Friday, January 31, 2014

How Does Regular and Diet Soda Affect Your Teeth?

       It is common knowledge that soda can cause tooth decay and damage your teeth. However, many people still believe that drinking diet soda eliminates the risk of cavities. The truth is any type of soda or soft drink can be potentially harmful to your teeth when not used in moderation. We will discuss why sodas can damage your teeth and what you can do to properly reduce your risk.
            Some non-diet sodas may contain as many as 11 teaspoons of sugar per serving, and sugar is directly correlated with an increased risk of tooth decay. The normal bacteria on your teeth feed on the sugar to create acid, which destroys teeth. The type of sugar found in soft drinks and candy are used by the bacteria, not the type of sugar you would find in whole grains. Continually supplying bacteria with the fuel to damage your teeth will lead to cavities and can create painful and expensive problems.
            So by drinking diet sodas without all the sugar, do you eliminate all of the harmful properties of soft drinks? Unfortunately most still contain phosphoric acid and citric acid, so they can still be very harmful to the teeth. Prolonged exposure to these substances can cause erosion of the teeth. This permanent condition results in the loss of hard tissues from the tooth surface. After the enamel of the tooth begins to erode, you are at increased risk of sensitivity and even tooth decay. The sensitivity results from less protection between the pulp (nerve) and any temperature changes your mouth experiences. The increased risk of tooth decay is because the underlying layers of the tooth (dentin) are not as strong as the outer layer (enamel).
            Despite some of the potential risks of both regular and diet sodas, it does not mean you have to completely eliminate them from your diet. Like most things, moderation is the key. You should limit the amount of soda you drink each day and avoid sipping on the drink throughout the day. This constant exposure can cause major problems. So when you do have a soft drink, I recommend brushing your teeth or rinsing with mouthwash when you finish. At a minimum, you should rinse with water or chew sugar free gum to help cleanse the teeth. If you aren’t sure about your individual risk to soft drinks or sodas, talk with your dentist or dental hygienist for more guidance.

For more information on tooth decay, go to

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

(513) 860-3660

Friday, January 24, 2014

What Happens If I Don't Replace Missing Teeth?

          Despite the best efforts of you and your dentist, teeth can reach the point where they are no longer restorable and must be extracted. Soon after losing the tooth, you must begin to decide how, when or if you will replace the tooth you recently lost. If you look back at a previous blog entry, we detail the pros and cons of replacing missing teeth with implants or bridges. But what happens if you delay the decision or decide not to replace at all? Below we will talk about what can happen to the surrounding teeth, bone, and gums.

            After a tooth is extracted, it can take between 2-4 months for the gums and bone to heal completely. Without proper intervention, the bone and gums will not return to their original height and can affect the cosmetic appeal of the adjacent teeth. Without the presence of a tooth or dental implant, the bone will continue to resorb over time in both the vertical and horizontal direction. If too much time has passed and too much bone is lost, your replacement options become limited. Some cases could then require a bone graft, a sinus lift, or even lead to the inability to restore with a dental implant.

            If you lose a tooth, the positioning of the surrounding teeth may be affected as well. Teeth tend to move into the space where there is no resistance. So if an adjacent tooth is lost, the tooth may tip or tilt into the open area. If there is tipping, it can lead to spacing between other teeth and more foot traps. These food traps can lead to gum disease and tooth decay. The only way to return the tipped teeth to their original position is through orthodontics (braces or clear aligners).

            The opposing teeth can also erupt into the open space and limit your ability to replace the missing tooth. Not only does it then become difficult to restore the missing tooth, but the erupting tooth can then be at risk of gum disease as the area between its adjacent teeth becomes larger and more difficult to clean.

            If or when the day comes that you lose a tooth, it is good to remember how losing one tooth can affect the overall harmony of other teeth. Before losing or shortly after losing a tooth, be sure to discuss different strategies to replace that tooth. Too much delay can turn one problem into several problems.

For more information about tooth replacement options, visit us at

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

Friday, January 17, 2014

Do I Need Antibiotics Before My Dental Appointment?

      In recent years there has been some debate over the need for prophylactic antibiotics before a dental appointment. Unfortunately, there are varying opinions among different medical specialties or organizations. In light on some of the more recent changes, we would like to discuss where the dental community stands and how it will affect your visits.

            There have been differing opinions on the use of antibiotics before dental treatment for those who have had total joint replacements. Some have argued to continue premedication for two years following surgery while others for your entire lifespan. While your physician should have the final say, the dental community currently only recommends antibiotic prophylaxis for the first two years following surgery. If further premedication is recommended by your doctor, we would like them to be responsible for providing the prescription.

