50 27th Street West Suite D Billings, Montana 59102

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  Contact : 406-655-7970

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Welcome back!

NOTICE: Welcome back!

Periodontal Specialists of Montana will begin seeing patients for routine periodontal care beginning May 4.  While we look forward to seeing our valued patients once again, the lingering effects of this pandemic mandate some changes to our daily operations.

For your protection, the following protocols have been put in place:

  • Staff will be screened daily for any possible risk of infection.  Those showing any indication of infection will be sent home for three weeks or until testing confirms negative status.
  • We request you notify us if you are experiencing symptoms (fever, dry cough) or have been in contact with a known COVID positive patient.  If you are an exposure risk, we will reschedule your appointment no sooner than 3 weeks from your exposure date to allow adequate clearance of the virus or until testing confirms a negative status.
  • To fulfill current Montana requirements for social distancing, we ask that only scheduled patients come into the office.  Appointments will be staggered so patients spend minimal time in the reception area.  If you have a concern regarding insurance or any other nonclinical concern, we ask you to contact us by phone to minimize the foot traffic in our reception area.
  • We practice the latest and most effective forms of infection control mandated by the CDC and OSHA.  Fortunately, the SARS-n-CoV-19 virus is eliminated by all infection control measures currently utilized.  These infection control protocols were designed to address the risk of cross-contamination for diseases far more dangerous than the current virus.
  • We will be adding some infection control protocols, including a pre-treatment mouth rinse for all patients to reduce the risk of aerosols during treatment.  These protocols are effective in killing 99% of viral particles as well as reducing transient bacteremia during treatment.
  • Caring for patients with significant medical issues is a special concern during this time. If you believe your medical condition places you at substantially high-risk of complications from this virus, our staff will accommodate your appointment time to further minimize the risk of exposure.

Careful adherence to these protocols will assure your appointment is safe for both you and your provider as well as efficacious in managing your periodontal concerns.

Thank you for your continued support of our office.  We look forward to seeing you once again.

Dr. Scott Manhart & Staff

Periodontal Specialists of Montana

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Periodontal Disease Billings MT

Periodontal Comprehensive Exam

It’s important to get an annual dental exam; important to get your teeth cleaned but also important to check on the status of the teeth and gums. But did you also know that it’s important to get a routine periodontal examination? The American Academy of Periodontology believes that all adults should receive a regular yearly periodontal exam.

What is a Comprehensive Periodontal Exam?

A Comprehensive Periodontal Exam (CPE) assesses your periodontal health by examining the teeth, plaque, gums, bite, bone structure, any risk factors—life factors as well as possible genetic factors—for evidence or potential indications of impending Periodontal disease. During a CPE, Dr. Manhart will assess your periodontal health in relation to these factors. Periodontal disease is prevalent in the United States, and unfortunately most people don’t realize that they have the disease. Consider the CPE to be an evaluation of the health of the entire mouth. No, you may not have periodontal disease—and hopefully you never get periodontal disease—but finding periodontal disease early is the key to a quick and successful treatment.

The Link of Periodontal Disease to Other Systemic Disease

There is evidence that some types of systemic disease are linked to periodontal diseases. No, this does not mean that if you have periodontal disease you will contract diabetes or heart disease, but it’s possible that the periodontal disease could be a trigger for other disease, especially since some types of systemic diseases such as cardiovascular disease, heart disease, and diabetes are known to be linked to inflammation within the body.

You can also do a number of things at home to help prevent periodontal disease (remember, however, that periodontal disease is linked to certain genetic factors, and it’s possible to contract the disease even with the best oral care regimen). Make sure that you’re brushing your teeth twice daily, for two minutes, and that you’re brushing all the brushable parts within your mouth such as the teeth, gums, and tongue (remember the tongue is home to lots and lots of bacteria!). Make sure to floss once daily, cleaning the teeth all the way to the gum line. And pay attention to the life factors that can contribute to periodontal disease, and remember to pay a regular visit to your periodontist, Dr. Manhart, at least once every year for a CPE.

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gum diesease treatment billings mt

Alcohol And Dental Health

Did you know that alcohol consumption can be bad for your oral health? It’s true. Alcohol consumption, especially in high doses, can be very, very detrimental to long term oral health. Here’s a few of the reasons why.

