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All Posts in Category: Restorative Dentistry

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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Periodontal Disease Treatment Billings MT

Periodontal Disease Is Linked to Diabetes and Heart Disease

Did you know that Periodontal Disease is more than bacteria in your mouth?  It’s true, but we don’t often think of periodontal disease when it comes to Diabetes and Heart Disease. Inflammation within the body is responsible for both oral disease and other systemic bodily diseases, which means that it is vital to your health to treat the inflammation from periodontal disease as well as inflammation from other diseases.  Here are a few reasons that periodontal disease can occur if you have one of these diseases.

Diabetes

Periodontal disease is common in diabetics.  The cause of periodontal disease in diabetics is the bodies inability to fight infection.  If you have diabetes, you are at greater risk for Periodontal Disease.  In order to manage periodontal disease, it is recommended that you manage your diabetes well. On the flip side, if you don’t manage your periodontal disease, it may be more difficult for you to control your blood sugars.

Heart Disease

Periodontal Disease is also common in people who have Heart Disease. If you don’t treat your gum disease, then it could increase your risk for heart disease, it’s that simple. If you have heart disease and you’re not treating your gum disease, then it can exacerbate your existing heart conditions.

Arthritis

In many ways, periodontitis and arthritis are very similar diseases.  Recent research is now indicates that periodontal disease may be a trigger for causing arthritis to attack other joints.   If you have family history of arthritis it is important to begin screenings for periodontal disease in your 30’s.

Other bodily conditions associated with Periodontal Disease

Open angle glaucoma has recently been associated with periodontal disease.  The bacteria that cause bone loss also cause the blood vessels on the eye to malfunction contributing to this sight robbing condition.

Osteoporosis is linked with a loss of bone in the jaw, which causes problems in your mouth.  You can lose your teeth due to osteoporosis because of bone loss; the foundation of all of the teeth in your mouth.

There are some respiratory diseases are linked to gum disease, because often bacteria in the mouth is inhaled into the lungs.  Which would make you put you at greater risk for pneumonia.

If you think that you might have periodontal disease, schedule an appointment today with your Periodontal Specialist.  As Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.”

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Temporomandibular Joint Disorders (TMD, TMJ)

Temporomandibular Joint Disorders (TMD, TMJ)

TMJ, which is short for temporomandibular joint and muscle disorders—we’ll simply refer to it as TMJ from here on out, is a condition that can cause pain and or improper function of the muscles, which control the jawbone. For most people this isn’t a serious problem, although it can be more serious for some, while merely an annoyance for others. Often pain from TMJ is temporary, although it can continually occur in cycles.

Temporomandibular Joint Disorders (TMD, TMJ)

Several different things could cause TMJ disorders. Firstly, TMJ is caused by trauma to the jaw. But often TMJ just appears even if no trauma has occurred. It’s possible that oral disorders such as an overbite or other alignment issues can cause TMJ. Even orthodontic braces can cause TMJ to occur.

There are several symptoms that a person has TMJ: a radiating pain in the jaw or in the neck or the face, or, more obviously, in the jaw; if the jaw muscles feel overly tight; if the jaw is locked, or a person’s ability to move the jaw is limited—this could also be a symptom of a worse condition and treatment should be sought immediately; there’s a pain at the jaw when a person opens or closes their mouths and with the pain is a clicking feeling or sound; if a person’s teeth suddenly change, and the rows of teeth fit differently. These symptoms could all be signs of other oral issues, so it’s important to not jump to conclusions if you’re suffering from one or more of these symptoms. But, how will you know? It’s important if you’re suffering from any of these symptoms to consult your periodontist.

Treatments for TMJ vary with severity. For some, simple jaw-stretching exercises could relieve the pain, while others may require pain medications to subside the insistent cycles of pain. Anti-inflammatories and muscle relaxants can be used for worse case scenarios.

If you believe that you have TMJ disorder, it’s important to not immediately panic—remember the discomfort in your face or jaw could be from anything besides TMJ like, for instance, a sinus infection which is easily treatable. If you are suffering from TMJ please visit Periodontal Specialists of Montana today!

