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Perio charting: What do all those numbers mean?

Recently a patient asked, “When I have a periodontal examination at during a cleaning, what do all those numbers mean? What do you do with them?” Good questions which we thought we’d answer here.
As our dental patient, you are regularly screened for oral cancer, bite problems and periodontal disease at routine dental visits. But once every few years we do a more comprehensive periodontal charting (CPC). If you’re a long time patient you’re probably familiar with the routine: the hygienist calls in another staff member and together they record all kinds of numbers for every tooth in your mouth. Maybe you’ve wondered yourself, what does it all mean?

perio charting philaldelphia pa

Periodontal disease, like many diseases, may not be obvious without testing. High blood pressure, high cholesterol, high blood sugar levels must be measured in order to be evaluated. Similarly the measurements we take during a CPC are one of the ways we test for signs of periodontal disease. A CPC serves several purposes in helping Dr. Doray monitor and assess your overall dental health.

An important part of your periodontal health is the depth of the pockets around each tooth. Since the top of the gum doesn’t attach directly to a tooth there is a space or a pocket between the gum and the tooth. Pocket depths of 1-3 millimeters are normal. Deeper pocketing especially with bleeding is a sign of disease and may indicate additional treatment is needed.

But in addition to pocket depths and bleeding we are measuring other factors including tooth mobility, gum recession and the level of attached gingiva. All of these indicators are entered into the computer and Dr. Doray carefully reviews the current and prior examination results to see if your periodontal health is improving, maintaining or getting worse.

gum disease philadelphia pa

This information, in conjunction with a review of your most recent x-rays, gives Dr. Doray a more accurate assessment of your bone levels. Often with periodontal disease small changes happen over time. If identified early, periodontal disease is more easily managed and the prognosis for your teeth is much better.

Because Dr. Doray is so thorough in her care she is able to comprehensively evaluate your oral health and provide treatment recommendations tailored to your mouth in order for you to maintain or achieve a healthy and functional smile.

Contact our office at 215-772-3100 or schedule an appointment online by visiting our website.

Thirty-five million American adults are without all of their teeth. Ninety percent wear dentures. The adverse effects of wearing dentures are many including:

  • Deterioration of the jaw bone
  • Impaired speech
  • Premature aging in the face
  • Difficulty eating
  • Poor nutrition (due to difficulty eating)
  • Negative self esteem

Most denture wearers don’t consider dental implants because they think treatment will be prohibitively expensive, time consuming and require complicated bone grafting procedures. This is not always the case.

Philadelphia cosmetic and implant dentist, Dr. Pamela Doray offers All-On-4®, a procedure that can replace all of a person’s missing teeth (on one arch) with four or more dental implants. This is a special technique for placing and restoring dental implants that saves both time and money. Dr. Doray collaborates with implant surgeons teaches other dentists this technique for their own practices.

What is All-On-4®?

All-On-4®, sometimes called “Teeth in a Day”, is the name for a dental implant procedure that maximizes the use of available bone and allows for the immediate restoration of missing teeth. As few as four dental implants will be placed to support a hybrid bridge or overdenture. Dr. Doray and her surgical team will secure the restorations to the implants on the same visit as the surgery so you never have to go without your smile.

Is All-On-4 New®?

While relatively new in the United States, All-On-4® is a tried and true dental treatment that has been successfully used throughout Europe for more than a decade.

How Does It Work?

Careful planning is key to the success of the All-On-4® procedure. The first step is to make a consultation with Dr. Doray to evaluate your condition and discuss the treatment options. In conjunction with the implant surgeon, three-dimensional scans and intraoral imaging will be done to diagnose your condition and start the treatment planning.

As few as four dental implants will be strategically placed at optimal inclinations to maximize support. By placing the dental implants at an angle, we can avoid areas that previously required bone grafting. Eliminating the need for bone grafting saves months in healing and thousands of dollars in treatment cost.

Schedule a Consultation for All-On-4®

Dr. Pamela Doray is one of the leading restorative and cosmetic dentists in Philadelphia and lectures to dentists from around the world on cosmetic, restorative and implant dentistry treatments.

If you have lost or will be losing some or all of your teeth, contact us for a consultation. We will carefully review your condition and outline the various treatment options available to you. We offer several payment options to make affording your dental implant procedure easy and stress-free.

