Friday, December 27, 2013

Does My Child Need Sealants on Their Teeth?

           We typically recommend dental sealants for children as soon as the permanent molars have erupted above the gums. In cases where the child is more prone to tooth decay, we may also advise placement of sealants on premolars (bicuspids), maxillary (upper) incisors, and even baby teeth. The goal of dental sealants is to protect the pits and grooves of the teeth in an effort to prevent the growth of decay. Children are more disposed to cavities in these locations than adults, and protecting them now can save them from larger issues in the future.
            One of the challenges of placing successful dental sealants is isolating the tooth we are working to protect. In a perfect world, we would attempt sealants as soon as the tooth has erupted above the gums. However, permanent molars typically erupt around the age of 6. Even though a single tooth can be sealed in a minute or two, a child may not have reached the point where we can maintain isolation from saliva for that long. If it becomes contaminated before completion, the sealant will not last as long.
            The expected lifetime of dental sealants last can vary. They may remain on the tooth for only a few years, but sometimes we see remnants of sealants from 10 or more years ago. We usually recommend sealants are maintained until a few years following the eruption of the second molars. But depending on the patient’s dental history and homecare, we may recommend the sealants remain for longer.
            Dental sealants are an easy and non-invasive way to protect children from tooth decay. Our hope is by limiting cavities throughout the childhood years, we can greatly reduce the need for larger and more invasive dental procedures as your children grow older. If you have any particular questions about your child’s need for sealants, I encourage you to speak with your dentist and dental hygienist.
For more information on sealants and dentistry for children of all ages, visit
Lee T. Brown, DDS
Brown and Kupper, DDS

Friday, December 20, 2013

Which Toothbrush Should I Use?

                    If you have ever walked down the aisle where toothbrushes are sold, it can be a little overwhelming. With traditional brushes, there are different brands, sizes, shapes and bristle hardness. Electric toothbrushes offer different brands, shapes, brush heads, and extra features. They can range in price from around $30 to over $200! Hopefully we can add a little clarity on what works best and what is most important when purchasing and using a toothbrush at home.
                 In my opinion, an electric toothbrush offers the best opportunity to provide the good yourself with good oral hygiene at home. One of the most important features an electric toothbrush can offer is a two minute timer. It is recommended that you spend two minutes each time you brush. Unfortunately, our internal clock usually goes off a lot sooner than the full amount of time. This feature takes out that risk and helps us clean our teeth more effectively each day.
                   We must also discuss which type of brush head is most effective. Oral B offers brushes with a circular motion of cleaning, while Sonicare offers a vibrating head. I believe both can prove equally effective when used properly, but the key is to let the brush do the work. If you aggressively ‘scrub’ your teeth instead of simply moving the brush head across the tooth surface, damage can still be done to your gums. You must trust that the motion of the brush head will do the job, and extra hard scrubbing is no longer necessary. 
                    Now you need to decide how much to spend on your brush and what features are most important. For this, I think it depends what is most important to you. If used correctly, a $50 brush can work just as effectively as a $200 brush. But if having a visible timer is important to you, or having a self-cleaning function is vital, there is nothing wrong with getting a brush with all the bells and whistles. The first thing I would look for when comparing brushes at a different price would be the replacement brush heads. If the $50 brush has the same replacements heads as the $200 brush, chances are the brush itself is very similar. This is not always 100% true, but hopefully it can help narrow your search. 
                      There are lots of different brushes that can help you maintain good oral hygiene on a daily basis. The key is to find one you feel comfortable using, and make sure you are using it correctly. The most expensive brush available won’t keep you healthy unless you know what you’re doing. So whether it is an electric or manual toothbrush, be sure to consult your dentist or hygienist on proper use.

For more tips and FAQs on keeping your teeth healthy, check out

Lee T. Brown, DDS
Brown and Kupper, DDS
(513) 860-3660


Thursday, December 12, 2013

Dental Amalgams: Are Silver Fillings Still OK?

