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IfAppropriateAntibioticsbeforeImplantSurgeryCouldReduceInfectionRisk

Millions of microorganisms call your mouth home—and while most are friendly, some are not. An invasive procedure like implant surgery can disrupt the mouth's soft tissues and allow disease-causing bacteria to enter the bloodstream.

This isn't necessarily a major concern if your immune system is sound—your body will move quickly to quash any developing infection. But if your body's defense is weak or compromised by other health conditions, an ensuing infection could cause you problems. In the case of a dental implant, a localized infection around it could lead to its failure.

The bone normally grows and adheres to the surface of an implant soon after it's placed, giving it the added strength and durability for which implants are best known. A bacterial infection, though, could impede bone integration and weaken the implant's hold within the jaw.

One way to avoid this is by treating patients at high risk for infection with an antibiotic before the procedure. In one recent study, researchers concluded that patients receiving a 2-gram dose of amoxicillin an hour before implant surgery helped reduce the risk of future implant failure.

But before taking this route, the dentist must first decide whether antibiotic pre-treatment might be more detrimental than beneficial to an individual patient. Antibiotics can cause side effects in certain people ranging from diarrhea to allergic reactions. Healthcare providers must also be prudent with administering antibiotics for the good of society in general—overuse can potentially give rise to antibiotic-resistant bacteria.

A number of healthcare associations highly recommend antibiotic pre-treatment for any dental patient with prosthetic heart valves, a history of infective endocarditis, a heart transplant and similar heart conditions. They also recognize patients with conditions like prosthetic joints, weakened immune systems, diabetics or other serious health problems could also benefit from antibiotic pre-treatment, but leave it to the physician's discretion on whether or not it's appropriate for an individual patient.

If you're planning to undergo implant surgery or a similar procedure and are concerned about infection, speak with your dentist about whether you would qualify and benefit from antibiotic pre-treatment. If appropriate, taking an antibiotic beforehand could minimize your infection risk.

If you would like more information on pre-surgical antibiotic treatment, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”

HowBigBangTheoryActressMayimBialikGetsHerKidstoFloss

How many actresses have portrayed a neuroscientist on a wildly successful TV comedy while actually holding an advanced degree in neuroscience? As far as we know, exactly one: Mayim Bialik, who plays the lovably geeky Amy Farrah Fowler on CBS' The Big Bang Theory… and earned her PhD from UCLA.

Acknowledging her nerdy side, Bialik recently told Dear Doctor magazine, “I'm different, and I can't not be different.” Yet when it comes to her family's oral health, she wants the same things we all want: good checkups and great-looking smiles. “We're big on teeth and oral care,” she said. “Flossing is really a pleasure in our house.”

How does she get her two young sons to do it?

Bialik uses convenient pre-loaded floss holders that come complete with floss and a handle. “I just keep them in a little glass right next to the toothbrushes so they're open, no one has to reach, they're just right there,” she said. “It's really become such a routine, I don't even have to ask them anymore.”

As many parents have discovered, establishing healthy routines is one of the best things you can do to maintain your family's oral health. Here are some other oral hygiene tips you can try at home:

Brush to the music — Plenty of pop songs are about two minutes long… and that's the length of time you should brush your teeth. If brushing in silence gets boring, add a soundtrack. When the music's over — you're done!

Flossing can be fun — If standard dental floss doesn't appeal, there are many different styles of floss holders, from functional ones to cartoon characters… even some with a martial-arts theme! Find the one that your kids like best, and encourage them to use it.

The eyes don't lie — To show your kids how well (or not) they are cleaning their teeth, try using an over-the-counter disclosing solution. This harmless product will temporarily stain any plaque or debris that got left behind after brushing, so they can immediately see where they missed, and how to improve their hygiene technique — which will lead to better health.

Have regular dental exams & cleanings — When kids see you're enthusiastic about going to the dental office, it helps them feel the same way… and afterward, you can point out how great it feels to have a clean, sparkling smile.

For more information about oral hygiene, please contact our office or schedule a consultation. You can read the interview with Mayim Bialik in the latest issue of Dear Doctor magazine.

CrownLengtheningCouldHelpwithTreatingHardtoReachCavities

There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.