Call 215-395-6076 or request a consultation online.

Clinically Proven to Move Teeth Up to 50% Faster

AcceleDent is an easy-to-use, hands-free device that compliments your Invisalign treatment to speed up results. Simply insert the mouthpiece, which fits around your existing orthodontics appliances and turn on the activator for 20 minutes every day.

Invisalign orthodontic treatment works by moving your teeth in a specific direction through a series of clear aligners. AcceleDent uses exclusive SoftPulse Technology to generate small vibrations or micropulses that enhance the movements directed by your aligners encouraging faster more efficient tooth movement.

How Much Faster?

A patient who has 25 Invisalign aligners would expect treatment to last about a year (50 to 62 weeks). With AcceleDent, there is the potential to decrease that treatment time by half. On average, patients who use AcceleDent are able to reduce treatment time by 38 to 50%.

Benefits of AcceleDent

Faster treatment isn’t the only reason to choose AcceleDent. Clinical trials also show:

  • Improved fit of aligners
  • Improved tracking results which means more accurate tooth movement
  • Less discomfort with fit of new aligners
  • Less sensitivity during orthodontic treatment

See It In Action

Find Out If AcceleDent is Right for You

If you’re interested in finding out how you can get a straighter smile in a fraction of the time, contact our Philadelphia dental office. Dr. Doray will help you decide if Invisalign is right for you and how AcceleDent might help speed up your results. Call 215-772-3100 or request an appointment online.

Philadelphia dentist Pamela Doray, DMD attended the American Academy of Cosmetic Dentistry’s (AACD) 31st Annual Scientific Session, in San Francisco earlier this month. Dr. Doray is the only AACD Accredited Member dentist in Philadelphia and has recently completed a four year term on the AACD Board of Directors.

The AACD is the world’s largest international dental organization dedicated to advancing excellence in the art and science of cosmetic dentistry through responsible esthetics.

The conference featured more than 48 hands-on workshops, 85 lectures, and 100 speakers. Roughly 2,000 dental professionals attended the event, which is geared toward dentists, lab technicians, hygienists, and dental team members to help them refine their skills, learn the latest techniques, and share ideas.

Dr. Doray attended a number of courses to continue to improve her cosmetic dentistry skill and meet continuing education requirements for her AACD Accreditation including:

  • Esthetic Temporary Restorations
  • High Level Esthetics with Zirconia Materials
  • Advanced Restorative Dentistry – an Adventure in Excellence
  • Complex Decision Making for Teeth & Implants in the
  • Aesthetic Zone
  • Art & Science of Tissue Reconstructions Around Implants

“This conference is like none other in dentistry,” said Dr. Doray. “Beyond the high level of clinical education offered, this is a unique opportunity to spend time with colleagues and gain exposure to the latest materials and techniques in cosmetic dentistry.”

Learn More About Dr. Doray’s Accreditation

About the American Academy of Cosmetic Dentistry

The AACD is the world’s largest non-profit member organization dedicated to advancing excellence in comprehensive oral care that combines art and science to optimally improve dental health, esthetics, and function. Comprised of more than 6,300 cosmetic dental professionals in 70 countries worldwide, the AACD fulfills its mission by offering superior educational opportunities, promoting and supporting a respected Accreditation credential, serving as a user-friendly and inviting forum for the creative exchange of knowledge and ideas, and providing accurate and useful information to the public and the profession. Dr. Dory is one of only 400 dentists in the world accredited by the AACD.

Choosing to go through with cosmetic dentistry treatment can be a big decision. Many patients worry about what the end results will look like and whether or not they’ll be happy. Cosmetic dentistry requires an investment of time and money. Patients want to know that it will be “worth it” in the end.

In our office, we use digital imaging to make that decision a little bit easier.

SNAP Smile Simulation Software

snap_smile-simulationDr. Pamela Doray is one of the few cosmetic dentists in Philadelphia to use SNAP imaging – a digital software that allows us to simulate the results of a cosmetic dental procedure.

When you first visit our office, you will have a private consultation with the Dr. Doray to discuss your medical and dental health history and to talk about the concerns you have for your smile. Then you will have a examination to evaluate your periodontal and dental health and to gather other important information, including photos of your face and smile, digital x-rays (if needed) and intra-oral scans. We can also begin discussing potential treatment options.