          There has been some recent controversy about amalgam (silver) dental fillings and any issues they may present to the patient or environment. Dental amalgam is a mixture of copper, silver, tin, and zinc; trace amounts of mercury are added for strength and durability. There are claims that the amalgam is toxic and can cause serious issues. However, the American Dental Association still supports use the use of dental amalgams as an appropriate restorative material for children and adults.
           It is admirable that people today are conscientious about what materials are put into their bodies, and it is a normal to question if dental amalgam is safe. Mercury occurs naturally in the environment and also comes from industrial pollution. Nearly everyone has trace amounts of mercury in their bodies, regardless of the presence or absence of amalgam fillings. At high levels, mercury can be very dangerous. However, in the average human, the consumption of fish accounts for about 70% of the mercury present in our bodies.
           Many studies have been conducted to discover if harm is caused by the miniscule amounts of mercury released from an amalgam filling. None have shown convincing evidence of harmful effects or increased risks. In fact, the CDC, FDA, EPA, NIH, World Health Organization, and the American Dental Association have all concluded that dental amalgams are safe. And if you saw the Dr. Oz show that reported on the potential harm of mercury vapor in the mouth, I encourage you to visit for a full critique on that segment.
           Removing undamaged dental amalgams is typically unnecessary and potentially damaging to the teeth. Unless you have a history of high exposure to mercury or you have had classic symptoms of mercury poisoning in the past, there is no clinical reason to avoid amalgam fillings. In fact, there are still a number of situations where a dental amalgam filling is recommended over a white (composite) filling.
           At the end of the day, they are your teeth and you can decide what type of filling material you feel comfortable with. Nearly all of our fillings are tooth colored, but situations can arise where it is beneficial to consider a dental amalgam filling. At that time, we would take time to review the positives and negatives of each to help you make the best decision for your dental and overall health.

If you have other questions on dental fillings, please visit us at

Lee T. Brown, DDS
Brown and Kupper, DDS Inc.
(513) 860-3660

Wednesday, December 4, 2013

How Does My Diet Affect My Risk of Tooth Decay?

        This time of the year it seems like we are constantly snacking on sweets both at home and at work. Our first concern may be packing on a few extra pounds over the holidays, but all of this snacking can put you at a higher risk for tooth decay. Hopefully we can share a few helpful hints to reduce the possibility of developing cavities during this time and throughout the year.
         Plaque is a term we use to refer to a sticky film of bacteria that adheres to your teeth. It forms as a result of different bacteria attaching to your teeth after eating or drinking.  If you do not properly clean our teeth, the plaque bacteria use can the sugar we ingest to make acid. The acid can attack the enamel for up to 20 minutes after consuming sugar filled food or drinks. So if you eat or drink throughout the day or for a long time, your teeth are exposed to acid attacks over and over. These repeated attacks often result in tooth decay and the need for intervention by the dentist.
         So how can you reduce your risk of tooth decay? Below are a few easy things to remember that can limit the possibility of developing cavities:
  1. Limit sugary snacks and drinks between meals. This includes energy drinks and sports drinks.
  2. When you do have sugary snacks and drinks, try to have them with your meals and not throughout the day with snacks.
  3. Chewing sugar free gum or gum with xylitol for 20 minutes after meals has been shown to reduce tooth decay.
  4. Drinking tap water throughout the day can help prevent tooth decay because it contains fluoride and can help rinse away any sugary drinks.
  5. See your dentist regularly. They can help personalize a plan to limit your risk of decay. And if you do develop a cavity, they can help find in early.

For more answers or tips on good oral health, visit us at

Lee T. Brown, DDS
Brown and Kupper, DDS Inc.

Tuesday, November 19, 2013

Do I really need to floss?

    Essentially everyone abides by the notion that we need to brush our teeth in order to maintain good oral health. For whatever reason, flossing our teeth daily does not hold the same level of importance with the every person. But by flossing just once a day, you can decrease your risk of gum disease and increase the odds of achieving and maintaining good oral health.
    A toothbrush and toothpaste can clean the majority of the tooth’s surface area, but only flossing can clean in between the teeth where the toothbrush can’t reach. Dental floss will help to remove debris, plaque and bacteria that remain on the teeth and gums. Removal of this additional debris can also aid in controlling bad breath.
    Flossing should take you between two and three minutes to complete and should be done at least once daily. The ideal time to floss is right before bed, but any way you can incorporate it into your routine should work. The idea is to find a time that is convenient for you so you won’t forget.
    There are a wide variety of flosses available, and in general they do a similar job or removing debris and plaque. Wide floss (dental tape) works really well in cleaning large spaces and under bridges, while waxed floss works well between tight contacts. The pre-threaded flossers or floss holders can help when flossing someone else’s teeth or if you have difficulty reaching any spots in your own mouth.  And if you have children, they should begin flossing as soon as they two or more teeth that touch.
    While waterpicks are a good adjunct to help clean the teeth, they are not made to replace flossing. They can help to remove food from difficult areas and around braces, but they do not remove the plaque that remains in between the teeth. When in doubt about what type of floss to use in your particular case, be sure to contact your dentist or dental hygienist.

If you have any more questions about flossing or gum disease, visit us at for more answers.

Lee T. Brown, DDS
Brown and Kupper, DDS Inc
(513) 860-3660

Friday, November 1, 2013

Should I Get an Implant or a Bridge?

