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Posts for: January, 2016


You’re considering dental implants and you’ve done your homework: you know they’re considered the best tooth replacements available prized for durability and life-likeness. But you do have one concern — you have a metal allergy and you’re not sure how your body will react to the implant’s titanium and other trace metals.

An allergy is the body’s defensive response against any substance (living or non-living) perceived as a threat. Allergic reactions can range from a mild rash to rare instances of death due to multiple organ system shutdowns.

A person can become allergic to anything, including metals. An estimated 17% of women and 3% of men are allergic to nickel, while 1-3% of the general population to cobalt and chromium. While most allergic reactions occur in contact with consumer products (like jewelry) or metal-based manufacturing, some occur with metal medical devices or prosthetics, including certain cardiac stents and hip or knee replacements.

There are also rare cases of swelling or rashes in reaction to metal fillings, commonly known as dental amalgam. A mix of metals — mainly mercury with traces of silver, copper and tin — dental amalgam has been used for decades with the vast majority of patients experiencing no reactions. Further, amalgam has steadily declined in use in recent years as tooth-colored composite resins have become more popular.

Which brings us to dental implants: the vast majority are made of titanium alloy. Titanium is preferred in implants not only because it’s biocompatible (it “gets along” well with the body’s immune system), but also because it’s osteophilic, having an affinity with living bone tissue that encourages bone growth around and attached to the titanium. Both of these qualities make titanium a rare trigger for allergies even for people with a known metal allergy.

Still, implant allergic reactions do occur, although in only 0.6% of all cases, or six out of a thousand patients. The best course, then, is to let us know about any metal allergies you may have (or other systemic conditions, for that matter) during our initial consultation for implants. Along with that and other information, we'll be better able to advise you on whether implants are right for you.

If you would like more information on the effects of metal allergies 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 “Metal Allergies to Dental Implants.”

By Gary W. Machiko, DMD
January 13, 2016
Category: Dental Procedures
Tags: cosmetic dentistry  

Achieving the Hollywood smile you have always dreamed about has never been easier. Advances in dental technology has made cosmetic dentistry more effortless and effective than ever before. However, with so many options to brighten, straighten and even out Cosmetic Dentistryyour smile, understanding these procedures can be confusing. With help from Dr. Gary W. Machiko, DMD in Pittsburgh, PA, you can determine which procedure is best for you and the results you want to see.

Common Cosmetic Dentistry Procedures

  • Bonding: Dentists use bonding materials to correct small imperfections, such as gaps or chips. This bonding material is also used to fill cavities.
  • Braces: Orthodontic treatment like traditional metal braces or Invisalign straighten your teeth and correct bite issues. Braces correct a myriad of problems, including misaligned or overlapped teeth, overcrowding and undercrowding, overbite, underbite and crossbite.
  • Bridges: When a patient is missing a tooth with healthy teeth surrounding its gap, a bridge is attached using crowns on either side to provide a replacement tooth.
  • Crowns: Crowns sit over a natural tooth to stabilize and strengthen it. Broken, weak or otherwise compromised teeth benefit from dental crowns. They are also used to reinforce a large filling.
  • Contouring and Reshaping: This procedure involves reshaping or contouring the teeth to improve their appearance. Teeth which are uneven in length, have small chips or are crooked or overlapping often benefit from contouring and reshaping.
  • Dental implants: Dental implants replace a missing tooth’s root. Implants are surgically placed into the jawbone, and integrate into the bone to provide a stable foundation for a dental restoration. A crown attaches to the implanted post and permanently replaces a missing tooth.
  • Periodontal procedures: These procedures deal with the gum tissue. Uneven gum lines, “gummy” smiles and exposed roots are repaired using periodontal procedures.
  • Teeth Whitening: Professional teeth whitening sessions are one of the easiest and fastest ways to restore your smile. The whitening agents used by your dentist can whiten your teeth up to 10 shades in a single session. The results are immediately noticeable.
  • Veneers: Veneers are a thin porcelain shell fitted over the front of the tooth. Veneers cover imperfections in the teeth, including chips, cracks, staining or discolorations and slight misalignments or overlaps in the teeth.

For more information on cosmetic dentistry in the Pittsburgh, PA area, please contact Dr. Gary W. Machiko, DMD. Call (412) 367-1319 to schedule your appointment today!


A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.

We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?

Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.

When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?

In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.

So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.

If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”