            There are still certain situations where we will continue to  provide the prescriptions needed for antibiotics. The ADA (American Dental Association) currently recommends the following:

·         artificial heart valves
·         a history of infective endocarditis
·         a cardiac transplant that develops a heart valve problem
·         the following congenital (present from birth) heart conditions:
o    unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure
o    any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device
If you are uncertain whether or not you fall into any of these categories, we will need to consult with your cardiologist before proceeding with any dental treatment.

            There are also some conditions that have required antibiotics in the past that are no longer included:
·         mitral valve prolapse
·         rheumatic heart disease
·         bicuspid valve disease
·         calcified aortic stenosis
·         congenital (present from birth) heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy
          The future will likely bring changes to regulations and guidelines regarding the need for prophylactic antibiotics before dental appointments. While we will continue to update you with any changes, the best way to reduce the likelihood of infection related to oral bacteria is to maintain excellent oral hygiene and great homecare.

For more information, go to
Lee T Brown, DDS
Brown and Kupper, DDS Inc.
(513) 860-3660

Friday, January 10, 2014

Why Should I Have My Child's Wisdom Teeth Removed?

        As your children reach their middle to late teenage years, their wisdom teeth (3rd molars) become more fully developed and may begin to erupt from the gums. The problem that most people face is there is not enough room in their jaw for the teeth to fit. The resulting impacted wisdom teeth can cause further problems, which is why we typically recommend removal of all wisdom teeth as early as possible.
        When the wisdom teeth do not have adequate room to fully erupt, the gums can experience chronic pain. Gum tissue that partially covers the exposed tooth can create a trap for extra food and bacteria to gather and proliferate. The painful condition that results is called pericoronitis and can only be definitively treated through extraction of the wisdom teeth affected.
          We are also concerned that misaligned wisdom teeth can lead to problems with nearby teeth. If the tooth erupts horizontally into the tooth in front, the resulting gum pocket produced can become a bacteria trap and decay may start on the tooth or even the root. In some extreme cases, the adjacent tooth may be non-restorable and may need to be removed as well. And there was previously a thought that a sideways wisdom tooth could also cause crowding amongst the surrounding teeth. However, more recent studies have found that the presence of wisdom teeth do not push the other teeth together.
           If wisdom teeth remain impacted in the jaw bone, you risk developing a cyst in the bone surrounding the tooth. Cysts can destroy bone, tooth roots, and even cause issues with nearby nerves. The larger the cyst becomes, the more invasive the surgery will be to remove the problem area.   
           So when is the best age to get wisdom teeth removed? We believe the earlier they are extracted, the better. At a younger age, the jaw bone isn’t as dense around the teeth and the roots of the wisdom teeth are not fully formed. This decreases the odds of complications and makes the healing process a little easier. In nearly all cases, we recommend seeing an oral surgeon for the extractions because of their expertise with wisdom teeth extractions and their familiarity with conscious sedation. These factors help make the experience as comfortable as possible.
          Like anything else, extenuating circumstances exist where there may be some different recommendations regarding how to treat the wisdom teeth. By consulting with the dentist, oral surgeon, and even the orthodontist, we can help find the best treatment for you or your children’s teeth.

 For more information, please visit us at

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

Friday, January 3, 2014

What is so Important About Oral Cancer Screenings?

          Each time you visit our office for a professional cleaning and examination, both the hygienist and dentist perform an oral cancer screening. There are a number of different markers we look for during the exam, but the most important thing you can do is maintain regular visits to help us identify any issues as early as possible. The sooner oral cancer is identified, the better the odds are in treating the disease.

            There is a lot of controversy and debate over which method of screening is most successful. Traditionally, we have looked for unusual areas of red patches, white patches, or mouth sores. We also examine the tissue with our hands to feel for any abnormal bumps or lumps. If any area of concern is identified, we must then determine if a biopsy is needed or if we should re-examine the area in 10-14 days. This decision is usually based off the severity of the area, the location, and the patient’s medical history. For example, if there is a history of oral cancer or if the patient has used tobacco products, we are more likely to refer to a specialist for a closer look. The only definitive way to tell if you have oral cancer is to remove the abnormal cells and have them checked with a biopsy.

            Some newer technology has become available that involves rinsing with blue dye or shining a special light on the tissue during an oral cancer exam. In theory, the atypical cells will distinguish themselves using these devices and we can better detect potentially harmful areas. However, most studies reveal it is no more effective than a standard oral cancer exam. In fact, it results in a large number of ‘false positives’ in areas that are not abnormal. Until the technology produces better results, we will continue to use the same techniques in identifying potentially harmful areas.

            If you have a history of tobacco use (cigarettes, cigars, pipes, chewing tobacco and snuff), heavy alcohol use, or a history of oral cancer, you can greatly benefit from routine oral cancer screenings since you are at an increased risk. Maintaining regular visits to the dentist is crucial in early detection, and an early diagnosis can improve your odds against oral cancer.

 For more information, visit us at

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