Okinawa White Dental Clinic

Dental care covered and not covered by health insurance

General dentistry

General dentistry refers to general treatment of tooth decay and gum disease in a dental clinic instead of specialized treatment such as orthodontics and implantation. Many general dentistry services are covered by health insurance, so many people think of general dentistry as dental care covered by health insurance. Even though the treatment is the same, some services are not covered by health insurance depending on the materials used or other aspects.

Treatment of tooth decay

Tooth decay is a disease where teeth are dissolved by acid. A film of bacteria called "plaque" adheres to the teeth. The bacteria ingest sugars contained in food and produce acid. Tooth decay is caused when this acid dissolves teeth. The dissolution of teeth is a process referred to as "demineralization." Healthy teeth are restored when the demineralized portion is repaired through a process referred to as "remineralization." These processes are usually balanced. If, however, bacteria frequently ingest sugars or if the oral environment promotes acid production by plaque, then demineralization proceeds faster than remineralization can catch up, and tooth decay progresses.

Stages of tooth decay and treatment

The progression of decayed teeth is classified into five stages, CO to C4, with "C" standing for "Caries (tooth decay)."

Extent of progression Symptoms and treatment
CO: incipient caries
  • Symptoms: The enamel (the surface of the tooth) is temporarily dissolved through demineralization, which is seldom visually identifiable.
  • Treatment: No special treatment is required because the tooth is likely to be repaired through remineralization.
C1: moderate caries
  • Symptoms: Bacteria have entered the enamel, but there are few subjective symptoms since there is no pain.
  • Treatment: The tooth is repaired with white resin. Treatment is completed in one session.
C2: advanced caries
  • Symptoms: Bacteria have reached the dentin (the body of the tooth), causing sensitivity and pain.
  • Treatment: A small lesion is repaired with an inlay while a crown is used for a larger lesion. At least two treatment sessions are required because a tooth mold needs to be made.
C3: severe caries
  • Symptoms: Bacteria have reached the dental pulp (bundle of nerves and blood vessels). The patient feels severe pain due to inflammation called "pulpitis."
  • Treatment: Root canal treatment is performed (to remove the dental pulp inside the root of the tooth). More than ten visits to the dental clinic may be necessary depending on the symptoms.
C4: last stage
  • Symptoms: The upper part of the tooth has been destroyed, leaving only its root. Because the nerves have died, the patient feels no pain.
  • Treatment: The tooth may be repaired with a crown or it may be extracted, followed by treatment with a denture, bridge, implant, etc.

The more tooth decay progresses, the more prolonged treatment and the more expensive treatment will be, posing a greater burden on patients. The burden will be minimal if tooth decay is treated in the early stages. If you feel slight discomfort with your teeth, immediately see your dentist.

Note: The descriptions of treatment are for reference only. Actual treatment of the same symptoms may differ from the description depending on the patient’s condition.

Prevention of tooth decay

The most important thing in the prevention of tooth decay is to eliminate its cause and prevent its progression. Please be sure to practice prevention routinely.

Eliminate the cause of tooth decay by brushing

Carefully brush your teeth before bedtime
Remineralization is less effective while you are asleep due to less secretion of saliva. This means that tooth decay easily progresses while you are asleep. To avoid this, carefully brush your teeth particularly before bedtime in the day.
Pay attention to misaligned teeth
Teeth that are misaligned, like crowded teeth, are particularly vulnerable to tooth decay. Fully remove debris from cracks and crevices using dental floss.

Dietary instructions to prevent the progression of tooth decay

The frequency of snacks, rather than the amount, matters
The more frequently you eat snacks, the more tooth decay The more frequently you eat snacks, the more tooth decay progresses because remineralization cannot catch up with demineralization. Avoid grazing on snacks. Instead, eat meals at regular times.
Do not eat or drink immediately before bedtime
Less saliva is secreted while you are asleep, so remineralization cannot catch up if you eat or drink immediately before bedtime. Avoid eating or drinking immediately before bedtime because it merely encourages bacteria.

Application of fluorine

Prevention of tooth decay with fluorine

Fluorine is an element present in nature. Fluorine is highly reactive (it strongly attracts electrons), so it is present not as an element but when it has bonded with other substances as fluorine compounds (collectively referred here to as "fluorine"). Fluorine is not a special substance, but is contained in soil, seawater, vegetables, fruit, fish, algae, and the tissues of plants and animals. Fluorine enhances resistance to tooth decay, so it is used around the world to prevent tooth decay. We naturally ingest fluorine from our meals every day, but they do not provide a sufficient amount of fluorine to prevent tooth decay. The application of fluorine to the tooth surface helps the intake of calcium from saliva into teeth, thus making them stronger.

Functions and effects of fluorine

The enamel that covers the tooth surface is the hardest part of the human body, but is dissolved by acid produced by bacteria. When fluorine is taken up by the enamel, the enamel is better able to resist dissolution by acid. The application of fluorine also promotes the remineralization of incipient caries so that they resolve on their own. Fluorine has the following effects.