Obviously, when we binge drink alcohol it is bad for our bodily health. It is bad for both the circulatory system and the cardiovascular system. It can lead to problems such as high blood pressure and stroke, and it can even cause certain brain problems; and, alcohol, in large doses—heavy, every day binge drinking—is even linked to certain systemic diseases such as heart disease and diabetes. But, while those things are bad and you may not need another reason not to overuse alcohol, know that alcohol is a detriment to oral health. Alcohol, in any dose, contributes to tooth decay and gum disease. Also, alcohol can contribute to the prevalence of mouth sores, and it’s the second most cause of oral cancer—second only to tobacco use.

Teeth are especially impacted by heavy alcohol consumption. People who over-consume—for the purposes of statistics these people have an alcohol use disorder, and there are no definitive, conclusive links, at least so far, to moderate drinking and overall tooth health—tend to have high levels of plaque, and they also tend to lose their teeth. (People who abuse alcohol are also several times more likely to experience permanent tooth loss!)

Alcohol also dehydrates the body, and when alcohol is consumed for long periods—say, throughout an evening—than the teeth are going to undergo both an attack from bacteria, because of the sugars in the drinks—some drinks, especially mixed drinks, have a considerably higher sugar content than others—but also, because alcohol dries out the mouth, we might have less saliva to combat the sugar problem naturally.

In moderate doses, alcohol has been shown to be good for our health—for instance, moderate doses of alcohol are good for blood pressure but too much alcohol is a terrible for blood pressure—but there is a clear and dividing line between moderate alcohol use and overuse.

Have a terrific holiday season.

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Study: Perio treatment alone may lower blood pressure

November 15, 2017 — Dental treatment may significantly lower the blood pressure of patients at risk for heart disease, a new study has found. Patients with prehypertension who received scaling and root planing ultimately had blood pressure that measured more than 10 points lower than those who did not.


This was the first time a study linked intensive periodontal treatment alone to reduced blood pressure levels, according to the researchers, led by Jun Tao, MD, PhD, from the First Affiliated Hospital of Sun Yat-sen University in Guangzhou, China. They presented their groundbreaking findings at this week’s American Heart Association (AHA) 2017 annual meeting in Anaheim, CA.

“Something as basic as periodontal care may be able to reduce the risk of future high blood pressure and cardiovascular events,” stated AHA spokeperson Richard Becker, MD, a professor and the director of the division of cardiovascular health and diseases at the University of Cincinnati College of Medicine and director of the university’s Heart, Lung, & Vascular Institute, in a press release that accompanied the study.

Link between heart and gum disease

Multiple studies have previously linked periodontal disease with cardiovascular disease, but fewer have investigated a direct relationship. Therefore, Dr. Tao and colleagues explored whether intensive treatment for periodontal disease alone could ultimately have an effect on blood pressure.

To find out, they conducted a single-blind randomized clinical trial with 107 Chinese adult patients. All patients had prehypertension and moderate to severe periodontal disease.

At the beginning of the trial, the patients were split into two randomized groups. The control group received four weeks of basic dental care, which included oral hygiene instructions and tooth scaling above the gum line, while the intervention group received four weeks of intensive periodontal treatment, which included scaling and root planing, antibiotic treatment, and extractions when necessary.

Those with intensive periodontal treatment showed significantly lower systolic blood pressure beginning one month after treatment. By six months after treatment, the intervention group had systolic blood pressure that was nearly 13 points lower and diastolic blood pressure that was nearly 10 points lower than the control group’s.

“The present study demonstrates for the first time that intensive periodontal intervention alone can reduce blood pressure levels, inhibit inflammation, and improve endothelial function,” stated Dr. Tao in the press release.

The researchers cautioned that additional research is needed, including with patients from diverse backgrounds. Nevertheless, the study is important because it demonstrates a direct relationship between periodontal treatment as an intervention and improved blood pressure. As a result, periodontal treatment in combination with other proven steps to treat and prevent heart disease, including exercise and diet, could improve the health of millions, Dr. Becker noted.

“A combination of things that are readily available to people could, in fact, have a major impact on health both in the United States and throughout the world,” he stated.

If you like this content, please share it with a colleague!

Copyright © 2017 DrBicuspid.com

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Periodontal Disease Billings MT

Diabetes And Dental Health

The month of November is National Diabetes Month. Did you know that over 29 million Americans have been diagnosed with diabetes? It’s true. And it’s predicted that the total number of people who have diabetes, but have yet to be diagnosed, is somewhere between eight and nine million people. That’s a lot of people. But why are we talking about diabetes, here, on Dr. Manhart’s blog? Because, while diabetes can be such a detrimental disease to the body, it can also put a person at a higher risk for dental disease.

