Dr. Irene Grafman

Before using any whitening products with any concentration, you have to go to the dentist to make sure you have no cavities. If there is decay and the bleach seeps inside the tooth, it can cause serious nerve damage that won’t go away, you may even need a root canal. 

They can prevent stain from coming back on the teeth on a daily basis, but they won’t make any difference as far as whitening.

It depends on the concentration of the bleach. They can only sell a certain amount over-the counter, so they would have to be used for an extended period of time. 

I use a technique called Kor Whitening that was developed by a doctor. I like it better than ZOOM whitening because it is the only product to significantly whiten genetically discolored teeth. ZOOM and other treatments only take you back to your original tooth color. It’s a combination of an in-office and an at-home treatment, so you get trays to keep at home and maintain. The difference between these trays and others are that these trays are made so precisely, like those made for Invisalign, so they don’t impinge the gum. They also suction to the tooth, keeping the bleach where it is supposed to be. The bleach stays on the tooth and doesn’t leak out. Also, he changed the consistency of the bleach to make it more stable. You start off with two weeks at home using the trays overnight. That is followed by an in-office laser treatment, and then another one to two weeks at home. I have gotten to paper white with this system, if that is what they want to do.

You can maintain it at home a couple by using the trays a couple of days a month at home. 

Yes, usually on people who grind, where some of dentin is exposed or where there is recession by the gum line. If you get bleach on those areas, you get sensitive. We place a desensitizer on before we use in-office whitening and block out those areas that are exposed.

Yes. You want to avoid all dark liquids (including red wine, cranberry juice, sodas, soy sauce, and coffee) avoid for 48 hours after you whiten. Also, avoid anything acidy, like citrus, because they promote sensitivity.

I consider my specialty bonding. I prefer to do bonding in a lot of cases. I hate to shave down healthy teeth if there is nothing wrong with the teeth. With bonding, I don’t have to touch the teeth but add to them. If it’s done right, it can look just as good as your own natural tooth and you can’t tell the difference between where the tooth ends and the bonding begins. The disadvantage is bonding stains a little over time, but natural teeth stain overtime as well, so it actually blends in better. Bonding is less expensive because we don’t have to send anything to the lab. The other disadvantage is once you’ve had bonding you can’t whiten your teeth.

They are used when there is a very large restoration—where at least 50 percent of the tooth is old filling or has decay—when there is really nothing left of the tooth. If you have something wrong with the tooth, if there’s trauma or discoloration, a veneer would not mask the darkness. In that case, you would need a crown to cover it. Also, if one tooth is uneven, pushed in or out or rotated, we would use a crown. To put in a crown, we have to build up a foundation to support it, and then we put the crown on. If the tooth is gone, or has broken off, we may insert a post and core.

With crowns, we have to fill the middle and drill away the entire outside of the tooth, removing almost the entire tooth from the outside. Then the crown goes on the filling material in the middle. Crowns have to be replaced every 10 to 15 years, and each time it is replaced we have to put it further under the gum line because of inflammation caused by bacteria that gets trapped at the junction where the crown meets the gum line With an onlay, the outside of the tooth stays intact—we are just replacing what was decayed. This eliminates all the gum problems. Nothing is better than your own tooth.

They are clear so nobody knows you have them. Metal braces make it more difficult to clean the teeth, so you end up with gum problems, and after metal braces teeth can get white spots. Not an issue, so difficult to clean with braces on and wind up with gum problems. People actually brush more with Invisalign so their hygiene improves greatly.