  • Suppresses the production of acid by bacteria
  • Makes teeth stronger and more resistant to dissolution by acid
  • Promotes the adhesion of calcium in saliva and helps with remineralization

Uses of fluorine to prevent tooth decay

The use of fluorine to prevent tooth decay is common, and this method is considered effective by most dentists around the world. The application of fluorine at a dental clinic and other uses of fluorine to prevent tooth decay are described below.

  • Application of liquid fluorine at a dental clinic
  • Brushing one's teeth with a toothpaste containing fluorine
  • Washing out one’s mouth with a mouth rinse containing fluorine

Fluorine should be applied at a dental clinic not just once but periodically (three or four times annually) so that it is fully effective. There is a common assumption that fluorine is used in dental care for children, but it is similarly effective in adults. Effectively incorporate fluorine in your daily routine to prevent tooth decay.

Aesthetic dentistry

Aesthetic dentistry refers to dental care intended to produce an aesthetic dental appearance by means such as whitening the teeth or making a silver crown less conspicuous. Oral functions, such as chewing and speaking, should be fully maintained rather than merely producing an aesthetic dental appearance.


Orthodontics refers to treatment of malocclusion (unsightly or misaligned teeth, such as an overbite, an underbite, or crooked teeth) with orthodontic appliances. Orthodontics seeks to improve not just the aesthetics of teeth alignment but also to prevent tooth decay and gum disease and to keep the patient healthy.


Types and characteristics of malocclusion

"Malocclusion" refers to unsightly or misaligned teeth, such as an overbite, an underbite, and crooked teeth. There are several types of malocclusion, and each type has conspicuous characteristics.

Type Characteristics
Maxillary protrusion
Commonly referred to as: an overbite
The upper dentition or the entire upper jaw protrudes. The main causes include the overgrowth of the upper jaw, the undergrowth of the lower jaw, and thumb sucking.
Mandibular protrusion
Commonly referred to as: reversed occlusion or an underbite
The lower teeth protrude further than the upper teeth. There are congenital causes such as heredity, as well as acquired causes such as tongue thrusting (a habit of pushing the lower front teeth with the tongue).
Crowded teeth
Commonly referred to as: crooked teeth or snaggle teeth
Teeth are unevenly aligned or overlap. The main cause is that there are more teeth than the jaw can contain.
Open bite The upper and lower front teeth do not touch even though the back teeth do. The main causes include tongue thrusting, thumb sucking, and breathing through the mouth.
Overbite The upper and lower teeth severely overlap and the lower front teeth are not visible. The main causes include the downward overextension of the upper front teeth and a small lower jaw.
Spaced dentition There are many gaps between the teeth. The main causes include teeth that are too small for the jaw and too few teeth.
Median diastema
Commonly referred to as: a gap between the teeth
There is a gap between the front teeth. The main cause is that the jaw is too large, providing too large a space for the teeth to grow.

Problems with malocclusion and the necessity for orthodontic treatment

If left untreated, malocclusion negatively affects the patient physically and mentally, causing various problems.

  • The patient develops an inferiority complex regarding his or her appearance and is distressed when interacting with others.
  • The risk of tooth decay and gum disease increases due to difficulty brushing and many areas are left unbrushed.
  • Articulation is unclear, causing difficulty particularly when pronouncing a foreign language.
  • The patient's chewing power diminishes, causing a burden on the digestive organs since food is not adequately chewed.
  • The jaws move inefficiently when chewing, applying excessive force to the jaw joints and shoulders, causing headaches, stiff shoulders, and other problems.

These problems are relieved by orthodontic treatment, providing the patient with aesthetic teeth alignment as well as mental and physical health. Orthodontic therapies vary depending on the type of malocclusion, symptoms, the patient's preferences, lifestyle, diagnosis by the dentist, and other factors. Consult our clinic if you are considering treatment.

Preventive dentistry

Preventive dentistry is aimed at preventing the possible causes of oral problems, such as tooth decay and gum disease. A dental clinic is not a place to visit after you have developed tooth decay but a place to visit to prevent the development of tooth decay, so periodically visit a dental clinic even if you do not have any abnormalities. You should undergo a dental examination and receive brushing advice so that you can maintain your oral health and live with your teeth throughout your lifetime.


Even if you make a habit of brushing your teeth after each meal, some areas will inevitably be left unbrushed. Moreover, tartar (plaque that has hardened due to the adhesion of calcium in saliva) cannot be removed by brushing. If left untreated, plaque and tartar can cause tooth decay and gum disease.

To avoid this, PMTC is available. PMTC stands for "Professional Mechanical Tooth Cleaning," which refers to the removal of plaque and tartar that cannot be removed through brushing by the patient, and it is performed by a dentist or a dental hygienist in a dental clinic. Oral health maintenance is promoted by removing tartar using an instrument called a "scaler" and by removing plaque and discoloration on the tooth surface using specialized instruments and a polish containing fluorine. Oral health cannot be maintained just by daily care at home. Oral health can only be maintained by both at-home care and specialized care at a dental clinic.

