My Blog

Posts for: March, 2018

By Gary W. Machiko, DMD
March 28, 2018
Category: Dental Procedures
Tags: TADs  

As a basic orthodontic appliance, braces are what allows us to move teeth into better positions to improve a person’s bite. In certain cases, though, this treatment application gets a little assistance from Temporary Anchorage Devices (TADs) to improve accuracy and reduce treatment time.

Braces take advantage of our teeth’s natural ability to move. Teeth are held in place within the bone by the periodontal ligament, an elastic tissue that attaches to the teeth with microscopic fibers secured by a hardened substance called cementum. The periodontal ligament is constantly remodeling in response to changes in the mouth. As pressure is placed on a tooth, new bone, ligament and cementum are formed on the “pulling” side of the tooth; on the other side, the bone and ligament dissolve (resorb), allowing the tooth to move in that direction.

Braces allow this natural process to occur with controlled forces applied by thin flexible wires threaded through the small brackets attached to the front of the teeth and then affixed or “anchored” to other teeth. By attaching the teeth to the other teeth by wires running through all the brackets, “anchorage” is created to allow teeth to be moved where the dentist wants them to go. By adjusting the tension on the wires, we can apply light but constant pressure on the “unanchored” teeth to move them into a new desired position.

Teeth we do not want to move are referred to as the anchorage for teeth we do want to move. If, however, the situation calls for more precise isolation of teeth to be moved, TADs can be very useful. TADs are mini-implants imbedded in the bone to serve as anchorage at strategic locations in the mouth. In this way, the group of teeth to be moved receives forces that are applied through the additional anchorage provided by the TADs. That “tension” or “pressure” is applied only to them and not to adjacent teeth that should not move. This increases efficiency for tooth movement and helps reduce the treatment time.

TADs can be placed using local anesthesia and with little discomfort, and are removed when orthodontic treatment is completed. Although the procedure is pretty straightforward, it does require collaboration between orthodontist and surgeon to ensure correct positioning.

In the end, TADs increase our ability to control the forces that move teeth during orthodontic treatment. This lessens discomfort for the patient and helps ensure the end result — a more functional bite and a transformed smile.

If you would like more information on the use of TADs and other orthodontic appliances, 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 “What are TADs?


Your smile isn’t the same without healthy gums—neither are your teeth, for that matter. So, maintaining your gums by protecting them from periodontal (gum) disease is a top priority.

Gum disease is caused by bacterial plaque, a thin biofilm that collects on teeth and is not removed due to poor oral hygiene practices. Infected gums become chronically inflamed and begin to weaken, ultimately losing their firm attachment to the teeth. This can result in increasing voids called periodontal pockets that fill with infection. The gums can also shrink back (recede), exposing the tooth roots to further infection.

Although gum disease treatment techniques vary, the overall goal is the same: remove the bacterial plaque fueling the infection. This most often involves a procedure called scaling with special hand instruments to manually remove plaque and calculus (tartar). If the infection has spread below the gum line we may need to use a procedure called root planing in which we scrape or “plane” plaque and calculus from the root surfaces.

As we remove plaque, the gums become less inflamed. As the inflammation subsides we often discover more plaque and calculus, requiring more treatment sessions. Hopefully, our efforts bring the disease under control and restorative healing to the gums.

But while gum tissue can regenerate on its own, it may need some assistance if the recession was severe. This assistance can be provided through surgical procedures that graft donor tissues to the recession site. There are a number of microsurgical approaches that are all quite intricate to perform, and will usually require a periodontist (a specialist in gum structures) to achieve the most functional and attractive result.

While we have the advanced techniques and equipment to treat and repair gum disease damage, the best approach is to try to prevent the disease from occurring at all. Prevention begins with daily brushing and flossing, and continues with regular dental cleanings and checkups.

And if you do notice potential signs of gum disease like swollen, reddened or bleeding gums, call us promptly for an examination. The sooner we diagnose and begin treatment the less damage this progressive disease can do to your gums—and your smile.

If you would like more information on protecting your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Periodontal Plastic Surgery.”

By Gary W. Machiko, DMD
March 08, 2018
Category: Dental Procedures

The last thing you want to think about is your smile on your wedding day. Let us help!teeth whitening

It’s about that time again: wedding season. While wedding bells are ringing for many couples who are ready to tie the knot in the coming months, a lot of couples are thinking about how they can boost their appearance before the big day. If you are worried that your dress might outshine your smile, then our Pittsburgh cosmetic dentist Dr. Gary Machiko is here to help.

We know your wedding photos are going to be framed around your home and maybe even sent to family and friends, so don’t you want a smile you can feel confident in? If you want to wipe away stains and brighten yellowing teeth before the big day then the most effective and fast approach is professional in-office teeth whitening.

Our Pittsburgh dentist offers Philips Zoom in-office whitening system because it is the best in whitening care. In just one session we could get your smile eight shades whiter in less than one hour. Plus, if you are someone who deals with tooth sensitivity you may be wary about getting teeth whitening because you’ve heard that this treatment can often exacerbate the problem. Don’t worry! Zoom Whitening delivery results with little to no sensitivity.

And if you decide that life is just a little too hectic right now to sit in the dentist’s chair to get treatment, we completely understand. Why else do you think we offer at-home whitening? We create custom whitening trays that are designed to fit over your teeth to provide even whitening results. We will also provide you with full instructions for how to use your at-home whitening kit so that you can get the results you want before the big day!

Of course, we also know that weddings can be expensive, and the idea of putting money into cosmetic dentistry on top of everything else might have your head spinning. Our Pittsburgh family dentist believes that everyone should have a beautiful smile and that money shouldn’t keep them from having the smile they want. This is why we are currently offering 20 percent off whitening treatments for brides and bridal parties. Now, that’s something to smile about!

Here in Pittsburgh, Dr. Machiko prides himself on providing the very best cosmetic, restorative and preventive dentistry. Want to get a whiter smile before your wedding day? No problem! And if you are considering other options like dental veneers or dental implants we offer free consultations so that you can truly discover what dental treatment will give you the results you want without the pressure.