children so lately the kids, maybe a student in elementary school tend to start wearing braces.

 

Howard:

What percent of your practice is small children versus adults our age?

 

Okuda:

When I open my clinic almost 10 years ago my patients are adult mostly but lately the kids patient are increasing.

 

Howard:

Would you say the adults want to hide the braces on the lingual and the children don't care? Some children like to have colorful rubber bands. Do young Japanese children like to show braces with bright colored rubber bands?

 

Okuda:

It depends on the kids. Some kids don't want to show their braces.

 

Howard:

Some kids want the lingual?

 

Okuda:

No. I never put the lingual to kids.

 

Howard:

You don't do lingual to kids? Why is that.

 

Okuda:

They don't need it.

 

Howard:

Why do they not need it.

 

Okuda:

The kids, the braces for kids is the 2 by 4 appliances, interior and maybe all they need is molar. I don't put adult braces in the kids.

 

Howard:

You use removable?

 

Okuda:

No. Not removable. I put some on permanent teeth only to gain the space for the canine and [inaudible 00:14:31] in the future and make the molars to the class 1 relationship. I don't need to put all the braces.

 

Howard:

It's all on the labial?

 

Okuda:

Yes.

 

Howard:

Do you have any models that show that?

 

Okuda:

I don't have models. Maybe I can show you something like that.

 

Howard:

There is the color rubber bands. What percent of the children like to have colorful rubber bands and show it versus what percent are embarrassed and don't want to show it.

 

Sato:

[Japanese 00:15:03]

 

Okuda:

[Japanese 00:15:04]

 

Sato:

[Japanese 00:15:09]

 

Okuda:

Over 50%. They say over 50% are wearing color brand.

 

Howard:

50% want colors? Do they people that like color, are they more likely to be a girl versus a boy or same boy girl?

 

Okuda:

[Japanese 00:15:27]

 

Mitsuoka:

[Japanese 00:15:29]

 

Okuda:

The girl tend to wear the color.

 

Howard:

Would you say braces in Japan, is it half boys half girls or is the appearance more ...

 

Okuda:

Attractive?

 

Howard:

Is orthodontics, improving your appearance more popular for women or is it equally as popular for men?

 

Okuda:

Women mostly.

 

Howard:

What percent of your practice is women?

 

Okuda:

[Japanese 00:15:56] We have female patient over 80%.

 

Howard:

80%. 4 out of 5 patients are women? They are more into beauty. They buy more makeup, lipstick.

 

Okuda:

Yeah. They want to correct their high canine.

 

Howard:

They want to what?

 

Okuda:

High canine, and they want to align the crowdings, and they want to change their profiles.

 

Howard:

I want to ask a couple of Japanese Dental questions. Does Japan use water fluoridation to prevent decay? Does Tokyo adjust the fluoride level in the water? Does it do that or not really?

 

Okuda:

No, not really.

 

Howard:

It doesn't do that?

 

Okuda:

Yeah, but I give all patients the fluoride gel when I start the treatment.

 

Howard:

Does Japan not use water fluoridation anywhere? Have you heard of water fluoridation in Japan?

 

Okuda:

You mean the water?

 

Howard:

Yeah, the public drinking water.

 

Okuda:

No.

 

Howard:

Would you say ... We hear from around the world that some countries are drinking more soda pop, sugar, consuming more sugar today than say 25 years ago. My question is do you think Japanese children today have more cavities than 25 years ago, or the same number of cavities or less?

 

Okuda:

I think it's less.

 

Howard:

They have less cavities. Japanese children have less cavities today, is it a lot less?

 

Okuda:

It is less. Yes.

 

Howard:

If it's not from water fluoridation do you think it's from less sugar in the diet or just improved brushing, flossing, what do you attribute it to?

 

Okuda:

Parents care for it really.

 

Howard:

So you have seen that? It's amazing because it seems to me it has more to do with increasing awareness of brushing and flossing than it is changes in diet. I'm fat. I eat a lot of sugar, but I don't have any cavities. Just because countries start eating more sugar if they brush or floss it's not a cavity issue. It might be obesity or diabetes not so much decay.

