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Posts for category: Oral Health

By Gary W. Machiko, DMD
March 19, 2019
Category: Oral Health
Tags: gum disease  
StopGumDiseaseBeforeitHarmsYourHealth

If you're over 30 your chances for developing periodontal (gum) disease are better than half. And it's not a minor matter—untreated gum disease can lead not only to tooth loss, but to an increased risk of cardiovascular disease and other inflammatory conditions.

Fortunately, we have effective ways to treat gum disease, even in advanced stages. But the best approach by far in avoiding a devastating outcome for your teeth is to prevent gum disease from developing in the first place.

It helps first to know how gum disease begins. The most common cause is dental plaque, a thin biofilm of food particles on tooth surfaces that harbors the bacteria that triggers the disease. If you keep your teeth clean of built-up plaque and tartar (calcified plaque) with daily brushing and flossing and regular dental cleanings, you'll minimize the growth of disease-causing bacteria.

If you don't practice effective oral hygiene, however, within a few days you could develop an initial infection called gingivitis. This form affects the outermost layers of the gums and triggers a defensive response from the body known as inflammation. Ordinarily, inflammation helps protect surrounding tissues from infection spread, but it can damage your gums if it becomes chronic. Your weakened gums may begin to detach from the teeth, forming voids filled with inflammation known as periodontal pockets. Eventually, the infection can spread to the supporting bone and lead to tooth loss.

In addition to a dedicated oral hygiene and dental care program, you should also be on the lookout for early signs of gingivitis. Infected gums can become red, swollen and tender to the touch. You may notice they bleed easily while brushing and flossing, or a foul taste or breath that won't go away even after brushing. And if some of your teeth feel loose or don't seem to bite together as they used to, this is a sign of advanced gum disease that deserves your dentist's immediate attention.

Practicing preventive hygiene is the best way to stop gum disease before it starts. But if gum disease does happen, catching it early can be a game-changer, both for your teeth and your smile.

If you would like more information on preventing and treating gum disease, 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 “How Gum Disease Gets Started.”

By Gary W. Machiko, DMD
March 09, 2019
Category: Oral Health
NBAPlayersInjuryPointsOutNeedforMouthguards

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

By Gary W. Machiko, DMD
February 27, 2019
Category: Oral Health
Tags: loose teeth  
LoosePermanentTeethisaProblem-takeActionNow

If you've noticed one of your teeth feeling loose, you're right to believe it's not a good thing. Loose permanent teeth are a sign of an underlying problem.

Periodontal (gum) disease is usually the culprit. Caused by bacterial plaque, a thin film of food particles, gum disease causes the tissues that support teeth to weaken and detach. While a tooth can become loose from too much biting force (primary occlusal trauma), it's more likely bone loss from gum disease has caused so much damage that even the forces from normal biting can trigger looseness.

A loose tooth must be treated or you may lose it altogether. If it's from gum disease, your treatment will have two phases.

In the first phase we need to stop the gum infection by removing plaque and calculus (hardened plaque deposits). Hand instruments known as scalers or ultrasonic equipment are usually sufficient for removing plaque and calculus around or just below the gum line. If the plaque extends deeper near or around the roots, we may need to consider surgical techniques to access these deeper deposits.

Once the infection is under control and the tissues have healed, we can then undertake the second phase: reducing biting forces by breaking clenching and grinding habits, doing a bite adjustment for advanced problems and securing loose teeth with splinting.

Although there are different types of splinting — both temporary and permanent — they all link loose teeth to adjacent secure teeth much like pickets in a fence. One way is to bond dental material to the outer enamel of all the teeth involved; a more permanent technique is to cut a small channel extending across all the teeth and bond a rigid metal splint within it.

To reduce biting forces on loose teeth, we might recommend wearing a bite guard to keep the teeth from generating excessive biting forces with each other. We may also recommend orthodontics to create a better bite or reshape the teeth's biting surfaces by grinding away small selected portions of tooth material so they generate less force.

Using the right combination of methods we can repair loose teeth and make them more secure. But time is of the essence: the sooner we begin treatment for a loose tooth, the better the outcome.

If you would like more information on treating loose teeth, 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 “Treatment for Loose Teeth.”

