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    On the Job

    He brings lustre back to smiles

    Joseph Maniscalco, a dentist in Arlington, specializes in dental implants and other cosmetic techniques.
    Josh Reynolds for The Boston Globe
    Joseph Maniscalco, a dentist in Arlington, specializes in dental implants and other cosmetic techniques.

    Joseph Maniscalco, an Arlington dentist with a specialty in cosmetic dentistry known as prosthodontics, says most people start life with bright white smiles. But over the years, as the enamel wears down, the yellow dentin layer shows through.

    “My job as a prosthodontist is to fix smiles, whether it’s discoloration or chipped teeth,” said Maniscalco, 39, who specializes in dental implants.

    You say that putting pure white teeth in someone’s mouth might actually make them look ridiculous. Why?

    If you look at a porcelain sink, it’s usually never solid white, but has subtle hues. Likewise, there are different characteristics for individual teeth — some are very glossy and shiny while others have a muted appearance and are less reflective.

    What sort of patients might need implants?


    If teeth are missing or failing, it isn’t a matter of just looking unsightly. The other teeth can begin to tilt and possibly cause bite problems. A bridge or dentures are a temporary fix but dental implants are a more permanent option.

    How have implants changed over the years?

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    Most implants are a screw or post made of surgical titanium. There have been lots of advancements in the titanium, including making it a certain roughness so it adheres more strongly to the bone as well as coloring the titanium, making it partially pink, which blends with the gums.

    How did you get into dentistry?

    My last name in Sicilian means “blacksmith” — my family has been working with their hands for centuries. I went back to my roots and used the gift I was given to help fix people’s smiles.

    More patients are seeking dental treatment in hospital emergency rooms. Why do you think that is?

    A lot of people are putting off dental work, so if they get a toothache at 2 a.m., the only recourse usually is an ER. But unless it’s life threatening, very few ERs will do oral surgery. They will give you painkillers, possibly antibiotics, and tell you to call your dentist in the morning.

    Do they teach you about management in dental schools?

    We’re trained on the science of dentistry and not how to run an office. The information that a dentist needs to know about running their own business — rent, utility, overhead, accounting, etc. — is barely acknowledged.

    Have you had work done on your own teeth?


    When I was a kid, I was allergic to milk, so I used to mix sugar into water when I ate my breakfast cereal. So I have old-school silver fillings on my teeth.

    Cindy Atoji Keene can be reached at