 

 

How would you describe the average Japanese routine as far as how often do they Brush, floss, mouth wash, what would you say is the average routine in Japan. Are mouth washes big, is flossing big, is it mostly brushing?

 

Okuda:

We're mostly brushing.

 

Howard:

Mostly brushing?

 

Okuda:

Yeah, mostly brushing. It depends on the person. Some people use the floss too but not so many.

 

Howard:

What about mouth washes?

 

Okuda:

[Japanese 00:19:08]

 

Mitsuoka:

[Japanese 00:19:11]

 

Okuda:

We don't think that is so popular.

 

Howard:

Some countries have in the last 10 years added a lot of new dental schools, like Malaysia has gone from 4 schools to 18. Some countries, like in the last 10 years United States has started 6 new dental schools. What is that like in Japan. Has Japan started the same number of dental schools as they did 10, 20 years ago or are they building more dental schools. Are they increasing the supply of dentist or is it more flat?

 

Okuda:

Dentist is supplied enough.

 

Howard:

The dentist supply is much?

 

Okuda:

Too much. Too much dentist.

 

Howard:

There are too many dentist?

 

Okuda:

I don't know, any dentist probably close but probably number of students is getting less.

 

Howard:

The number of students is getting less?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

They have closed schools?

 

Okuda:

Not closed.

 

Howard:

Graduating less?

 

Okuda:

Graduating less, that's right.

 

Howard:

Is it a lot less than 10 years ago or a little bit less?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

You would say Japan is decreasing the number of dentist they are graduating?

 

Okuda:

Yeah. The Japanese government is trying to do that.

 

Howard:

Very good. I bet the dentist like that. Most people don't like competition so I imagine the dentals like the fact that the government is decreasing the number. Why do you think the government decreased the number of dental school graduates?

 

Okuda:

We already know that there are too much dentist and they can't close the dental school so the only thing they can do is to make the decreased numbers of the students.

 

Howard:

Very good. What are you passionate about? What would you like to talk about? What has got you excited in orthodontics now as opposed to ...

 

Okuda:

My topics is, my specialty is lingual orthodontics. It was [inaudible 00:21:36] technique.

 

Howard:

You are passionate about lingual orthodontics? Why is that?

 

Okuda:

It depends on demands. There is now so many doctors they can treat within the lingual technique.

 

Howard:

It's your unique selling proposition to do lingual braces?

 

Okuda:

Yeah, I could say so.

 

Howard:

In Japan are you allowed to advertise?

 

Okuda:

Yes. Basically yes.

 

Howard:

Do you advertise?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

How do you advertise?

 

Okuda:

Internet.

 

Howard:

What about Facebook?

 

Okuda:

We allow it of course.

 

Howard:

Are you on Facebook?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

Explain your advertising. You have a website, how do you get other Japanese people to find your website and see that you do lingual braces?

 

Okuda:

They find it through Google.

 

Howard:

Through Google?

 

Okuda:

Yeah, area and orthodontics.

 

Howard:

Do you buy Google ad words?

 

Okuda:

I do.

 

Howard:

How often do you do that?

 

Okuda:

I mean how often?

 

Howard:

Are you always buying Google?

 

Okuda:

Yes.

 

Howard:

Always buying Google ad words, and that works?

 

Okuda:

It works well.

 

Howard:

Is there any other type of marketing you are doing?

 

Okuda:

I do with the Yahoo, I forgot the name.

 

Howard:

Yahoo?

 

Okuda:

Yeah, what is it, ad words. I forget the name of the advertising by Yahoo. I forget it. Anyway, those advertisements in the internet.

 

Howard:

What keywords are you buying on ad words?

 

Okuda:

Lingual orthodontics.

 

Howard:

You buy the word lingual orthodontics?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

That's very exciting. Do you get a lot of word of mouth referrals for lingual's?

 

Okuda:

I do.

 

Howard:

Because they like that?

 

Okuda:

Yeah. Word of mouth is getting much popular here in my clinic.

 

Howard:

How long has your clinic been here, how long?

 

Okuda:

Almost 10 years.