By Gary W. Machiko, DMD
February 07, 2019
Category: Oral Health
Tags: gum disease  
GingivitisCouldBecomeaMoreSeriousFormofGumDisease

People with poor hygiene habits can develop a chronic form of periodontal (gum) disease known as gingivitis. Characterized by inflamed and bleeding gums, gingivitis is caused by an infection triggered by bacterial plaque, a thin film of food remnant built up on tooth surfaces.

This chronic form of gingivitis, though, can quickly escalate into more serious forms of gum disease that may lead to tooth and bone loss. One such condition is Acute Necrotizing Ulcerative Gingivitis (ANUG), also known as “trench mouth.” ANUG is a painful condition that can appear suddenly and result in extensive tissue damage and ulcerations, particularly in the papillae, the small, triangular bits of tissue between teeth. Persons with ANUG may also develop a foul breath and taste.

Gingivitis often develops into ANUG when certain mouth conditions exist: poor diet, smoking, which can dry the mouth and disrupt healthy bacterial flora, and increased stress or anxiety. If caught early, though, ANUG is highly treatable and reversible.

After determining you have ANUG and not another condition, our first step is to relieve the symptoms with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to manage pain and reduce swelling. We also prescribe a regimen of antibiotics like Amoxicillin (a proven antibiotic against the specific bacteria that cause ANUG). This should decrease the symptoms within 24 to 48 hours.

As the inflammation subsides we want to continue treatment by removing any plaque or calculus (hardened plaque deposits), especially in hard to reach places. This involves a technique known as scaling in which we used specialized hand tools or ultrasonic equipment to manually remove and flush away plaque and calculus.

The final step depends on you. To prevent reoccurrence, it’s important for you to consistently practice effective oral hygiene to remove plaque — brushing twice and flossing once each day, and visiting us at least twice a year for cleanings and checkups. Quitting tobacco and improving your diet will also reduce your risk for ANUG.

ANUG and any other form of gum disease can cause a lot of damage. But taking steps to care for your teeth will help keep this acute form of gingivitis from arising in the first place.

If you would like more information on gingivitis and other forms of gum disease, 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 “Painful Gums in Teens & Adults.”

By Gary W. Machiko, DMD
November 29, 2018
Category: Oral Health
Tags: gum disease  
StopGumDiseaseBeforeitBecomesaMajorHealthIssue

If you think gum disease only happens to the other guy (or gal), think again. If you’re over 30 you have a 50-50 chance for an infection. After 65 the risk climbs to 70 percent.

Fortunately, we can effectively treat most cases of gum disease. But depending on its severity, treatment can involve numerous intensive sessions and possible surgery to bring the disease under control. So, why not prevent gum disease before it happens?

First, though, let’s look at how gum disease most often begins—with dental plaque, a thin film of bacteria and food particles built up on teeth and gum surfaces. If plaque isn’t consistently removed through daily brushing and flossing, it doesn’t take long—just a few days—for the bacteria to infect the gums.

While it’s not always easy to detect gum disease early on, there are signs to look for like red, swollen and tender gums that bleed easily when you brush or floss, and bad breath or taste. The infection is usually more advanced if you notice pus-filled areas around your gums or loose teeth. If you see any of these (especially advanced signs like loose teeth) you should contact us as soon as possible.

Obviously, the name of the game with prevention is stopping plaque buildup, mainly through daily brushing and flossing. Technique is the key to effectiveness, especially with brushing: you should gently but thoroughly scrub all tooth surfaces and around the gum line, coupled with flossing between teeth.

To find out how well you’re doing, you can rub your tongue along your teeth after you brush and floss—you should feel a smooth, almost squeaky sensation. You can also use plaque-disclosing agents that dye bacterial plaque a particular color so you can easily see surface areas you’ve missed. You can also ask us for a “report card” on how well you’re doing during your next dental visit.

Dental visits, of course, are the other essential part of gum disease prevention—at least every six months (or more, if we recommend) for cleaning and checkups. Not only will we be able to remove hard-to-reach plaque and tartar, we’ll also give your gums a thorough assessment. By following this prevention regimen you’ll increase your chances of not becoming a gum disease statistic.

If you would like more information on recognizing and treating gum disease, 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 “How Gum Disease Gets Started.”