Thursday, January 22, 2015

How Can the Dentist Help with Sleep Apnea?

            More people than ever before are being diagnosed with sleep apnea. Obstructive sleep apnea is a potentially serious disorder when your breathing starts and stops. Some of the initial signs and symptoms can be snoring or still feeling tired after a full night of sleep. The proper way to be diagnosed is to undergo a sleep study under the supervision of a sleep physician. From there, they can help determine whether a CPAP (continuous positive airway pressure) or an oral appliance is needed.
            The most important thing to remember is treatment should begin with the physician. Even though a dentist can help identify some key factors of sleep apnea, it is important that a definitive diagnosis and treatment plan is done with a medical doctor. Here are some examples of when you may be directed to try an oral appliance to help treat your sleep apnea:
  • You have attempted to use a CPAP, and have been unable to tolerate it.
  • You have a mild form of sleep apnea and the physician believes it can be adequately controlled with an oral appliance.
  • Your apnea is so severe that it requires a CPAP and an oral appliance to adequately control.
  • You don’t like to travel with your CPAP, and you need something to help your apnea while out of town.

Whatever the reason may be, it is just as important to do a follow up sleep study after receiving the appliance. This is the only way to measure how it is helping you and if any adjustments need to be made.
            What if you know you snore at night, but don’t think you have sleep apnea? We would still recommend you get a sleep study to verify. If you find out you do not have apnea and would like to reduce or eliminate your snoring, we can make a similar appliance to advance the lower jaw forward and reduce the snoring.
            We are always happy to discuss the different options available to help treat your sleep apnea or snoring. But it is important to remember that the role of the dentist should be completely dependent on the recommendations of the sleep physician.

For more information, visit us at

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

Thursday, January 15, 2015

Candy that Won’t Ruin Your Teeth!

            We have always been taught that candy and sugars are bad for your teeth and will lead to cavities. This has not changed. Traditional sugar can definitely lead to tooth decay when not used in moderation and when homecare is not up to par. However, there is a new sugar substitute called xylitol that does not lead to tooth decay. It is an all natural substance that is commonly derived from renewable resources like corn cobs. Even more encouraging than the fact that it is does not cause cavities is that research has shown it may even help fight tooth decay. 
            One of the best applications we have found so far for xylitol is for helping patients who have reduced saliva flow. There are many medications that reduce the amount of saliva produced and can even alter the cavity fighting properties of your saliva. To compensate for the dry mouth feeling, people will often use candy to stimulate saliva. Unfortunately, this can lead to cavities because of the sugar present in the candy. This is where the xylitol candy can prove so useful. People can still use candy to stimulate saliva flow, but not have the negative effects brought on by traditional sugars.
            There are also a number of different types of xylitol products. There are hard candies, gum, simple sweetener, toothpastes, gel and even rinses. So far, the best results we have been through using the hard candies. There is a higher concentration of xylitol in the candy and the prolonged exposure of the candy in the mouth has proved to be more effective.
            There is still more to be learned about the potential benefits of xylitol vs. sugar, but so far we have been pleased with what we have seen. While I don’t believe it will ever replace fluoride as a powerful cavity fighting tool, I think it can be an excellent adjunct to good homecare if used properly. Feel free to contact us about how it may be helpful for you and go to for more information.

Lee T. Brown, DDS

Brown and Kupper, DDS Inc.

Wednesday, January 7, 2015

Are Silver (amalgam) Fillings OK for my Teeth?

            There has been some controversy involving amalgam (silver) dental fillings and possible issues they present to the patient or environment. Dental amalgam is a mixture of copper, silver, tin, and zinc. However, the controversy exists because trace amounts of mercury are added for strength and durability to the filling. Claims exist that the amalgam is toxic and can cause serious issues for anyone who has these fillings or may receive them. But it must be understood that the American Dental Association still supports use the use of dental amalgams as an appropriate restorative material for children and adults because there are no reliable studies that show any harm.
            I believe it is admirable when people are conscientious about what materials are put into their bodies. So it is justifiable to question if dental amalgam is safe. Since mercury has become the key concern, we need to know more about how trace amounts can affect us. 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. Make no mistake, I am not disputing that at high levels mercury can be toxic. But for the average person, the consumption of fish accounts for about 70% of the mercury present in our bodies.
            Numerous studies have been conducted to discover if harm is caused by the miniscule amounts of mercury released from an amalgam dental filling. So far none have shown convincing evidence of harmful effects to our bodies or increased risk of toxicity from silver fillings. 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.
            We frequently discuss the pros and cons of having existing amalgam fillings removed for cosmetic reasons. From a clinical stance, we sometimes argue that removing undamaged dental amalgams is typically unnecessary and potentially damaging to the teeth. However, we certainly understand and empathize with the esthetic reasons for removing the silver fillings and we are always open to discussing your options for cosmetic reasons. As far as having silver fillings placed, we believe that 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 many situations where a dental amalgam filling is recommended over a white (composite) filling to increase the prognosis of the restoration.
            At the end of the day, they are your teeth and you can typically decide what type of filling material you feel comfortable having placed. Nearly all of our fillings are tooth colored, but certain situations may arise where it is beneficial to consider an 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