My Blog

Posts for: December, 2018

By Gary W. Machiko, DMD
December 29, 2018
Category: Dental Procedures
Tags: porcelain veneers  
ChangeYourSmilefortheBetterwithPorcelainVeneers

Are you tired of those stained, chipped, slightly crooked or—in a word—unattractive teeth? We have an effective solution for you: cover them with life-like porcelain veneers.

As the name implies, a veneer is a thin layer of dental porcelain custom-made to match your tooth’s shape and color and permanently bonded to the outside enamel. With its translucent, light-reflective quality similar to tooth enamel, dental porcelain looks completely natural. Veneers are well suited for minor to moderate imperfections, and can even be used to correct slight gaps between teeth.

We begin the process by performing a comprehensive dental exam to begin planning the exact shape and color of your new veneers. We can now do much of this planning with computer imaging, which may also give you the chance to see how your veneers will look on you after treatment.

We often will also need to prepare the teeth to accommodate the veneers when we bond them. Although the alterations shouldn’t be anywhere near as extensive as with a porcelain crown, we will still often need to remove some of the enamel layer so the veneer won’t look bulky. Even though we’ll remove as little as possible, if needed it will still permanently alter your teeth—so they’ll require some form of restoration from then on.

Once we’ve prepared the teeth, it’s then time to create the veneers. This is typically done by a dental laboratory technician through a manual process that may take several weeks. Increasingly, though, equipped dental offices are now able to generate their veneers in-house with computer-aided design/computer-aided manufacture (CAD/CAM) milling technology.

Once the veneers are ready, they’re bonded securely to the teeth with a detailed process that helps ensure they’ll endure biting and chewing forces for a long time. Still, you’ll need to avoid biting into hard objects or using your teeth for such things as cracking nuts. If you have a clenching or grinding habit, we may also recommend you wear a night guard to prevent excessive forces against not just your veneers but your teeth as well.

By taking good care of them, your new veneers can give you many years of service. Most of all, they can transform your embarrassing appearance into a smile you’re proud to show.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”


By Gary W. Machiko, DMD
December 19, 2018
Category: Dental Procedures
JohnnysTeethArentRottenAnyMore

Everyone has to face the music at some time — even John Lydon, former lead singer of The Sex Pistols, arguably England’s best known punk rock band. The 59-year old musician was once better known by his stage name, Johnny Rotten — a brash reference to the visibly degraded state of his teeth. But in the decades since his band broke up, Lydon’s lifelong deficiency in dental hygiene had begun to cause him serious problems.

In recent years, Lydon has had several dental surgeries — including one to resolve two serious abscesses in his mouth, which left him with stitches in his gums and a temporary speech impediment. Photos show that he also had missing teeth, which, sources say, he opted to replace with dental implants.

For Lydon (and many others in the same situation) that’s likely to be an excellent choice. Dental implants are the gold standard for tooth replacement today, for some very good reasons. The most natural-looking of all tooth replacements, implants also have a higher success rate than any other method: over 95 percent. They can be used to replace one tooth, several teeth, or an entire arch (top or bottom row) of teeth. And with only routine care, they can last for the rest of your life.

Like natural teeth, dental implants get support from the bone in your jaw. The implant itself — a screw-like titanium post — is inserted into the jaw in a minor surgical operation. The lifelike, visible part of the tooth — the crown — is attached to the implant by a sturdy connector called an abutment. In time, the titanium metal of the implant actually becomes fused with the living bone tissue. This not only provides a solid anchorage for the prosthetic, but it also prevents bone loss at the site of the missing tooth — which is something neither bridgework nor dentures can do.

It’s true that implants may have a higher initial cost than other tooth replacement methods; in the long run, however, they may prove more economical. Over time, the cost of repeated dental treatments and periodic replacement of shorter-lived tooth restorations (not to mention lost time and discomfort) can easily exceed the expense of implants.

That’s a lesson John Lydon has learned. “A lot of ill health came from neglecting my teeth,” he told a newspaper reporter. “I felt sick all the time, and I decided to do something about it… I’ve had all kinds of abscesses, jaw surgery. It costs money and is very painful. So Johnny says: ‘Get your brush!’”

We couldn’t agree more. But if brushing isn’t enough, it may be time to consider dental implants. If you would like more information about dental implants, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implants” and “Save a Tooth or Get an Implant?


By Gary W. Machiko, DMD
December 09, 2018
Category: Dental Procedures
Tags: oral surgery   orthodontics  
ExposingandPreservingImpactedCanineTeeth

The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.

At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.

Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.

Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.

At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.

If you would like more information on the effects and treatment of impacted 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 “Exposing Impacted Canines.”