Treatment Planning
After your visit, Dr. Doray will study the information we collected and begin to create a treatment plan. Often times, this includes a digital smile simulation. We use a sophisticated software called SNAP that can be used to simulate any treatment including teeth whitening, dental implants, porcelain veneers and tooth bonding. Dr. Doray can even use the SNAP software to show you what your smile might look like after orthodontic treatment.

Smile Simulation
Your second appointment will be a treatment conference. During this visit, you will meet with Dr. Doray, to review treatment options, your cosmetic goals cost, and treatment sequencing. It is during this appointment that Dr. Doray may present you with the smile simulation. This is a digital image that shows you the “before” and the simulated “after” of your cosmetic dental treatment. We can even print a photo for you to take it with you while you think about your treatment.

Once you’re confident in your treatment plan, we will start the smile makeover process!

Cosmetic Dentistry Before & After with SNAP Imaging

Explore the Possibility

SNAP Smile Simulation
This cosmetic dentistry before and after photo was generated using the SNAP imaging software. No changes were made to the actual teeth. Using sophisticated imaging software, the cosmetic dentist was able to simulate what the outcome of cosmetic dental treatment would be.

Lea’s Smile Makeover
In the three photos below, you can see the “before”, the “smile simulation” and the “after”. Lea came to Dr. Doray to improve her smile and whiten her teeth. Dr. Doray completed a cosmetic dental treatment plan that included teeth whitening and porcelain veneers. In addition, Dr. Doray replaced an old silver filling on a front tooth with a tooth colored (resin) filling.

Jessica’s Smile Makeover
Jessica came to Dr. Doray because of failed dental bonding that had left fractured edges on her upper teeth and space between front teeth. She also wanted whiter teeth and a fuller smile. Dr. Doray used SNAP smile simulation software to mimic the end result. Dr. Doray completed cosmetic dental treatment that included resin bonding and deep bleaching.

Jill Imagines the Possibility

Jill came to Dr. Doray wanting a smile makeover. She has a missing tooth and failed dental restorations. It was important to Jill that the final results be very natural looking. Dr. Doray used the SNAP software to simulate what Jill’s new smile could look like. We look forward to helping Jill get her smile back.

Cosmetic Dentistry Before & After
Photos above show Jill before treatment along side Smile Simulation image

Theresa Explores Cosmetic Dentistry Options

Theresa doesn’t like her small crooked teeth and wants a fuller, brighter smile. Using the SNAP software, Dr. Doray has simulated what the final results might look like. This treatment can be achieved through a variety of procedures including gum recontouring, Invisalign treatment, porcelain veneers and teeth whitening. Once her treatment is complete, we know Theresa won’t stop smiling.

Cosmetic Dentistry Before & After
Photos above show Theresa before treatment along side Smile Simulation image

How Can We Help Your Smile?

If you’ve been considering a smile makeover or wondering what your teeth would look like after cosmetic dentistry – a Digital Smile Simulation can give you the peace of mind you need. Call our Philadelphia dental office today to schedule a consultation with Dr. Pamela Doray.

Call us at 215.395.6076 or visit our website www.drdoray.com

In our Philadelphia dental office, we make it a priority to provide patients with the best treatment experience and finest results possible. One of the ways we achieve this goal is by incorporating the latest technology into our practice. Dr. Pamela Doray stays on the cutting edge of dental technology and serves on the Council for Innovative Dentistry for 3M-ESPE Company. 

“Cutting edge dental technology isn’t about having the newest toys.” says Dr. Doray, “It’s about choosing the tools that have proven performance. Whether the technology is less invasive, more comfortable, offers better diagnostics or delivers better, longer lasting results, the bottom line is that it needs to equate to a better experience for the patient.”

Dr. Doray was featured in the January issue of Dental Economics, explaining to other dentists how digital scanning technology can improve dental practice workflow along with patient experience.

She was the first dentists in Philadelphia to use digital scanning technology. Our first device was the 3M Lava Chairside Oral Scanner, which was called a digital dentistry breakthrough when it debuted in 2008. Today we use the latest 3M scanner, True Definition, which is proven to be the most accurate scanning device on the market. The True Definition wand is also the smallest of any other model for faster, easier and more comfortable scanning for the patient.