 

Howard:

10 years. These two don't even look 10 years old.

 

Okuda:

I know. They were working for my clinic for 3 years.

 

Howard:

For how long?

 

Okuda:

3 years.

 

Howard:

They just got out of school 3 years ago?

 

Okuda:

No, they were already working on different clinics.

 

Howard:

That's neat. This is your unique specialty. I would think they would be popular just by looking at how poplar invisoline is getting. When you see how many people are buying Invisoline you can tell they don't want to show the braces so if you can put the braces on the inside, it's got to be obvious that that's what the-

 

Okuda:

Invisoline is getting popular here too in Japan but Invisoline [inaudible 00:24:38] I believe that Invisoline doesn't work for the extraction cases because the distance to move the teeth is too long for the invisoline.

 

Howard:

I'm sure there is 100 different ways to do anything but yeah. What else are you passionate about? Do you have a 3 dimensional x ray unit or do you just use 2 dimensional?

 

Okuda:

2 dimensional.

 

Howard:

2 dimensional is fine? Do you feel you need any CBCT or do you feel [crosstalk 00:25:17]

 

Okuda:

Probably I will need it in the future, but not now.

 

Howard:

Why in the future and not now?

 

Okuda:

Yeah. Also I like to know the thickness of the bone probably.

 

Howard:

That's something you plan on getting someday?

 

Okuda:

Yeah.

 

Howard:

What other technology things do you like today and have or things you think you want someday in the future?

 

Okuda:

For example, this is harmony and we change the information into the United States and also Paris, France. We change the date to each other and they make this appliance along my diagnosis. I think that's a pretty high quality technique, latest technique.

 

Howard:

Very good. Have you heard of Ortho Town?

 

Okuda:

No.

 

Howard:

I would be so honored if you would join Ortho Town. It was started in the United States and the United States has 10,000 orthodontist and half of them are on that website sharing cases.

 

Okuda:

Okay.

 

Howard:

I think they would just love to have a Japanese friend. That would be, I'm sure everybody would love that. Anything else you want to talk about?

 

Okuda:

[inaudible 00:26:57]

 

Howard:

I want to ask how often do your patients get a cleaning? How often?

 

Okuda:

Every time. What do you mean?

 

Howard:

Just a full regular cleaning. How often do your patients get a cleaning?

 

Okuda:

When they visit my clinic to change wires every 6 weeks.

 

Howard:

Every 6 weeks when you take off the wire you also clean the teeth?

 

Okuda:

Yeah, I do.

 

Howard:

How long does that take them to take off the wire and clean all the teeth and put the wire back on?

 

Okuda:

If the patient wears a labial appliances probably within 30 minutes.

 

Howard:

If they were lingual?

 

Okuda:

45 minutes.

 

Howard:

Lingual is harder then?

 

Okuda:

Just for in case patient break the bracket so we have to replace that. We keep that time much more than labial.

 

Howard:

Labial appointments are half an hour and lingual appointments are 45 minutes?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

Do you ever do fillings?

 

Okuda:

No, never.

 

Howard:

Just specialized?

 

Okuda:

Right. I refer to my friend doctor.

 

Howard:

You've been so pleasant and fun to visit and talk to.

 

Okuda:

Welcome to Tokyo.

 

Howard:

Thank you. We're having a blast. Anything else you want to talk about?

 

Okuda:

In your American culture how many people take the Orthodontic treatment basically? For example, one class in elementary school, how many kids do you think are taking the orthodontic treatment.

 

Howard:

You know, that's a good question. I wish I had the answer. I could say some numbers. We have 9 specialties and Orthodontics is the biggest one, so there is 10,000 orthodontist. The next biggest specialty is only half that amount. Oral surgeons, 5,000. Periodontist, 5,000. Endodontist, 4,000. I would say 10,000 orthodontist the average one starts about 15 cases a month. 10,000 times 15 would be, they start 15,000 cases a month in a country that has 330,000,000 million people.

 

Okuda:

15 case start in one month?

 

Howard:

How many cases do you start in a month?

 

Okuda:

10, around.

