DR Alex
 

JUST SOME OF THE DENTISTRY WE OFFER!
Dr. Alex and his staff are committed to delivering the highest quality of care possible to our patients. Dr. Alex is highly trained and one of the most sought after dentists in NY for prosthetic (reconstructive) and esthetic dentistry. The practice is, and always has been, a referral based practice not dependent on external marketing for patients.

We work with only the best materials, ceramists, and dental specialists, for all our cosmetic and prosthetic reconstructions. Dr. Alex acts as the “quarterback” directing and integrating all aspects of treatment to insure an optimal and predictable outcome.

Comprehensive dentistry
Comprehensive dentistry is about looking at the big picture. It’s about developing a long-term vision of health and beauty customized for each patient. It’s about understanding the intimate relationship between the teeth, joints, muscles, and gum tissues, and how each is dependent on the other for ideal beauty and comfort. This is a much different approach then the typical dental office where the tendency is to focus on individual teeth and problems and often lose sight of the big picture.
A smile by Dr. Alex

Modern dentistry
Dentistry has made remarkable advances over the past decade. Our office employs state-of-the art technology that is not found in many dental offices. We offer our patients the newest and latest techniques and approaches to advanced, state-of-the-art, comfortable, affordable, clean, safe and personalized care.

Digital x-rays
Allows us to take and process x-ray images without the use of chemicals and at significantly reduced radiation levels.

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:

bulletBrush you teeth twice a day with a desensitizing toothpaste that contains potassium nitrate and fluoride to decrease tooth sensitivity while you whiten.
bulletMake sure any gum tissue cuts or scratches are healed.

INSTRUCTIONS

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Brush and floss your teeth before putting in your bleaching trays

Be sure not to overfill the tray

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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.

Do not overfill the tray with whitening gel

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DO NOT OVERFILL THE TRAY

Carefully insert tray so as not to get gel on your gum tissue

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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)

Rinse your tray after each use

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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

Side Effects

    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

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 teethYou 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.

Cautions

    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****
Q
uick 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

Longevity

    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.

 ADA Seal of Acceptance

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.