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Intraoral and digital cameras
Intraoral
and digital cameras allow for improved accuracy in diagnosis, improved
visualization of problems, better communication with the patient and
laboratory, faster response from insurance companies due to their
ability to see first-hand the patient's needs, and more accurate
documentation of existing patient conditions.
Computer imaging
The
computer imaging system allows us to see and evaluate cosmetic &
restorative possibilities before anything is actually done on the
patient.
Complete office computerization
Provides
the ability for the patient to look at similar procedures to what they
might require, watch information DVD’s, and gives us the ability
utilize the latest diagnostic tools available in dentistry.
State-of-the-art autoclave steam sterilization
This insures instrument sterility, office cleanliness and patient safety.
ZOOM single visit tooth whitening
We offer both in office and take home tray tooth whitening. In
office whitening, along with conventional tray bleaching, safely and
rapidly restores a smile's bright appearance. We will help you decide
if tooth whitening is right for you. Click this link to FAQ's for more information on ZOOM.
Porcelain veneers (laminates)
 
Porcelain
veneers (also called laminates) can conservatively transform a smile,
providing long-lasting, natural-looking, bright and straight teeth.
Although the concept of "no prep" veneers ("Lumineers") has been widely
publicized, Dr. Alex feels most teeth require some tooth preparation if
the goal is to achieve an optimal physiologic and esthetic
result. In a select number of cases no tooth preparation may be
acceptable. The amount of tooth reduction is very case specific but
significantly less reduction is required compared to full crowns
(caps). Dr.
Alex has placed thousands of porcelain veneers and teaches porcelain
veneer dentistry throughout the United States, Canada, Central and
South America. He can advise you if you are a good candidate for
porcelain veneers.
Routine use of non-metallic, tooth-colored resin and porcelain filling, crowns, and bridgework.
One
of the things that separate the average dentist from the excellent
dentist is knowing what restoration is right for each specific clinical
situation and patient. There are literally dozens of different type of crowns and restorative materials to choose from. Dr. Alex has extensive experience working with many different materials and will help you decide what is best for you.
Implants Implants are one of the most exciting treatment modalities ever to emerge from the dental profession. Implants
allow us to restore appearance and function for patients that have lost
teeth. Implants are a very comfortable and conservative way of
replacing missing teeth. They can also be used to secure full dentures. Click this link to FAQ's for more information on Implants. You can also visit the Nobel Biocare site here to learn more about dental implants!
Invisalign Straighten
your teeth without having to wear metal braces and wires!
Invisalign aligners are virtually invisible and excellent for mild to
moderate anterior teeth that are too crowded or mal-positioned.
Dr. Alex and his staff are Invisalign certified.
Tooth Whitening (Bleaching)
The active ingredient in the gel that causes the whitening is
carbamide peroxide. This ingredient breaks down into hydrogen peroxide,
which acts as an oxygenating agent causing oxygen to enter the enamel
and dentin (the outers layer of your teeth) to break up deposits lodged
in your tooth structure.
This whitening acts only on the molecules that
carry the discoloration and its affects will depend on the strength and
duration it is in contact with your teeth.
The strength of this active
agent is limited by safety concerns. Your tooth structure remains
unchanged, only the tooth surface is made lighter. Porcelain
restorations and White fillings will not usually whiten.
Three weeks before you
start:
 | Brush you teeth twice a day with a
desensitizing toothpaste that
contains potassium nitrate and fluoride to decrease tooth
sensitivity while you whiten.
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| Make sure any gum tissue cuts or
scratches are healed. |
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Brush and floss your teeth before putting in your bleaching trays
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Apply a small thin line
of gel or a drop in each tooth indentation for a total
of 10-12 drops into each of the tooth
imprints in the tray.
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DO NOT OVERFILL THE TRAY
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Insert the tray into your mouth and seat the tray firmly against
your teeth, be sure not to push all the gel out
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Wipe the excess material from your gum with your finger or dry
toothbrush
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Try to wear the trays about 2-3 hours per day or for convenience
sake you can wear the trays over night (the gel loses 80% of its
activity after 2 hours of being in your mouth)
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Rinse your mouth after removing the trays and brush away any
remaining gel
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Clean the tray with a toothbrush and warm water, hot water will
damage the tray; dry carefully and store in the tray holder in a cool,
dry place
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Fill your tray with professional strength
fluoride and wear for about 2-5 minutes following the
whitening. Make sure you remove all the fluoride and avoid
swallowing any of the fluoride
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AVOID EATING, DRINKING OR SMOKING while the whitening tray is in
place
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Don’t use any household or other whitening products to whiten your
teeth
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Keep out of reach of children
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Keep away from direct sunlight
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Maximum results are achieved when the process is continued for 14
nights
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AVOID citrus fruits and other acidic foods while in process of
bleaching. They can contribute to sensitivity by changing the acidity
of your saliva and could cause damage to the outer tooth surfaces or
slow down the whitening process
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AVOID tobacco, coffee, dark colas and red wines because these
substances may restain your teeth
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You should AVOID stain-causing beverages such as coffee, tea, coke
for several days after the procedure, because your teeth may more
readily absorb stain at this time. |
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Try using a straw. |
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Utilize whitening toothpastes. |
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After 2-4 weeks your teeth are probably bleached as much as possible
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The area of the tooth closest to the gums may take longer to whiten
than the biting edge and will continue to remain the darkest part of
the tooth
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Renew the whitening as needed (every 3-6 months), by re-applying the
gel in the tray and wearing the tray with the get for 2-3 hours for
two to three applications
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Regular dental cleanings will keep your
teeth whiter, maintain gum tissue health, keep staining to a minimum
and determine need for whitening touch-ups |
10% of patients might experience some discomfort to their teeth,
gums, lips, or throat and increased sensitivity to cold, heat, or
pressure during the whitening process.