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3D Dental x-rays Billings MT

The Benefits of Technology in Dentistry

Planmeca Promax 3D

From tablet computers to smart phones, Google to Uber, there is no question that our daily lives have been more than reshaped by technology. Some of these changes have been truly beneficial while some have been more a case of technology for technologies sake alone. Dentistry has not been left out of this revolution. Over the last 15 years technology has redefined many aspect of dentistry as well.

Nowhere in dentistry has these technological changes been more evident than in the case of X-rays. We are all acquainted with the standard drill of holding x-ray film in the mouth while an X-ray machine exposes the film or sensor.  This is an inconvenience for most of us and quite literally a real pain for others.   Jaw anatomy is not always conducive for comfortable placement of the film or sensor, not to mention the problem with gag reflexes. Over the past 20 years technology has replaced the use of traditional X-ray film with digital substitutes but the practice of placing something in t the mouth to capture the image has remained the same.

Extra-oral X-rays, those taken with the film outside of the mouth have been in existence for decades as well.   These too have become digitized and capable of conveying more information including three-dimensional CT X-rays that have been a boon to implant dentistry. Again these technologies have been digital modifications to what we already doing rather than being a revolution in how we obtain information.

Recently these worlds of intra-oral and extra-oral X-rays have started to merge. Planmeca, a medical equipment company from Finland recently released its new series of Dental CT X-ray units that is capable of obtaining intraoral, extra-oral and 3-D CT dental X-ray images all using a sensor that goes around the patient’s head. The most important aspect of this advance is not just that the days of placing a sensor in the mouth to get X-ray images is coming to an end but that all of this is being accomplished with dramatically reduced exposure to X-rays as well.

The new Planmeca Promax is equipped with an ultralow dose HD setting that can produce a full 3D image with less radiation than an X-ray series taken with conventional sensors. It can also produce regular 2D images with less radiation than two regular intraoral X-rays. In addition to a faster and more comfortable experience for patients, this also means better and more complete information for diagnosis with reduced need for follow up up X-rays and less overall radiation exposure.

Please schedule an appointment today with Dr. Marnhart for all of your periodontal needs!

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Dental Implants Billings MT

What Are the Advantages of Dental Implants?

The goal of dentistry is to help patients care for and maintain their teeth. Compared to previous generations we have made great strides in this regard. Adults today have only a fraction of the restorations and missing teeth of previous generations. Yet despite our best efforts teeth can still be lost to trauma, wear & tear, the slow onslaught of chronic disease and poor anatomy. Ultimately most of us will have to deal with replacing some missing teeth in our lifetime. The options to replace teeth are removable restorations, restorations attached to natural teeth, and dental implants.

Over the last 20 years, dental implants have moved to the mainstream of dental treatment. Yet many patients are unsure about the advantages of implants over other restorations. When having to decide between options for replacing missing teeth, patients have to weigh the risks and benefits of each. While each individual situation must be judged on the specifics, below is a list of advantages implant provide that apply to most people.

Better nutrition:
In our appearance centered culture we often overlook the obvious. The primary function of teeth is to help you extract nutrition from the food you eat. Dentures can restore only 20% of chewing efficiency.  Simply put, sliding dentures make chewing difficult. Consequently denture patients select foods that are softer that tend to be low in fiber and high in sugar & salt. Dental implants function like your own teeth. They can restore up to 80% of the chewing efficiency of natural teeth allowing you to eat your favorite foods and have a healthier diet.

Improved appearance.
When teeth are lost, bone support for the lower face is lost as well. This loss of support is what gives people a “denture look” when they lose their teeth. Dental implants look and feel like your own teeth. Dental implant restorations can be design to recreate the support for the soft tissues lost with tooth extraction. Dental implants can give you back your smile and help you feel better about yourself.

Improved speech& comfort.
With poor-fitting dentures, the teeth can slip within the mouth causing you to mumble or slur your words. Implants fuse to the bone and become part of you.   Because they are fixed in place, implants eliminate the discomfort of loose removable dentures allowing you to speak without the worry that teeth might slip.

Improved oral health.
In addition to providing artificial surfaces upon which bacterial can grow, dentures cover the soft tissue of the mouth preventing the normal flushing of bacteria and yeast organisms. The increases in these microorganisms can lead to inflammation in the soft tissues. Further the physical irritation of the denture rubbing on the soft tissue can produce acute ulcers.   In rare cases this chronic irritation can contribute to the development of oral cancer.

