My Blog

Posts for: March, 2015


What causes stains on teeth?

Staining can occur on the outside surfaces of teeth and is caused by foods such as red wine, coffee, and tea, as well as by tobacco use. They can also be developmental, affecting the structure of the teeth due to excessive fluoride levels or from tetracycline antibiotics given during childhood to name a few. Changes in a tooth's enamel or dentin during tooth formation, or as teeth age, can also cause discoloration.

What is going on inside a tooth's structure that makes it look stained?

Most of a tooth's covering (95 percent) is composed of highly mineralized enamel. The crystals of enamel are contained in a framework, or matrix, of organic matter. Dentists believe that various organic compounds that get into this matrix can cause staining.

How do whiteners work?

Tooth whiteners or bleaches expose the teeth to a peroxide compound. This creates reactive oxygen that breaks down highly colored organic compounds within the tooth's sub-surface matrix, making the tooth look whiter, but without changing its internal structure.

What professional in-office whitening techniques are available?

During treatment, a high concentration of peroxide solution in the form of a gel is applied directly on the teeth, often with activation by a heat or light source. These systems use custom tailored trays fitted to an individual's mouth. Silicone barriers or protective gels are used to keep the peroxide gel away from the gums or sensitive membranes in the mouth.

How are professional home whiteners different?

Home whiteners involve a less concentrated solution of peroxide in a gel form. It is delivered to the tooth surface by a bleaching tray that is custom-made in your dentist's office. Over-the-counter whiteners such as whitening strips or paint-on formulas can also be used, but they take longer and they're not as effective — the more diluted solutions are used for safety.

Can toothpastes really whiten teeth?

Mild abrasives in toothpastes clean surface stains but cannot change the underlying tooth color or remove significant staining.

How long do the results last?

Usually, the results last from six months to two years, but effects will diminish over time. You can make them last longer by avoiding the foods and habits that cause staining.

Are teeth whiteners safe to use?

Teeth whitening products are safe if used according to our recommendations or the product manufacturer's directions. Peroxide products may be toxic if used in excess of recommended intervals and amounts.

Read more about teeth whitening in the article “Teeth Whitening, Brighter, Lighter, Whiter...” Contact us today to schedule an appointment or to discuss whether tooth whitening is right for you.

By Gary W. Machiko, DMD
March 23, 2015
Category: Dental Procedures

Knowing what you want to change about your smile will help you decide which cosmetic procedure is right for you.

What is restorative dentistry?

Restorative dentistry focuses on different treatments and procedures to improve the overall health and appearance of your smile. There are a variety of different types of restorative dentistry available in Pittsburgh, and the best treatment option for you will depend on your treatment goals and the health of your smile now. Restorative dentistry ranges from minor, non-invasive procedures that offer subtle adjustments to full makeovers for those with severe dental issues.

What should you consider before opting for restorative dentistry?

There is a lot that you need to consider before getting restorative dentistry in Pittsburgh. Ask yourself these questions:

  • What are the issues I have with my smile?
  • What smile problems do I want to fix?
  • How much time and money do I want to put into my treatment?
  • Will my insurance company cover my restorative dentistry?
  • Am I looking for minor corrections or a serious transformation?

The most common dental issues people want to fix include:

  • Stains and discolorations
  • Chips and cracks
  • Gaps between teeth
  • Crooked or misshapen teeth
  • Crowding and overlapping teeth
  • Missing teeth

Most external dental stains can be removed with professional teeth whitening; however, for those with stains caused by internal trauma or antibiotic use, our teeth whitening system will not be effective. In this case, we will recommend dental veneers to hide these problem areas.

If you have very small chips or cracks, dental bonding is a non-invasive and painless way to hide these tiny imperfections. If you are dealing with more noticeable damage, then dental veneers will be recommended.

For those with spaces between teeth, overcrowding or crooked teeth, dental veneers are also a great way to hide these problems and produce a straighter looking smile. This cosmetic procedure is also a great option for someone who wants straighter teeth but doesn’t want to wear braces.

Those with missing permanent teeth have a variety of options, from dentures and bridges to dental implants. Those missing a few teeth may opt for partial dentures, dental bridges or even dental implant-supported dentures or bridges. Dental implants are also a great way to replace one missing tooth. For those missing all of their teeth, full dentures or implant-supported full dentures are also great options. What tooth loss replacement you opt for will depend on your overall health and lifestyle.

If you want to improve the look and health of your smile, then it’s time to discuss your restorative dentistry options in Pittsburgh. Call our office and schedule a consultation with Dr. Gary W. Machiko today.


One’s a singer who made her name playing New York clubs in the 1980’s before catapulting to international pop stardom; the other’s an actress from New Zealand who, in 1994, at the age of 11, became the second-youngest person ever to win an Academy Award. Both remain at the top of the A-list today. What other feature do Madonna and Anna Paquin have in common?

You guessed it — it’s their teeth. Both have a small but noticeable gap between their two front teeth, known as a diastema. This condition is relatively common, and it’s normally easy to treat — if that’s something you’d like to do. But wait a moment… In certain African countries, this kind of smile is considered a sign of fertility; in France, they call it “dents du bonheur” (lucky teeth); some other cultures consider the gap a predictor of future wealth. So if you’ve already made this look work for you, there’s no need to change it — even if you might need other cosmetic dental work.

The “perfectly imperfect” smile has become an increasingly popular option for people having veneers, cosmetic bonding, or even dental implants. Some trend-watchers have even noted a pushback against the ideal of a completely even, flawless, Hollywood-white smile. Does that create a problem at the dentist’s office?

Absolutely not! We call the process of figuring out how your teeth should look “smile design” — and it’s as much an art as a science. When we’re just beginning to design your smile, we look at a number of features — including the size, shape, color and alignment of your teeth, the position of your lips, the amount of gums exposed, and the relationship between your smile and your other facial features. We’re also listening carefully to you: what you like and don’t like about your smile, how you think it could be improved… and what should stay just the way it is.

Of course, before doing any cosmetic work, we will always perform a complete dental exam to detect any underlying condition and determine what treatments are best. Then, we will work with you to help you get the smile you’ve always wanted. Not sure exactly how it will look when it’s all done? Ask us for a preview — from computer-generated pictures to actual 3-D models, we can show you how your new smile will enhance your appearance.

So if your smile needs a little help to look its best — but you still want it to be uniquely yours — maybe now is the time to come in and see us. If you would like more information on smile design, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “The Impact of a Smile Makeover” and “Beautiful Smiles by Design.”