Improving Smiles And Lives

By Dr. Kimi Caswell
Interviewed by Melissa Moniz
Wednesday - May 05, 2010
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Dr. Kimi Caswell

Where did you receive your schooling and training?

I went to Drury College in Springfield, Mo., and got a degree in biology. Then I went to University of Missouri in Kansas City for dental school, and Northwestern University in Chicago for my orthodontic residency and training.

How long have you been practicing?

I’ve been in Hawaii since 1992.

You have three offices (Mililani, Honolulu and Kahala) here on Oahu. Can you explain how you split your time?

I think it evolves and depends on where the greatest need is. Of course, our Downtown office is the busiest, so I do spend the most amount of time here.

What are the most common problems that require braces?

Teenagers are the bulk of our practice. The most common conditions are teens with overbites or underbites, impacted teeth and those types of problems. But we also have the younger people, where we’re adjusting growth issues where early correction can prevent other problems later. But probably the biggest change has been with adults. I think Invisalign is part of that change, but I also think that adults seek care because we recognize that when the teeth are crowded, we have more gum issues. So it becomes a multifaceted approach.

Kimi Caswell with her Downtown office staff: Ashley Iliff, Leslie Meyer-Bernades, Marcia Janicki, Cori Nakamoto, Janet Arelliano, Julie Smith, Remi Ganiko and Ano Puchalski

At what age would you recommend braces? Is it when their permanent teeth are all in?

Most kids see us when they still have some baby teeth. That’s when we start talking about if things are developing normally and growing normally. Some of our kids will actually get braces while they still have baby teeth to help facilitate a permanent tooth coming in, so it comes in more favorably. Sometimes we wait until all the permanent teeth are in and then go from there.

Can you talk more about Invisalign and how that compares to the traditional type of braces?

What we see is that it looks very different, but the biology is the same. So whether you use braces that are fixed on the tooth or something that’s removable, we expect the same kind of results. It’s just that the modality is different. The greatest thing about Invisalign is that you can take it off to brush and floss your teeth, and I love that. But the challenge with Invisalign is to discipline yourself to wear it all the time because you can take it off. And if it’s off, then it’s not working.

With Invisalign, how often do you need to have it on?

Invisalign is designed to be worn 22 hours a day. So the challenge is: When do you get your two hours off? I try to tell people to try to think of it as always in, and then once it becomes more a part of your life then that’s when it’s working its best. Some of our patients even eat with it in and we get excellent results because they have it in all the time.

Do you recommend Invisalign for just adult patients, or for teens and children as well?

Most of the parents of our younger patients are concerned about their ability to wear it and be disciplined about it, so most of our younger patients get braces for that reason. But the younger patients who have used Invisalign have done very well with it.

Generally, how long do braces need to stay on? And how does that compare to the Invisalign?

Braces have gotten high tech - they’re called self-ligating. What that means to the patient is that it’s designed to be more comfortable and move the teeth faster. The reason is that it’s a much more gentle movement. So what used to take maybe two to three years to straighten takes about a year and a half now. So it’s gotten much shorter. Invisalign, if it’s done with the discipline that’s needed, can finish in that same timing. I would say that they are both very similar.

For the past six years you have organized a food drive for the Hawaii Foodbank at Ward Theaters by inviting more than 1,200 patients to enjoy a movie screening. The next one is set for Saturday, May 8. Can you talk about why you decided to do this?

It’s an event we started to thank our patients, and after starting it we thought that we should do this for a greater cause, so we got the Hawaii Foodbank involved in it. We asked our patients that, when they come to the movie, they bring food. So last year we had 800 show up and we had this huge pile of food, and it was just fabulous. The movie we’ll be showing this year is Iron Man 2. It’s exciting because it’s the opening weekend for the movie!

You also have another exciting project in the works, having just purchased the Ossipoff Building (1210 Ward Ave.) to expand your office. Can you talk about that?

I just had the building blessed, and the kahu who came told us that we’re all in this canoe together and we are all here to take care of each other. And I thought that’s a very good analogy for the way we do business and just living here in Hawaii. We as a team (me and my staff) are trying to be a part of our patients’lives, and they are a part of ours.

The idea behind the new office is trying to make it as convenient and enjoyable as possible where parking isn’t an issue, or where the place is spacious enough for mom to read a magazine while her little one can go to the game room. So it’s where the time spent in the office is pleasant for everyone. For us, we see a lot of kids, so they come in with their family, so we’re trying to make it comfortable for everyone. I think, for my staff, they are the ones who really are providing the care for the families, so for me it’s to provide for them a place that they can do their best work.

The other thing we’re going to do is incorporate a lot of the new technology such as new 3-D imaging. And we’re also going green. We’ll be doing things such as putting in rooftop photo-voltaic systems. And this should all be done sometime next year.

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