Maintenance of your natural teeth.
Any time dental work is done on a tooth there is a risk of complications. Dental implants don’t require grinding down other teeth, as a tooth-supported bridge does. More of your natural teeth are left unaltered, improving long-term oral health. Individual implants also allow easier access between teeth, improving oral hygiene.

Convenience.
Removable dentures are just that; removable. Dental implants can eliminate the embarrassing inconvenience of removing dentures, as well as the need for messy adhesives to keep them in place.

How Successful Are Dental Implants?
Dental implants are the longest lasting dental restorative treatment available. Success rates vary, depending on where in the jaw the implants are placed.   Depending on location, dental implants have a success rate of up to 98%. With proper care (see previous posts), implants can last a lifetime.

 

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Implant Treatment For Problems That Can Occur

Implant Treatment For Problems That Can Occur

Implant bone loss
Last months topic pertained to dental implants and what you can do to ensure your dental restorations serve you for the longest time.  Yet even with our best efforts a few implants will develop bone and soft tissue problems.  This month I will discuss treatment options for the problems that can arise.

Implant infection and bone loss:
Dental implant infections can happen but are not common.  The good news is rarely do these infections cause significant symptoms.   The other good news is just because you have bone loss on an implant does not mean it must be removed.  If the implant is stable and functional it can remain in place as long as the infection can be controlled.  However the minimal symptoms associated with these infections often permit patients to ignore the problem until there is a substantial amount of bone loss.

Treatment:
If there is only inflammation in the gum tissue with minimal one loss, nonsurgical approaches alone or in conjunction with topical antibiotics can often address the problem.     More commonly there is significant bone loss present around the implant.  These situations will require some form of surgery to remove foreign material, clean and decontaminate the surface of the implant.  Placing graft materials and/or growth factors to regenerate bone support is often included in these procedures.

Lasers
While effective, conventional surgery carries significant downsides such as post treatment pain and significant gum tissue recession.  While recession may not be an issue for implants in the molar areas that are not visible, it can be disastrous for implants in the front.  In areas where post surgical recession of the gum tissue cannot be tolerated surgery can be done with a Laser, which can preserve the gum tissue in most cases.  Laser based therapy, according to patient feedback, is significantly less painful and conventional surgical approaches.

Fortunately, more than 90 percent of dental implants will never experience bone loss problems.  Keeping you implants clean and having the bite checked periodically to protect from overload are the most important aspects of maintaining these type of restorations.   If problems arise early treatment is always best.  If the problem have progressed beyond the early stages fortunately there are good treatment options that can repair and maintain your implant restorations.

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Dental Implants

Dental implants have been a boon to many patients. Not only do implants provide options to avoid loose and poorly fitting dentures, they can be used to provide crowns and bridges avoiding placing at risk the natural teeth that traditionally have been used to secure fixed dental work. Implants have truly revolutionized modern dentistry.

Dental Implants Billings MT

With all the good news about implants it is easy to overlook the few but important problems that can arise with this type of treatment. Implants can experience bone loss. This can happen for several reasons. First is inadequate home care.   Although implants cannot decay they still must be cleaned daily to the best of your ability. Bacterial accumulation around the base of the implant where it meets the gum tissue will cause inflammation and if left long enough can induce bone destruction. Therefore it is essential that you clean the implants daily. Each implant and restoration is unique so there is no cookbook approach to what works best. Certainly brushing is essential. Automated brushes can be more effective in some case but are not usually mandatory. Using some thicker forms of floss that can frame out and adapt to the implant surface. Some patients find that a thin yarn works very well.

Dental Implants Billings MT

Regardless of your efforts some bacterial will work into places your homecare cannot reach. Professional cleanings on a regular basis will be needed to address this problem and maintain health tissue around your implant. The frequency of such cleanings will be based on you previous history of periodontal disease problems. If you have a history of periodontal bone loss you need to be seen on a more frequent basis. If you have active periodontal disease on your natural teeth it is essentially guaranteed that your implants will lose bone as well.

Other health issues can affect the survival of your implants. First among these is smoking and other uses of tobacco. Tobacco use shortens the life of dental implants. Ideally you should quit before beginning the treatment process. If you have implants and are currently smoking quit or at the very least reduce your frequency of smoking dramatically. While you still with have the systemic smoking risks the topical effect on the gum tissue will be lessened.