    When faced with the question of how to best replace a missing tooth, the first two options we typically discuss are a dental implant or a dental bridge. Each individual situation is unique, and our goal is to educate you to help assist in making the best possible decision for your dental health.
    In the majority of cases, when replacing a single tooth in the front or the back, a dental implant is the standard of care. It is the closest we can get to restoring the feel and function of a natural tooth. Unlike a dental bridge, an implant allows you to brush and floss the area the same way you would with a natural tooth. Even though gum disease around the implant can develop if proper care is not used, cavities can not exist on a dental implant. Since there is no remaining natural tooth structure, there is no place for traditional tooth decay to form.
Another major advantage of the dental implant is it does not require drilling or invasive work on the adjacent teeth. The entire procedure is isolated to one specific tooth. A bridge requires substantial work on at least two other teeth to work properly. Subsequently, if these adjacent teeth develop a cavity in the future, the entire bridge may need to be removed to stop the growing tooth decay.
When discussing the advantages of a dental bridge, we always talk about the original time commitment of the procedure. Dental implants can take around 6-8 months to fully restore, but sometimes only one month is needed to complete a new bridge. Because of the time involved and the materials used, a bridge is often less expensive and can be more appealing to patients from a financial standpoint. However, depending upon the location of the bridge of the patient’s history, a bridge may end up costing the patient more in the long run if it needs to eventually be replaced due to tooth decay.
Since each individual circumstance is different, the safest approach is to consult your dentist about your situation. Dental implants have become the standard of care in many cases when replacing missing or lost teeth, but dental bridges still have a very viable place in the modern dental practice.

For more information of dental implants or dental bridges, check out our website at

Lee T. Brown, DDS
Brown and Kupper, DDS Inc
(513) 860-3660

Thursday, October 17, 2013

Dental Insurance Limitations

    When I began my dental career 34 years ago, the maximum benefit for a dental insurance policy was $1000 per year. The fee in our office for a dental crown was $225. So, a patient could get 2 professional examinations and cleanings per year, covered at 100%, and still have the benefits remaining to cover 6 dental crowns covered at 50%.
    In the beginning of 2013, the fee for a crown was $1055. The amazing fact is that the usual insurance maximum benefit is still only $1000! If a patient receives their two examinations and cleanings, their remaining benefit would cover 1 crown, if covered at 50%.
Any amount that is covered is a huge benefit, and it means that much less has to come out of your pocket directly. However, it is clear that dental insurance has become quite limited. While we work hard to maximize your benefits, our goal is to recommend and provide the best available treatment for each patient independent of whatever insurance limitations there may be.
If you ever have any questions about what the benefits or limitations of your own insurance may be, or you would like some help in choosing a new type of insurance, please feel free to call us with any questions. We will do our best to help you find the coverage which best suits yours and families needs.

For more answers to any dental questions you may have, visit us at

Lawrence R. Brown, DDS

Tuesday, October 15, 2013

When Can My Child Bleach Their Teeth?

    More frequently than ever before, dentists and dental professionals are confronted with questions regarding teeth bleaching for children and young adults. While there may not be a clear cut answer, our goal is to help educate the parents and the patients of their options when it comes to bleaching their teeth.
    The first concern of many parents is whether or not teeth bleaching effects the strength of the tooth in any way. The active ingredients for bleaching in the United States are typically carbamide peroxide or hydrogen peroxide, and neither will weaken the enamel or increase the risk of cavities. However, improper use or too high of concentrations can lead to tooth sensitivity and irritation of the gums. This can be very difficult to predict, but to reduce the risk of these situations; we always recommend consulting with a dental professional before beginning any type of bleaching regiment.
    In younger patients, the nerve of the tooth is larger and more susceptible to sensitivity. The nerve, or pulp chamber, typically remains enlarged during the teenage years and gradually shrinks as we age. There is no evidence that shows irreversible long-term damage to the pulp chamber when proper bleaching techniques are used, but teenagers have the highest risk of developing sensitivity during and after use of teeth bleaching products.
    So how do you know when or if it is OK for your kid to start using over-the-counter or doctor prescribed teeth bleaching products? It is always a good idea to check with your dentist first. They can help with the decision using x-rays and/or knowing the particular person’s clinical history. Based on the individual circumstances and knowing the desired results, a personalized plan and timeline can be developed that will reduce the likelihood of tooth sensitivity and gum irritation for the patient.

For more information on teeth bleaching, visit us at  

Lee T. Brown, DDS
Brown and Kupper, DDS Inc.
(513) 860-3660

Tuesday, October 8, 2013

When Should I Begin Taking My Kids to the Dentist?