High Blood Sugar and Other Complications

Gum disease is an inherent problem for someone with diabetes. High blood sugars can contribute to gingivitis or the more severe, and considerably more detrimental, Periodontal Disease. Early signs of gum disease are bleeding gums and bad breath. Early stage gum disease can be reversed with a regular routine of brushing and flossing, and a change in diet. But it’s best, especially when a person suffers from diabetes, to visit Dr. Manhart when gum disease is apparent. If gum disease isn’t immediately dealt with, and the complications of diabetes cause the symptoms to be more severe, to progress at a faster pace, a person’s teeth could fall out, and damage could be done to the bone surrounding the teeth.

Dry mouth is a common symptom for a diabetic. That’s why it’s important to keep hydrated—and that tip applies to everyone—because saliva helps to wash away the food debris. If bacteria are allowed to thrive in the mouth, then so, too, could gum disease flare up.

Because Diabetes has such a detrimental effect on your body’s immune system, infections within the mouth can occur. One such condition, called thrush, is common for diabetics. Thrush is a yeast infection caused when yeast thrives on the higher amounts of sugar in a person’s saliva. It manifests in the mouth as a white coating on the tongue and cheeks.

Diabetes has become a chronic problem—the sheer number, in millions, of people both diagnosed and undiagnosed is staggering. If you suffer complications from the disease then make an appointment to see Dr. Manhart. Remember, it’s easier to manage oral health than to treat a chronic problem.

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Bad Breath

Bad breath is common. Everyone, at some point or other, will suffer from it. Coffee, onions, and garlic are all likely culprits. But what happens when the problem of bad breath isn’t easily solved? What happens when you brush and floss, stick to a quality dental routine, and you still have bad breath? The term for this extended, and sometimes chronic, condition is halitosis. Here are a few of the causes of halitosis, and the possible treatments.

Halitosis may be a sign of a chronic and severe condition; think of it as being a possible canary in the coal mine type of problem. Halitosis may be a sign of gum disease—gingivitis or the more severe periodontal disease—or even a cavity.

Halitosis may also be caused by an infection in the sinuses. Sinus infections, especially those infections accompanied by a post nasal drip, can trigger the condition of halitosis. This is because the bacteria in your mouth feed on the mucous secreted from the sinus membranes. Usually, if a sinus infection is the cause of bad breath, the condition will lessen or go away altogether, when the sinus infection is treated.

The condition of dry mouth may cause halitosis. Saliva clears the food debris from your mouth, and, if the mouth is unable to clear away food debris, bacteria are allowed to thrive, feed on the sugars in your mouth. The waste product produced by these bacteria is, unfortunately, stinky-smelling. The condition of dry mouth itself, may be the cause of any one of numerous things, including medication. Dry mouth is a very common side-effect for many medications.

If you think you suffer from bad breath then first consider your daily oral care routine. Make sure you’re brushing at least twice daily—for two minutes at least! Remember to brush your tongue as well as your teeth and gums (it’s kind of gross, but bacteria can thrive on your tongue!). Make sure you’re flossing or using interdental cleaners to clean the area between the teeth and around the gum line. Remember to stick to your regular dental visits, and visit your periodontist, Dr. Manhart, for treatment of gum disease.

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Restorative Dentistry Billings MT

Sleep Apnea

Sleep apnea is a breathing condition that affects our sleep. It happens when the muscles in the throat relax to the point that they block the airway. When the airway is blocked, there is a twenty-to-thirty second duration in which the person is no longer breathing. And when a person stops breathing, the brain sends panicked messages to the rest of the body to breathe. This panic comes as a jolt to the system, briefly awakening the person. These brief awakenings, most which are so brief that a person will not remember them the next morning, can happen up to thirty times an hour, even maybe more, and last all through the night.

What does Sleep Apnea have to do with Dental Health?

Sleep Apnea is a condition involving the muscles and tissues in the throat and mouth. It could be the product of enlarged tonsils (this is a common condition especially in children with tonsils, and, usually, the removal of tonsils is enough to treat it), a small jaw, or even a higher-than-normal palate. You may be able to treat the condition with an oral appliance that provides support to the structures in the mouth, preventing them from collapsing when your body relaxes during sleep. If a dental appliance doesn’t work, other treatments could include the recommended use of a CPAP machine; a machine that regulates your breathing while you sleep.

Symptoms of Sleep Apnea

There are many symptoms of the condition including: an inability to focus, to remain alert throughout the day, waking up in the night feeling short of breath, you may have a dry mouth or a sore throat in the morning (also the cause of excessive snoring), or you may even get headaches throughout the morning. While the symptoms of sleep apnea may not sound severe, the pervasiveness of these symptoms can lead to much worse conditions such as: hypertension, stroke, depression, ADHD, diabetes, and even heart attack.

