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Posts for: June, 2019

CrownLengtheningCouldHelpwithTreatingHardtoReachCavities

There is a primary principle dentists follow regarding tooth decay—treat it as soon as you find it. Something as simple and routine as filling a cavity could prevent future tooth loss.

But treating a cavity at or below the gum line could be anything but simple and routine. Older adults who may also be dealing with gum recession are more likely to have these kinds of cavities where the gums block clear access to it.

But there is a way to access gum-covered cavities with a minor surgical procedure known as crown lengthening. Crown lengthening is commonly used in cosmetic dentistry to expose more of the visible teeth when there's an overabundance of gum tissue or if the teeth are disproportionately small. We can use it in this instance to surgically relocate the blocking gum tissue out of the way of the cavity.

After numbing the area with local anesthesia, tiny incisions will be made in the gums to create a tissue flap. After reshaping the underlying bone to recreate normal anatomy but at a different level, this flap is then moved and sutured to a new position. This exposes enough tooth structure so that the cavity can be repaired after gum healing.

As with any minor surgery, there's a very slight risk of bleeding and/or infection with crown lengthening. If you undergo this procedure, you'll receive post-care instructions for the first few days afterward including avoiding strenuous activities, eating only soft foods and using an ice pack the day of surgery to help control swelling.

This versatile procedure can help save a tooth that might otherwise be lost due to decay. And, it might even improve your appearance.

If you would like more information on treatment options for tooth decay, 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 “Crown Lengthening: This Common Surgical Procedure Restores Function and Improves Appearance.”


By Gary W. Machiko, DMD
June 17, 2019
Category: Oral Health
SevereFacePaincanbeManagedtoReduceDiscomfort

Recurring episodes of severe pain along your face could mean you have trigeminal neuralgia (TN). Although not always curable, TN can be managed effectively with the right strategy.

TN affects a specific pair of nerves called the trigeminal that signal pain in the face or jaws. They originate from the brain stem through the skull on either side of the face, with each nerve having upper, middle and lower branches. TN can affect one or more of these branches and cause anywhere from a mild twinge to excruciating pain.

Causes for TN differ in individual patients. Though it could be linked to a tumor, lesion or cold sore, it most often seems to arise from a blood vessel impinging on the nerve and damaging its outer coating. This causes it to be hypersensitive: chewing, speaking or even lightly touching the face can set it off. The damaged nerve may also fail to "shut off" when the triggering stimulation stops.

If you have these types of symptoms, your first step is to obtain an accurate diagnosis. You'll need a thorough examination to rule out other possibilities like jaw joint problems or a tooth abscess. Once we've determined it's definitely TN, we can then devise a treatment strategy.

We usually begin with conservative measures like medication to block pain transmission to the brain or anticonvulsants that stabilize the nerve and decrease abnormal firing. If medication isn't enough, we may then consider an invasive procedure to control symptoms.

Percutaneous treatment — often recommended for older patients or those in poor health — involves inserting a thin needle into the nerve to selectively damage certain fibers that will prevent the nerve from signaling pain. We might be able to move an impinging blood vessel aside from the nerve with a microsurgical procedure. As an alternative to surgery, high-dose radiation could also be aimed precisely at the pain site with a controlled beam to alter the nerve's ability to transmit pain.

TN can be a source of great discomfort that lowers your quality of life. But employing treatment techniques that best suit your situation, we can greatly reduce the misery it inflicts.

If you would like more information on facial pain caused by trigeminal neuralgia, 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 “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”


By Gary W. Machiko, DMD
June 11, 2019
Category: Dental Procedures
Tags: dental crowns  

How dental crowns from your cosmetic dentist in Pittsburgh, PA, can enhance your smile

There are many ways dental crowns can enhance your smile. They can make your smile stronger by restoring your chewing function. They crown-and-bridgecan also make your smile more beautiful by replacing unnatural-looking metal fillings with crowns that blend perfectly with your smile. Dr. Gary W. Machiko in Pittsburgh, PA, offers a full range of dental services including crowns to give you the smile you deserve.

Dental crowns from your cosmetic dentist strengthen your teeth because they cover the entire tooth surface above the gumline, holding your tooth together. When you bite down on a dental crown, the biting pressure and stress is shared evenly across your entire tooth, preventing the tooth from breaking. A large dental filling can actually weaken a tooth by dividing the tooth into sections, so when you bite down, a section of tooth could break off.

One of the great benefits of dental crowns is that they can also make your smile visually appealing. Instead of seeing a smile full of unnatural-looking metal, dental crowns allow others to see a beautiful, white smile.

Today’s dental crown materials like porcelain enhance the natural beauty of your smile. Porcelain is one of the most popular crown materials because porcelain closely resembles the look of tooth enamel. It’s also light reflective, just like tooth enamel. The natural-looking appearance of porcelain allows your smile to look undamaged and beautiful.

