My Blog

By Gary W. Machiko, DMD
November 14, 2019
Category: Oral Health
Tags: gum disease  
PeriodontalMaintenanceCanHelpYouAvoidAnotherEpisodeofGumDisease

To keep a healthy smile, brushing and flossing your teeth every day should be at the top of your to-do list, along with regular dental visits. Dental visits are usually scheduled every six months when your dental professional will remove any built-up plaque and tartar (hardened plaque deposits) missed during everyday hygiene.

If you've experienced periodontal (gum) disease, however, these dental visits may become even more important toward preventing a re-infection. For one thing, your dentist may want to see you more frequently.

Gum disease is caused by bacteria living in dental plaque, which first infect the superficial layers of gum tissue. Even though the body initiates an inflammatory response to fight it, the infection continues to grow as long as there is plaque present to fuel it. The problem isn't just plaque on the visible tooth surface—hidden plaque beneath the gum line can create deep pockets of infection that can be difficult to treat.

To stop the infection, dentists must manually remove plaque through procedures known as scaling and root planing. Any and all plaque and tartar deposits must be removed, even those deep around the roots, to arrest the infection. This often requires several treatment sessions and sometimes gum surgery to access areas below the gum line.

These types of treatments, especially in the disease's early stages, have a good chance of restoring health to your gums. But because of the high possibility of reinfection, your dentist will need to step up your regular dental maintenance from now on. This could mean visits as frequent as every few weeks, depending on your particular case of gum disease and your dentist's recommendation.

Your dental visits after gum disease may also become more involved than before. Your dentist will now monitor you closely for any signs of reinfection and at the first sign initiate a new round of treatment. You may also need surgical procedures to make some areas around your teeth more accessible for future cleaning and maintenance.

Periodontal maintenance after gum disease helps ensure another infection doesn't rise up to undermine your progress. To paraphrase a well-known quote, eternal vigilance is the price of continuing good dental health.

If you would like more information on professional dental health maintenance, please contact us or schedule an appointment for a consultation.

By Gary W. Machiko, DMD
November 04, 2019
Category: Dental Procedures
NBCStarDeliversaMessageaboutthePerfectSmile

Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.

Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.

Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”

Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.

There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.

So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.

Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”

If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”

By Gary W. Machiko, DMD
October 25, 2019
Category: Dental Procedures
Tags: dental implant  
YourQuestforaDentalImplantMightBeInterruptedbyBoneLoss

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants After Previous Tooth Loss.”

ToothinOneDayProceduresRequireSpecialAttentionforSuccess

You've seen the ads for obtaining a new tooth in one day with a dental implant. Those aren't exaggerated claims — you can leave the dental office the same day with a new tooth that looks and functions like the old one.

But the dramatic marketing aside, there is a bit more to the story. Same day tooth replacement isn't appropriate in every situation. And even when it is, there are risks for failure.

We can minimize those risks, however, by focusing on certain goals during the three distinct phases in the process: removing the natural tooth; placing the metal implant into the jawbone; and affixing the visible, crown.

It's crucial during tooth extraction that we avoid damaging the socket bone that will ultimately support the implant's titanium post. If the socket walls break down it could set up future gum recession or cause us to abort the implant procedure altogether that day.

When placing the implant, we want to focus on achieving a strong hold. Due to its special affinity with titanium, bone cells gradually grow and adhere to the post to firmly anchor the implant in time. But since we're immediately loading a crown rather than allowing the bone to fully integrate first, we need to ensure the implant has a secure hold from the get-go. We can only achieve this with precise placement based on careful examination and planning, as well as adequate bone.

Even so, the implant still needs to integrate with the bone for a lasting hold, and that takes time. Even with normal biting forces the implant risks damage during this integration period. That's why we place a temporary crown a little shorter than the surrounding teeth. Those adjacent teeth will take the brunt of the biting force and not the implant.

Once the bone has fully integrated, we'll replace the temporary crown with a permanent one the proper height proportional to the other teeth. Even with the temporary crown, though, you'll still have a life-like tooth the day we removed the older one.

The key to success is planning — first determining if you meet the criteria for a same-day implant and then mapping out and carefully executing each succeeding step. Doing this will ensure your same-day implant is a success from day one.

If you would like more information on same-day tooth replacement, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Same-Day Tooth Replacement with Dental Implants.”

By Gary W. Machiko, DMD
October 05, 2019
Category: Oral Health
Tags: oral hygiene  
ImprovingHygieneSkillsMaximizesRemovalofDisease-CausingPlaque

Your mouth is teeming with bacteria—millions of them. But don't be alarmed: Most are benign or even beneficial. There are, however, some bacteria that cause tooth decay or periodontal (gum) disease, which can damage your oral health.

These disease-causing bacteria feed and multiply within a thin biofilm of leftover food particles on tooth surfaces called dental plaque. To reduce these bacterial populations—and thus your disease risk—you'll need to keep plaque from building up through daily brushing and flossing.

Now, there's brushing and flossing—and then there's effective brushing and flossing. While both tasks are fairly simple to perform, there are some things you can do to maximize plaque removal.

Regarding the first task, you should brush once or twice a day unless your dentist advises otherwise. And "Easy does it" is the rule: Hard, aggressive scrubbing can damage your gums. A gentle, circular motion using a good quality toothbrush will get the job done. Just be sure to brush all tooth surfaces, including the nooks and crannies along the biting surfaces. On average, a complete brushing session should take about two minutes.

You should also floss at least once a day. To begin with, take about 18" of thread and wrap each end around an index or middle finger. Pulling taut and using your thumbs to help maneuver the thread, ease the floss between teeth. You then wrap it around each tooth side to form a "C" shape and gently slide the floss up and down. Continue on around until you've flossed between each tooth on both jaws.

You can get a rough idea how well you did after each hygiene session by rubbing your tongue against your teeth—they should feel slick and smooth. If you feel any grittiness, some plaque still remains. Your dentist can give you a more precise evaluation of your cleaning effectiveness at your regular dental visits. This is also when they'll clean your teeth of any missed plaque and tartar.

While professional dental cleanings are important, what you do every day to remove plaque is the real game changer for optimum oral health. Becoming a brushing and flossing "ninja" is the best way to keep your healthy smile.

If you would like more information on daily oral care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”





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