But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.

But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.

After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.

As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.

This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.

If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”

By Gary W. Machiko, DMD
June 17, 2019
Category: Oral Health
SevereFacePaincanbeManagedtoReduceDiscomfort

Recurring episodes of severe pain along your face could mean you have trigeminal neuralgia (TN). Although not always curable, TN can be managed effectively with the right strategy.

TN affects a specific pair of nerves called the trigeminal that signal pain in the face or jaws. They originate from the brain stem through the skull on either side of the face, with each nerve having upper, middle and lower branches. TN can affect one or more of these branches and cause anywhere from a mild twinge to excruciating pain.

Causes for TN differ in individual patients. Though it could be linked to a tumor, lesion or cold sore, it most often seems to arise from a blood vessel impinging on the nerve and damaging its outer coating. This causes it to be hypersensitive: chewing, speaking or even lightly touching the face can set it off. The damaged nerve may also fail to "shut off" when the triggering stimulation stops.

If you have these types of symptoms, your first step is to obtain an accurate diagnosis. You'll need a thorough examination to rule out other possibilities like jaw joint problems or a tooth abscess. Once we've determined it's definitely TN, we can then devise a treatment strategy.

We usually begin with conservative measures like medication to block pain transmission to the brain or anticonvulsants that stabilize the nerve and decrease abnormal firing. If medication isn't enough, we may then consider an invasive procedure to control symptoms.

Percutaneous treatment — often recommended for older patients or those in poor health — involves inserting a thin needle into the nerve to selectively damage certain fibers that will prevent the nerve from signaling pain. We might be able to move an impinging blood vessel aside from the nerve with a microsurgical procedure. As an alternative to surgery, high-dose radiation could also be aimed precisely at the pain site with a controlled beam to alter the nerve's ability to transmit pain.

TN can be a source of great discomfort that lowers your quality of life. But employing treatment techniques that best suit your situation, we can greatly reduce the misery it inflicts.

If you would like more information on facial pain caused by trigeminal neuralgia, 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 “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”

By Gary W. Machiko, DMD
June 11, 2019
Category: Dental Procedures
Tags: dental crowns  

How dental crowns from your cosmetic dentist in Pittsburgh, PA, can enhance your smile

There are many ways dental crowns can enhance your smile. They can make your smile stronger by restoring your chewing function. They crown-and-bridgecan also make your smile more beautiful by replacing unnatural-looking metal fillings with crowns that blend perfectly with your smile. Dr. Gary W. Machiko in Pittsburgh, PA, offers a full range of dental services including crowns to give you the smile you deserve.

Dental crowns from your cosmetic dentist strengthen your teeth because they cover the entire tooth surface above the gumline, holding your tooth together. When you bite down on a dental crown, the biting pressure and stress is shared evenly across your entire tooth, preventing the tooth from breaking. A large dental filling can actually weaken a tooth by dividing the tooth into sections, so when you bite down, a section of tooth could break off.

One of the great benefits of dental crowns is that they can also make your smile visually appealing. Instead of seeing a smile full of unnatural-looking metal, dental crowns allow others to see a beautiful, white smile.

Today’s dental crown materials like porcelain enhance the natural beauty of your smile. Porcelain is one of the most popular crown materials because porcelain closely resembles the look of tooth enamel. It’s also light reflective, just like tooth enamel. The natural-looking appearance of porcelain allows your smile to look undamaged and beautiful.

In addition to porcelain, you can also choose porcelain attached to a metal underlay, known as a PFM crown. These crowns combine the beauty of porcelain with the added strength of metal, so they are a great choice for back teeth where you need increased strength for chewing.

Dental crowns are one of the most popular restorative treatments because they provide:

  • Excellent coverage and strength for teeth that are worn down or damaged
  • A beautiful, natural-looking alternative to large metal fillings
  • Increased resistance to stains because of the materials used
  • Increased chewing surface area so you can chew your food better
  • Long-lasting beauty and protection for your smile as you age

Both you and your smile can benefit from dental crowns. To find out more about why dental crowns are an excellent choice to restore your smile, call your cosmetic dentist, Dr. Gary W. Machiko, in Pittsburgh, PA, today!





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