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Posts for: February, 2019

By Gary W. Machiko, DMD
February 27, 2019
Category: Dental Procedures

Dental ImplantsLeaving a missing tooth untreated can cause serious issues with your smile. Luckily, dental implants provide a permanent and highly-effective solution to this problem. Implants can replace both your missing tooth and its root to give you back your smile and allow you to eat, speak, and chew normally. Read below to learn more about dental implants, and for treatment, call the Pittsburg office of Dr. Gary Machiko. Dr. Machiko is a dentist with dual degrees in dentistry and mechanical engineering, a background that allows for extremely precise implant measurement and placement.

What is a dental implant?
Dental implants are a cosmetic dental procedure which focuses on replacing a missing tooth and its root. The treatment uses three main components: the implant’s fixture, the abutment, and a prosthetic tooth. Implants take several dental appointments to complete and require an adequate amount of time to heal between initially placing the implant’s fixtures and completion of the procedure.

Can a dental implant help me?
If you have a missing tooth, you can probably benefit from a dental implant. However, some patients are not good candidates for this procedure. Someone who has significant bone atrophy in the implant site or who does not have a strong at-home oral care routine may not qualify for the implant procedure. However, these maladies can be fixed through care from your Pittsburg dentist, leading to eventual implant qualification.

Are dental implants safe?

Though there is a risk to any dental or medical procedure, the risk associated with dental implants is a low one. In use for decades, dental implants have come to be known as a safe, effective tooth replacement option in dentist’s offices around the world.

Dental implants in Pittsburgh, PA
A consultation with your dentist can help ensure that you receive the best implant care possible. In some cases, a patient may require other dental treatments prior to being considered for dental implants, such as bone grafts, fillings, or root canals. A consultation with your dentist can help you determine if this procedure is the best treatment for your dental situation.

For more information on dental implants, please contact Dr. Gary Machiko in Pittsburgh, PA, at (724) 719-2866.


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.”


TreatingGumDiseaseImportanttoSavingtheUnderlyingBone

If you've had periodontal (gum) disease, you've no doubt experienced gum inflammation, bleeding or pain. But your gums may not be the only mouth structures under assault — the disease may be damaging the underlying support bone.

Although easing soft tissue symptoms is important, our primary focus is to protect all your teeth's supporting structures — the gums, the attaching ligaments and, of course, the bone. To do so we must stop the infection and reduce the risk of reoccurrence.

Stopping gum disease depends on removing its source — plaque, a thin biofilm of bacteria and food particles accumulating on tooth surfaces, due to poor oral hygiene. We must remove it mechanically — with hand instruments known as scalers or ultrasonic equipment that vibrates the plaque and calculus (hardened plaque deposits) loose.

It's not always a straightforward matter, though, especially if the diseased gum tissues have pulled away from the teeth. The slight natural gap between teeth can widen into voids known as periodontal pockets; they fill with infection and can extend several millimeters below the gum line. We must thoroughly cleanse these pockets, sometimes with invasive techniques like root planing (removing plaque from the roots) or surgical access. You may also need tissue grafting to regenerate gum attachment to the teeth.

One of the more difficult scenarios involves pockets where roots divide, known as furcations. This can cause cave-like voids of bone loss. Unless we treat it, the continuing bone loss will eventually lead to tooth loss. Besides plaque removal, it may also be prudent in these cases to use antimicrobial products (such as a mouthrinse with chlorhexidine) or antibiotics like tetracycline to reduce bacterial growth.

Perhaps the most important factor is what happens after treatment. To maintain gum health and reduce the chances of re-infection, you'll need to practice diligent daily hygiene, including brushing, flossing and any prescribed rinses. You should also keep up a regular schedule of office cleanings and checkups, sometimes more than twice a year depending on your degree of disease.

If you would like more information on treatments for 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 “Treating Difficult Areas of Periodontal Disease.”


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.”