If you believe that you’re suffering the condition of sleep apnea, it may be time to get help. Remember, this is a chronic condition that could lead to more intensive problems. But there is treatment.

Call today to schedule an appointment today with your Periodontal Specialist!

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Gum Disease and Increased Link to Many Cancers

Brushing, flossing, and regular dental checkups appear to do much more than maintain a healthy smile. Now, a large prospective cohort study shows that postmenopausal women with a history of periodontal disease, including those who have never smoked, are at significantly increased overall risk for cancer as well as site-specific cancers, including lung, breast, esophageal, gallbladder, and melanoma skin cancers.

Read more here.


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Periodontal Disease Treatment Billings MT

Diabetes and Daily Oral Care

Diabetes can take its toll on dental health. The main reason is that diabetes is a systemic disease involving high blood sugar. The higher a person’s blood sugar, the higher risk for dental diseases and tooth decay.

Cavities and High Blood Sugar

Cavities happen when bacteria within our mouths produce acids that eat away at the enamel (enamel is the hard protective outer-coating on a tooth). These acids come from plaque, which is a sticky film produced when mouth bacteria interact with the starches and sugars from our foods and drinks. If you are diabetic and dealing with a high blood sugar level, there will be a greater supply of starches and sugars within our bodies—you will also have different requirements for diet.

The Early Stages of Gum Disease

When someone has diabetes, their bodies have a reduced ability to fight back against bacteria. When things like plaque are not removed by brushing and flossing (remember the importance of brushing twice daily and flossing once!) that plaque hardens at the gum line. This harder substance, called tartar, forms around the base of the teeth, causing the gums to swell and begin to form pockets—pockets where bacteria can creep in below the gum line and cause problems! Over time, swollen gums can begin to bleed. These initial stages, called gingivitis, are usually easy and non-invasive to treat.

Advanced Gum Disease and Diabetes

Gingivitis that is left untreated can progress to the much more severe, and much more invasive and difficult to treat, Periodontal Disease. Periodontal Disease is an infection that can destroy the soft tissues and bones within the mouth. Obviously, this is bad, because the bones and soft tissues support everything in the mouth. Overtime this breaking down causes the gums and teeth to pull away from the bone—inevitably the teeth will become loose and, possibly, fall out. Why is Periodontal Disease worse for those with diabetes? It’s because diabetes hinders a body’s ability to resist infection. Diabetes, and all systemic disease for that matter, can also hinder the body’s ability to heal. It’s so important to keep up a regular routine of oral care that includes a regular checkup with your periodontist, Dr. Manhart.

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Do Mouthwashes Work?

Do Mouthwashes Work?

Not all mouthwashes are created equal. And most mouthwashes are placed into two categories: cosmetic mouthwash and therapeutic mouthwash. Therapeutic mouthwashes are available both in the aisle at the grocery store and by prescription. Therapeutic mouthwashes help to combat bad breath, fight gingivitis, and even control plaque. But how?

The condition of having bad breath, called halitosis, is caused by several things including: food breakdown and oral disease (pervasive plaque and bacteria). Now, for a mouthwash to fight these problems, it needs to have antimicrobial ingredients. These ingredients have long names like, chlorhexidine (chlorhexidine is an active ingredient in mouthwashes given out by prescription), chlorine dioxide, and, the less chemically-sounding, essential oils (usually therapeutic mouthwashes with essential oils are found in the aisle at the grocery).

These antimicrobials have proven effective at combating halitosis. But, mouthwashes are only effective at removing plaque and bacteria from the mouth when they’re used in conjunction with brushing and flossing. It all comes back to a good quality everyday oral care routine.

Now, there are certain rules to using mouthwash. Don’t swallow it, and don’t give it to young children, even if they understand how to spit the mouthwash back out of their mouths properly. A child who swallows large amounts of mouthwash may suffer the consequences of diarrhea, vomiting, and (it’s possible in higher doses) intoxication—if your child has ingested enough mouthwash to be intoxicated, call poison control.

Now, there’s no best way to incorporate mouthwash into your daily oral care routine. If you brush first, you may want to swish out your mouth with water before you use mouthwash. Other than that, it’s personal preference. It’s most important that you are brushing at least twice every day, and flossing at least once.

If you are concerned about halitosis and what’s possibly causing it, make an appointment with Dr. Manhart. He can check for signs of oral disease—remember, it’s best to catch gum disease in its earliest stages, when it’s easily treatable—and develop an action plan to get it fixed.

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