In addition to porcelain, you can also choose porcelain attached to a metal underlay, known as a PFM crown. These crowns combine the beauty of porcelain with the added strength of metal, so they are a great choice for back teeth where you need increased strength for chewing.

Dental crowns are one of the most popular restorative treatments because they provide:

  • Excellent coverage and strength for teeth that are worn down or damaged
  • A beautiful, natural-looking alternative to large metal fillings
  • Increased resistance to stains because of the materials used
  • Increased chewing surface area so you can chew your food better
  • Long-lasting beauty and protection for your smile as you age

Both you and your smile can benefit from dental crowns. To find out more about why dental crowns are an excellent choice to restore your smile, call your cosmetic dentist, Dr. Gary W. Machiko, in Pittsburgh, PA, today!


By Gary W. Machiko, DMD
June 10, 2019
Category: Dental Procedures
Tags: dental implants  

Wondering if dental implants are right for you? Learn more about this tooth replacement option.

When dealing with tooth loss the sooner you can turn to our Pittsburgh implant dentist Dr. Gary Machiko for treatment the better for the Dental-implanthealth of your smile. After all, untreated tooth loss can lead to long-term complications such as bone loss and shifting teeth. One way to prevent these issues is with dental implants. Luckily, Dr. Machiko is dual degreed and both his dental degree and his mechanical engineering degree, which gives his patients the advantage of precise measurement and placement of their dental implants. Curious to know more about dental implants? Well, you’ve come to the right place.

What is a dental implant?

An implant is truly the closest you can come to having a real tooth again. If you are missing one, several or even all of your teeth then dental implants could help you get your smile back. Despite the fact that an implant looks like a small metal post, it is an artificial tooth root that our Pittsburgh aesthetic dentist will place into the jawbone to provide a long-term foundation from which to support a dental crown or even multiple false teeth.

Does getting a dental implant hurt?

Despite the fact that patients will have to undergo surgery in order to get a dental implant, the procedure is minimally invasive and performed right here in our office under local anesthesia and sedation. Most patients don’t experience any discomfort during the procedure; however, it is not uncommon to experience some swelling and discomfort after the anesthesia has worn off. Our dentist can prescribe a pain reliever to reduce pain and swelling that you may experience during the healing process.

How long do dental implants last?

One of the biggest advantages to getting dental implants is that it is durable and resilient enough to last several decades. This means that depending on when you got your implant it could end up lasting the rest of your lifetime. Of course, this also means maintaining good oral hygiene and keeping your implant healthy so that it can last as long as possible.

What makes someone a good candidate for implants?

Most adults who are healthy and maintain good oral hygiene are ideal candidates for dental implants. It doesn’t matter whether you need to replace one, several or even an entire row of teeth; dental implants can help you. Before determining whether implants are right for you, our dentist will need to examine your teeth and gums and run X-rays to make sure that your jawbone is healthy and strong enough to support an implant.

Do you have questions about getting dental implants in Pittsburgh, PA? Ready to find out if you are the perfect candidate for this artificial tooth? No matter where you are in the decision-making process turn to our dental practice today to get the treatment and care you’re looking for.


By Gary W. Machiko, DMD
June 07, 2019
Category: Dental Procedures
Tags: smoking   dental implant  
SmokingCouldShortenYourImplantsLongevity

Although costly in the beginning, dental implants often turn out to be the least expensive tooth replacement option. That's because their enviable record for longevity often outpaces dentures or bridges. Over the long-term you might spend less for implants than these other restorations.

But even with the high success rate of dental implants (greater than 95% survive the ten-year mark), we can't guarantee they won't fail. And if you're a tobacco smoker, the risk of failure might be even higher. One study, for example, found early implant failures were twice the rate for smokers over non-smokers. Although implant failures overall are low, smoking seems to be a factor in those that do.

There are a number of reasons to account for this. For one thing, inhaled smoke can damage salivary glands, reducing the flow of this important fluid. Saliva helps control bacterial growth and neutralize mouth acid, so without it you're more susceptible to tooth decay or periodontal (gum) disease. Either infection could ultimately weaken implant-supporting bone.

The nicotine in tobacco can also restrict oral blood vessels and lower their ability to supply antibodies and nutrients to the teeth and gums. This slows healing, which could have one particular effect on implant durability.

During the intervening weeks between implant placement and crown attachment, the implant's titanium post attracts bone cells that grow and adhere to its surface. The effects of nicotine on healing, especially right after implant surgery, can interfere with this integration process so that the implant doesn't anchor in the bone as well as it should.

If you're a smoker, you can increase your chances of implant success—and have a healthier mouth overall—by quitting smoking beforehand with the help of a cessation program. Or at the least, consider stopping smoking for one week before implant surgery and for two weeks afterward.

And be sure to brush and floss your teeth daily and visit your dentist regularly to keep your teeth and gums as healthy as possible. Stopping smoking and practicing effective oral hygiene could make a big difference in the success or failure of your implant.

If you would like more information on smoking and your dental health, 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 “Dental Implants & Smoking.”