1. I want to have my teeth whitened. What is the best method?

There are many different methods of bleaching teeth.
However, they all use the same chemical, hydrogen peroxide.
The only difference between methods is in the concentration of hydrogen peroxide and in the way it is applied to the teeth.

The most popular method involves custom fitted trays and a 15 - 20% bleach which the patient wears for approximately one hour per day for a week or two.
The longer the patient continues to wear the trays, the lighter the teeth become, until they reach a point at which additional lightening can no longer be detected.
Using the trays for very long periods of time (several months) has been shown to remove very dark stains, such as tetracycline stains.

2. Will my teeth or gums become sensitive from bleaching?

Mild to moderate tooth sensitivity is a possibility with most bleaching procedures.  If this occurs, simply stop bleaching for a few days and the sensitivity will disappear.  You can then cut your frequency in half, i.e. continue bleaching once a day instead of twice a day, or every other day instead of every day.  In cases where teeth are very sensitive, a desensitizing toothpaste (e.g. Sensodyne), twice a day, will usually alleviate the symptoms, otherwise, we can give you a prescription strength fluoride gel, which you wear in the trays for 5 minutes after each bleaching session.  This technique has proven very effective.

Sensitivity CAN BE CONTROLLED and shouldn't be an obstacle to whitening your smile.

3. What are the recommendations for patients taking Fosamax and other oral biphosphonates

There has been much discussion lately in the press resulting from a few cases where patients who were taking oral biphosphonates developed osteonecrosis  of the jaw.

1. there is a very low risk (estimated at 0.7 cases per 100,000 person-years exposure) of developing osteonecrosis

2. there are ways to minimize the risk, but not to eliminate the already low risk

3. the consensus is that good oral hygiene along with regular dental care is the best way to lower risk

4. there are no diagnostic techniques to identify those at increased risk for developing osteonecrosis