This sensitivity is short lived
and usually ends a day or two after the treatment is completed. If any
of these symptoms occur and are more than mild, and you have persistent
discomfort, discontinue the treatment until you can contact Dr. Alex at 631-421-4408. These symptoms usually reside 1-2 days after interrupting
the treatment.
If this uncommon cause of sensitivity develops he can
adjust your treatment regimen to help you attain the best results while
ensuring your safety.
Sensitivity can develop in 15-20% or more
of patients just from wearing the tray alone!
If you do develop sensitive teeth try these things:
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Use a soft-bristle toothbrush
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Special toothpaste (i.e. Sensodyne)
for sensitive teeth. You
may also try an application of potassium
nitrate or fluoride for 10-30
minutes prior to or after whitening, or alternating night with
whitening material, is more than 90% effective in reducing
sensitivity.
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Determine if the sensitivity is in the teeth or the
gums. The symptoms are temporary and will subside in 1-3 days
following termination of use of the whitening gel. |
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Check to make sure you are not overloading the tray
with gel. Follow the dosage markings on the syringe. |
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Brushing the teeth with baking soda
using a wet toothbrush for 30-60 seconds may help decrease tooth
sensitivity. |
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Fluoride rinse or gel for sensitive teeth. A
sensitivity protection toothpaste will usually take a couple of weeks to
ease the discomfort. Ask us for potassium nitrate and fluoride to put
in the tray after your "bleaching".
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Use short-term
treatments (20-60 minutes) in
order to control these problems. |
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Some times breaking up the amount of
time whitening is done into smaller, longer spaced segments, will
alleviate the sensitivity problem. Try taking a break for a day or
two. |
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Try taking ibuprofen
for acute sensitivity. However, only take this
medication if you have do NOT adverse reactions to this
medication and it does not interact with any medications
you are currently taking. |
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If you have a jolt or
sharp pain you could have recessed gums, enamel
fractures, a chipped tooth or leaking
margins. This is why an exam is performed
before whitening is started in order deal with these
problems first so you will be able to whitening your
teeth with fewer complications. |
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As of this time there seems to be no
apparent long term problems with tooth whitening |
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Apply
a ribbon of Sensodyne or Crest Sensitive toothpaste (alone) into their
bleaching tray for either 30 minutes before or for 30 minutes after
bleaching. |
If restorations are planned for the anterior (front) part of your
mouth it is advisable to accomplish the whitening first, then match the
new restorations to the now bleached teeth. You will need to plan to
wait three weeks or longer after whitening before starting these
restorative procedures.
The whitening process may
cause some temporary dehydration of the teeth. This
dehydration may appear as white spots or striations on the
teeth. These spots will disappear within 1-2 weeks
after completion of the whitening process.
| Contraindications/limitations
of home bleaching: |
Comments |
| Extensive composite
(white) & porcelain restorations |
Restorations will NOT bleach
and you need to be informed about the cost of replacement |
| Pre-existing sensitivity |
2/3 of these people will experience
some sensitivity for 1-4 days; usually reversible upon termination
of bleaching |
| Severe gray/blue banded tetracycline
staining |
Guarded prognosis, may reduce amount
of
"masking: required for future |
| Discoloration in gingival third or
exposed yellow |
Guarded prognosis for whitening |
| Pregnant or lactating |
No know adverse effects but avoid use
as a precautionary measure |
| TMJ |
Consider bleaching one arch and
monitor comfort |
| Translucent teeth |
May appear darker after bleaching |
| Amalgam
restoration in front teeth |
Replace amalgams to avoid
"greening effect" |
| Noncompliance or unrealistic
expectation |
Determine realistic whitening
results****
Determine realistic
whitening results****
Quick bleaching lasts a
shorter time and you will
have to wear the trays to keep the quick bleach stable and to
continue to have good results |
Usually we cannot predict the effectiveness of whitening for each
individual patient. The degree of whitening is variable because each
person’s reaction to the procedure is individual.
Because a tooth is translucent, and
because of light reflection the same tooth can look a
different color under a different light. This is why is is
difficult to tell patients exactly how many shade changes
they may reach with the whitening procedure. Teeth all
respond differently. But remember this general rule to
match the whites of your eyes for the most natural look. #
But your own long
term results will depend on if you smoke, drink coffee/tea/red wine and
if you have good dental health habits.
Depending on your oral health
habits you may need "touch-up’ treatments at regular intervals
You can periodic re-treat at home to maintain the desired color and
shade. To help keep your teeth white, don’t forget to see us twice a
year!
For a permanent change, you should consider the placement of
Veneers.
 There
are only four whitening products used by dentist that have the
ADA seal of acceptance. NiteWhite is one of them!
***An Update on Tooth
Whitening, Woman Dentist Journal, pg 10-22, Jan/Feb 2003 #Nightguard Vital Bleaching; Dr. Haywood; Dental Products
Report pg 82-86,96; Oct 2002.
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