    New and expecting parents often inquire about what age their children should begin seeing the dentist. In a perfect world, we would begin seeing children for visits after their first teeth begin erupting. Our hope is to become the ‘dental home’ at an early age and start developing a sense of familiarity. However, at such a young age it is difficult to gain compliance from patients.  We more frequently recommend their first visit around the age of 2-3 or when all of their primary (baby) teeth have erupted.
    There are a number of different goals we have for a child’s first dental visit. On top of the typical dental exam where we check the teeth and surrounding tissues, our goal is to educate the parents on how they can help maintain good oral health with their children. Among other things, we will discuss how much fluoride they need, what habits may lead to cavities, and how you can assist each day in cleaning their teeth.
    It is important to remember that each child develops at a different rate and the eruption timing of teeth are the same way. For most, the lower central incisors appear within 6-10 months, followed shortly by the upper central incisors. The final primary (baby) teeth to erupt are typically the upper second molars anywhere from 25-33 months. During the time the teeth are coming in, your child may experience sore or tender gums. You can rub their gums with clean wet gauze or even your finger. A chilled teething ring can also work, but you definitely do not want to dip it in sugar, syrup or other foods. If your child still remains uncomfortable, we recommend consulting your pediatrician.

    For more information of children’s dental health, check out our website at or call us at 513-860-3660.

Lee T. Brown, DDS   
Brown and Kupper, DDS Inc.
(513) 860-3660

Tuesday, October 1, 2013

Should You go to the Dentist if You're Pregnant?

            There are many women out there today that are not receiving timely dental care because some dentists are hesitant to treat pregnant patients. However, dental treatment is typically beneficial and there is now a shift towards continuing routine dental care during pregnancy.

            You obviously want to make all the right decisions during your pregnancy, and it is normal to question what dental services should be performed when you’re expecting. Dr. Howard Minkoff, the chairman of obstetrics and gynecology at Maimonides Medical Center in Brooklyn, believes that dental X-rays, antibiotics, and local anesthesia are not contraindicated in treatment of pregnant patients. And since 2006, a few state dental organizations have issued guidelines saying that dental care is safe and effective at any stage of pregnancy. This includes diagnostic X-rays, cavity restorations, and root canals.

            When pregnant, the risk for gingivitis (gum inflammation) is typically a litter higher. If this is left unchecked, the gum disease can lead to dental infections and even tooth loss. Just as importantly, there is evidence that a mother with active tooth decay can spread the cavity causing bacteria to her child and perpetuate poor oral health.

            Finally, we worry that dental pain may cause pregnant women to self-medicate incorrectly. While physicians recommend acetaminophen over ibuprofen for pain control, an overdose of acetaminophen can negatively affect the liver and endanger the fetus.

            As the shift towards more routine dental care during pregnancy continues, we understand that patients may still continue to have concerns. When in doubt, or if you have a history of other conditions, we always encourage you to consult your physician. But we believe that maintaining a healthy mouth will help aid in a safe pregnancy for you and your family.


For more questions and answers about your dental concerns, check our FAQ section at               


Lee T. Brown, DDS

Brown and Kupper, DDS Inc

(513) 860-3660

Thursday, September 19, 2013

Custom Fitting Sports Mouthguards

Benefits of Custom Fitting Sports Mouthguards

For over 50 years, high school football players have been required to wear mouthguards. Football is a high contact sport and it is logical that participants protect their teeth, gums, and jaw bone from injury. However, sports like soccer, basketball and volleyball can involve high impact collisions, but mouthguards are not yet required. Protecting you or your children with sports mouthguards lowers the threat of injury to their teeth, and new evidence is suggesting that it may even reduce the risk of concussions. 

A broken or chipped tooth that results from facial trauma can lead to much larger and more expensive issues. If the damage is small enough, a filling can be placed on the tooth to regain its original shape and color. More traumatic injuries may require root canals, crowns or even loss of the tooth. This can cost thousands of dollars and take months to properly fix. Having your dentist custom fit a mouthguard can greatly lower the chances of injuring your teeth without inhibiting your ability to compete. 

While there is no definitive way to completely eliminate the risk of concussions in contact sports, there is some evidence that suggests a properly fitting mouthguard can help reduce the probability. The logic suggests that the mouthguard attenuates some of the forces applied to the head and neck during upward contact with the chin. There are no current studies that establish a direct correlation with complete certainty, but the absence of proof is not necessarily proof of absence. 

Parents will do so many things to protect their kids, and we believe wearing a custom fitted sports mouthguard is an easy step in reinforcing their safety in nearly all sports. Please don’t hesitate to contact us if you have any questions or concerns regarding mouthguards or the differences between custom fitted guards and over the counter mouthguards.

For more information of dental health and ways to help protect your children’s teeth, visit us at!

Lee T. Brown, DDS
Brown and Kupper, DDS Inc.
(513) 860-3660