 

Howard:

You say 10, so 10?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

I think it's 15 a month, I could be wrong but that's what I always hear. You know what, if I find out, that's what interesting about Ortho Town. On the message board on Ortho Town when you start a thread you could start a poll. You could go on there and say "Hey, I'm from Japan. I'm wondering how many cases do you start each month in America." Or you could say Canada, or any country, or you could say just tell me the country you are from. You could start a poll. It's a very robust site. We've had 5 programmers since 1998. Facebook started in 2004 so we were 6 years before Facebook and it's really a robust website. The orthodontist only allow orthodontist on Ortho Town. Dental Town, the site that I'm on, it also has Orthodontist but Dental Town has 210,000 dentist from every country on earth. One of the categories is ... Let me ... One of the categories is ... Orthodontics. I would love for you, you could post in Orthodontics here, but of the specialties Orthodontics are the only one who wanted their own website.

 

 

Ortho Town is only for Orthodontist and I'm not allowed to go on that even though I own the site.

 

Okuda:

How do you allow? How do they know?

 

Howard:

Each person that joins Dental Town has to register. We have to know who they are. We have two people, Bridget and Milly, that verify every single person. It's about a 1,000 new members a month and they verify every single one. Then our program periodically pings your email address. If your email address ever stops working then we freeze the account because what we don't want, there are 2,000,000 dentist on Earth, we have 200,000 or 10% of them. What we don't want is all the public going on there asking what is this spot, taking selfies. It's not a ask the dentist a question it's a dentist helping dentist.

 

 

The whole website was based, with Dental Town no Dentist would ever have to practice solo again. Orthodontist, no orthodontist would ever have to be alone again. I think they would love to hear about your lingual braces. That's a neat specialty.

 

Okuda:

In Japan, in the orthodontics, with Korea, their lingual technique is very very popular.

 

Howard:

It's more popular in Korea than in Japan?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

Would you say that around the world lingual braces are the most popular in Korea?

 

Okuda:

I could say so, and Europe sometimes.

 

Howard:

Which countries in Europe?

 

Okuda:

France.

 

Howard:

I would say France is the most appearance culture of Europe. Far more than British or German. French lady at 80 year olds is still rocking high heel shoes and Chanel Number 5 and lipstick. They are still very into appearance.

 

Okuda:

Yeah. They want to show their braces.

 

Howard:

Korea has one of the highest plastic surgery rates too. Is that very common in Japan?

 

Okuda:

I don't think so.

 

Howard:

But you are aware that it's more common in Korea?

 

Okuda:

Mm-hmm (affirmative)

 

Howard:

What procedures are the most popular cosmetic surgeries in Korea?

 

Okuda:

[Japanese 00:33:58]

 

Mitsuoka:

[Japanese 00:34:10]

 

Sato:

[Japanese 00:34:14]

 

Okuda:

The facial line or eyes.

 

Howard:

Eyes. They also do a V thing with their jaw, don't they?

 

Okuda:

Yeah.

 

Howard:

What are they doing with their jaw. What is the cosmetic surgery on their jaw?

 

Okuda:

The widen [inaudible 00:34:31] is much more [inaudible 00:34:33]

 

Howard:

What do they actually do? What does the surgery do?

 

Okuda:

I don't know.

 

Howard:

You are not aware? I know they do get a ... They want a V on their jaw.

 

Okuda:

I heard that they cut their bone.

 

Howard:

They cut their jaw bone. I just want to say for the record, everyone thinks I've had plastic surgery, but this is all natural, it's all natural. No one believes me but it really is.

 

Okuda:

I bet.

 

Howard:

It really is all natural I'm not kidding you. I just think you guys are fun and adorable and I hope you join Dental Town and Ortho Town and thank you so much for spending time with us.

 

Okuda:

Thank you very much.

 

Howard:

Thank you very much. I hope to see you. If you get on Ortho Town you can talk to just the other Orthodontist but come on over to Dental Town and share these cases with us. I think they would like it on Dental Town too.

 

Okuda:

Thank you.

 

Howard:

All right. Thank you. All right. Bye bye.

 


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