Pediatric dentistry

Pediatric dentistry helps with the healthy growth of children from a dental perspective through the treatment and prevention of tooth decay mainly in children before their permanent teeth come in. As a parent, have you left your child’s tooth abnormality untreated since his or her baby teeth will be replaced with permanent teeth? An abnormality in baby teeth can negatively affect the permanent teeth beneath them. Even if there are no abnormalities, please visit our clinic once your child’s baby teeth start to come in.

Pediatric dentistry

Differences between pediatric dentistry and general dentistry

Unlike adults, children grow every day. In addition to mental and physical growth, their teeth and jaws also grow. Given these changes, different treatments are required for children than in adults. We identify the characteristics of the teeth and jaws of each child and perform treatment in consultation with their parents so that future problems will be prevented.

Causes of tooth decay in children

Baby teeth usually start to come in at around the age of five or six months, and a child has all of his or her baby teeth at around the age of three years. Baby teeth have different characteristics than permanent teeth and are considered more vulnerable to tooth decay.

Baby teeth have enamel (the surface of the tooth) and dentin (the body of the tooth) that are half as thick as the enamel and dentin of permanent teeth. The enamel is also soft and prone to dissolution by acid.
Limited regenerative capacity
Teeth are repaired through remineralization (returning the dissolved portion to its original state), but baby teeth are considered to have limited remineralization.
Collection of food particles
Baby teeth have more and deeper dental grooves than permanent teeth. Therefore, food particles more easily collect and many areas are left unbrushed. This creates an environment that promotes bacterial proliferation.

In addition to these characteristics, children are not able to effectively brush their teeth themselves, leaving many areas unbrushed. This means that toothbrushing by children is also a cause of tooth decay. The subsequent risk of tooth decay is considered to decrease if tooth decay in a child is prevented until the age of three years. Until then, parents should carefully brush their child's teeth. Even if children are able to brush their teeth themselves, parents should give their teeth a final brushing so that no areas are left unbrushed.

The negative effects of tooth decay in baby teeth on permanent teeth

Misaligned teeth
Baby teeth function as indicators for the proper emergence of permanent teeth. If a baby tooth is lost due to tooth decay or other causes, the permanent tooth cannot identify and come in at the correct position. This results in misaligned teeth.
Bad teeth
If tooth decay in baby teeth progresses until pus collects beyond the tooth root, it may dissolve the enamel of the permanent tooth lying beneath the baby tooth. This results in a permanent tooth of poor quality.

Prevention of tooth decay in children

Application of fluorine

Fluorine enhances resistance to tooth decay. The application of fluorine to the tooth surface makes the enamel more resistant to dissolution by acid, thereby making the tooth stronger. Fluorine has the following specific effects.

  • Suppresses the production of acid by bacteria
  • Makes teeth stronger and more resistant to dissolution by acid
  • Promotes the adhesion of calcium in saliva and helps with remineralization

Fluorine should be applied not just once but periodically (three or four times annually) so that it is fully effective.


Plastic sealant is used to fill in dental grooves and prevent tooth decay especially in the back teeth, which are prone to tooth decay. Sealant use does not require scraping of the teeth, but the sealant may come off depending on the shape of the tooth. In such an event, plaque can easily collect at the border of the remaining sealant and the tooth, increasing the risk of tooth decay. Periodic examinations should be undergone to make sure that the sealant is still in place.





Second opinions

Before undergoing treatment, many patients wonder if the proposed treatment is actually suitable for them or if there might be other therapies that suit them, and it might be difficult to decide on a treatment without more expert advice. In such cases, patients may seek a second opinion from another dentist so that they can select a suitable dentist and treatment.

The importance of a second opinion

Treatment closely interacts with a patient's body and health, and one could say that a treatment will affect the rest of their lives. If a patient undergoes treatment despite having reservations or unresolved concerns, a favorable outcome cannot be achieved no matter how good the dentist may be. A favorable outcome should be achieved by building an amicable relationship with a reliable dentist so that the patient will not have regrets after treatment.

When to seek a second opinion

When should a patient seek a second opinion? A second opinion will not cause a substantial difference in the results of treatment covered by health insurance because therapies and treatment costs are specified in advance. However, the treatment policy, costs, and other specifics of treatment not covered by health insurance vary among dental clinics and dentists, and the treatment period is prolonged in many cases. Therefore, a dental clinic and treatment must be carefully selected. A second opinion is usually sought before treatment not covered by health insurance.
Seeking a second opinion is particularly effective in situations such as implantation, orthodontic treatment, severe gum disease requiring surgery, a severe temporomandibular joint disorder, occlusal treatment, or aesthetic treatment.

When you actually consult a dentist

Be sure to fully prepare by listing the questions that you would like to ask. Consulting a dentist other than your primary care dentist is a precious opportunity. If you think of any questions during the dentist’s explanation or you think of new questions, be sure to ask them. Dental care affects your entire life. Use a second opinion to obtain treatment that you can accept so that you can stay healthy throughout your lifetime without regrets.