Poor management of systemic diseases, particularly diabetes, can make bone loss more likely around your implants. High blood sugar depresses your immune system function allowing more aggressive bacterial to grow around your implants. Following your doctors recommendations to keep blood sugars under control will help limit any damage.

Excessive bite forces can induce bone loss around implants. Unlike natural teeth, implants do not move, they are fixed into the jawbone.   Great care is taken during the construction of your dental restorations to minimize the risk of too much force being placed on the implants. However as time goes forwards your teeth can shift and wear, you may have other restorations placed the shift the bite slightly and in younger patients some delay facial growth can result in the implants coming und increasing bite forces. This happens slowly so it is not very noticeable to you. After a certain point the increased forces can begin to cause small fractures in the bone where it meets the implant. If not dealt with early this bone loss is progressive and can result in the loss of the implant.

To minimize these problems the bite on the implant should be checked at least once a year. It must be checked any time you have other dental work done.

Even with the best care, some problems may be unavoidable. We are just now reaching a time where a significant number of implants are in the range of 20+ years old. Most of these implants have reached this age with minimal problems. It does appear however that due to long term bone turnover some implants develop gum tissue problem for no apparent reason other than they have been in service for a long time. Fortunately most of these problems can be dealt with and rarely do they cause the implant to fail.

Checklists for implant care:

1) Avoidance. Be sure to check with your dentist that you do not have active periodontal disease before beginning implant treatment.

2) Quit smoking and other uses of tobacco. Keep other systemic disease such as diabetes well managed.

3) Once your implants are restored have your dentist check the bite, several times if needed, to assure the implant is not overloaded.

4) Be sure to do your best to clean your implants daily.

5) Remain faithful with your professional cleaning visits.

6) Ask to have the bite checked anytime you have new dental restorations placed.

7) If you have problems with your implants deal with it early. Small problems are easier and less expensive to fix.

Dental implants have been truly revolutionary. Yet no treatment is a panacea. Each therapy option brings with it a unique set of risks that if ignored can endanger the long-term success of your implants. Taking these simple steps can go a long was to assuring the comfortable functions of your implants for many years.

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periodontic services billings mt

Procedure Focused versus Problem Focused Dentistry

The first decision you must make is what dentist you are going to see. While individual practitioners have their specific approach to treatment, the fundamental issue for you is the choice between the Procedure Focused practices versus a Problem Focused office. Procedure focused offices tend to look at individual tooth problems, i.e drill and fill. You have pain from a particular tooth, the dentist treats that particular issue with minimal regard for other issues you may be unaware of. For many people the course of dental diseases is protracted over many years. This fact allows you to get away with a procedure focus for a while. However, this approach will often lead to more work needing to be redone in the future.

Problem focused practices (sometimes called Holistic practices) take into account the overall dental and medical conditions as well as potential future dental problems as part of making treatment decisions for the immediate concerns. This approach emphasizes the treatment and control of dental disease and the overall function of the dentition. Such an approach tends to address more than your immediate perceived problems but leads to more predictable restorations and avoidance of large-scale failures. Such practices emphasize a long term Doctor/Patient relationship compared to the episodic relationship of Procedure Focused practices based on emergent dental problems. This approach focus’ on the establishment and maintenance of dental health.

Is one approach better?
That depends on many factors. If your needs are minimal, procedure focused practices are very efficient in treating the few isolated concerns you may have. However in the early stages, most dental disease has minimal symptoms so patients are usually in a bad position to assess their needs. Waiting for symptoms such as pain and swelling means problems have progressed much further than they should have and treatment will be far more complicated.

Patients with several different dental problems tend to do better with Problem Focused practitioners. In this setting finding treatment solutions that achieve a harmony in addressing the multiple concerns is best. As we get older the complications from the accumulation of multiple past dental procedures tends to magnify. In adults the need to view cases in the entirety is essential to achieve the highest levels of success.

By their very nature, some dental specialties are more procedure oriented. Orthodontists, Oral Surgeons and Endodontists are specialty-trained dentists that are seen only when specific procedures are needed. Once the specific treatment is completed you return full time to your general dentist to continue care. Periodontists, Pedodontists, Prosthodontists tend to have longer-term relationships with their patients due to nature of the problems they deal with. You may still see your general dentist as part of your care as well.

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Periodontal Disease Billings MT

Gum Disease

Gum Disease is a common ailment afflicting good oral Health. The most common form of gum disease is gingivitis. The harmful effects of gingivitis are rarely felt by the person who has them, although if gingivitis remains untreated, it can lead to the much more severe periodontitis. Gingivitis can be caused by a multitude of factors such as diabetes, smoking, stress, inadequate nutrition, and even puberty. While poor oral health is a primary cause of gingivitis, it is not always the only factor. When a person is suffering from gingivitis, his gums will become red and swollen, and may even bleed from contact with foods, or a scrubbing from a toothbrush. After gingivitis is located, a professional cleaning of the teeth and gums followed by the use of an oral rinse in the home will most likely treat gingivitis.

Periodontitis is caused when plaque grows below the gum line, and the toxins from the plaque enflame the gum tissue and, eventually if left untreated, the enflamed gum tissue will separate from the teeth. Periodontitis can occur in adults and children, and it can be brought on by untreated gingivitis, or if a person is chronically unhealthy, genetically predisposed to the disease, or suffering from a systemic disease such as heart disease, diabetes, and respiratory disease. Periodontitis has an array of treatments based upon severity that begin with non- surgical treatments and end at plastic surgery. Periodontists are trained to treat the effects of periodontal disease, and have undergone three additional years of specialized training to learn to treat it.

To help prevent Periodontal Disease, a person should perform the daily habits of good, quality oral health such as brushing ones teeth and flossing. Also, remember that a good diet helps your body to stay healthy, and areas like your mouth benefit from a good diet as much as anywhere else. Also, if you are a smoker or if you use chewing tobacco, it will give you another reason to add to the long list of reasons why you should quit. Remember, while some people may not be able to prevent Periodontal disease, many people can help to prevent the disease by simply living healthy.

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Restorative Dentistry Billings MT

Restorative Dentistry

Restorative Dentistry Billings MT

Most people that take the time to brush and floss their teeth regularly and practice preventative dental care, may never experience severe dental problems. However, some people won’t brush regularly, develop oral diseases or have an accident and require restorative dentistry. Fortunately, dentistry techniques have come a long way and improved greatly. Learn what restorative dentistry is all about and how you might benefit.

What is Restorative Dentistry?

Many people don’t realize that gums and teeth just don’t have the ability to heal themselves when they become damaged or develop gum disease. What may start as a simple cavity that could easily be filled could turn into a broken tooth down the road. Gum disease won’t heal on its own; periodontal disease requires treatment. In many instances, the problems don’t go away, but actually worsen with time. These are just a couple of examples where people can benefit from restorative dentistry once damage occurs.

Restorative dentistry can greatly improve or enhance your smile, repair or replace missing teeth and improve the health of your gums.

  • Dental Bridges and Crowns

Bridges and crowns can be used to eliminate spaces where teeth are missing and greatly improve your chewing function as a result. This type of restorative dentistry not only improves functionality, but it improves aesthetics as well.

  • Dentures

Dentists can easily restore functionality to improve your bite with the installation of dentures. This restorative procedure is a radical change that can improve oral health.

  • Mouth Reconstruction

Thanks to improved dental procedures, dentists can make restorative changes for crowded teeth, blemished or decaying teeth and split or missing teeth.

  • Dental Implants

Dental implants are another popular option for people with missing teeth. Once they are properly fitted, patients can talk, eat and laugh easier and be assured they are tightly fastened to the jawbone.

The Benefits of Restorative Dentistry

  • Restore the health of your teeth.
  • Resolve and correct bite issues.
  • Alleviate pain.
  • Prevent the spread of decay.
  • Restore dental functions back to normal.
  • Stop and prevent teeth from shifting when teeth are missing.
  • Reduce or stop pain all together when chewing.
  • Correct speech impediments caused from missing teeth.
  • Help you to regain your self-esteem and self-confidence.
  • Improve your looks with a beautiful smile.

Whether you have a missing tooth or could benefit from a full mouth restoration, it might be worth a consultation with your dentist. Restorative dentistry has come a long way, and you might just be pleasantly surprised at the results.

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