See the True Definition Scanner in Action

Benefits of Digital Impressions

One of the greatest benefits is the improved comfort and efficiency for the patient. Digital scanners often eliminate the need for uncomfortable impression trays. Before the digital scanning technology, patients would have to bite down on trays for a few minutes while the impression material hardened. Now, with the technology, Dr. Doray can take a 3D image in just seconds without making contact with the teeth.  The “digital impressions” are transferred instantly to a computer so that they can be reviewed. If something doesn’t look right, Dr. Doray can simply rescan the tooth or teeth in a matter of seconds.

As the dental industry has embraced technology, digital impressions have also improved efficiency and communication between the dentist and the dental laboratory. Instead of mailing impressions of a patient’s teeth to the lab, Dr. Doray can transmit them electronically through a secure connection. Rather than taking hours or days to arrive at the lab it takes minutes. 

The 3D scans also give the lab technician a more accurate view of the teeth, meaning better fitting restorations. 

Digital Scanning – More than Crowns & Bridges

The True Definition scanner has a wide range of applications. The digital impression technology is used in nearly all of our cosmetic and restorative dental cases such as dental crowns, bridgework and veneers. The scanner can also be used to take impressions for Invisalign aligners, orthodontic retainers and night guards. The fit of the dental restorations and dental appliances is proven to be better compared to traditional impression methods.

Future of Digital Dentistry

The future of digital scanning and other dental technology is very bright. We look forward to continuing to bring our patients the latest tools to improve their treatment experience. Be sure to visit our website www.drdoray.com to learn more about Dr. Doray and the cosmetic dentistry treatments we offer.

Imagine if you never needed another filling. What would it be like if you didn’t need to worry about ever getting a tooth cavity? Sounds great, right? Well thanks to a breakthrough dental treatment that is being developed in Europe, living “cavity free” could soon be a reality.

“Tooth enamel is comprised mostly of minerals,” explains Philadelphia dentist Dr. Pamela Doray. “Because it is lacking essential cells and proteins, tooth enamel can’t regenerate itself quickly like our skin can. If too much mineral is lost, the enamel becomes weak, and that’s when a cavity can start to form.”

A filling is generally used to treat a cavity, says Dr. Doray. In her Philadelphia dental office, she uses “white fillings”, which are made of a composite resin. If a tooth has significant decay or structural damage, she might use a porcelain inlay or onlay, or a porcelain crown.

New Technology Could Eliminate Dental Fillings in the Future

But Dr. Doray and other dentists are keeping an eye on a new treatment that is being developed by dental researchers from King’s College London. A new company called Reminova Ltd. has been formed to commercialize the researchers’ work.

Reminova is developing a device that uses a tiny electric current to accelerate the remineralization process and “heal” tooth enamel. The treatment requires no drills, injections or filling materials. Developers say the electric current used by the device is painless and much smaller than the one being used by dentists today to check the pulp or nerve of a tooth.

According to the researchers from Kings College London, the treatment could be available in as few as three years. It is also expected to be very cost effective, at least comparable to that of current dental treatments. The technology can also be used to whiten teeth.

How to Prevent Tooth Cavities Naturally

Even though this is a promising treatment, Dr. Doray says there are simple things people can do now to improve the health of their teeth and lower their risk for tooth decay.

“Cavities are the number one most preventable dental condition,” stresses Dr. Doray. “I can’t encourage patients enough to eat fresh foods, limit sodas and sports drinks and avoid sugary or starchy snacks.”

Dr. Doray says that saliva contains calcium and phosphate and is a natural healing agent for tooth enamel. Drinking coffee, tea and alcohol can reduce saliva production. So while it’s ok to drink these beverage occasionally, Dr. Doray says don’t forget to drink plenty of water.

Dr. Doray also reminds patients to brush twice a day using a non-abrasive, fluoride toothpaste, floss once a day and visit the dentist office regularly.

How to Naturally Prevent Tooth Decay

Foods That Can Help Prevent Tooth Decay

Including milk, yogurt and cheese. Dr. Doray does caution that some yogurt can be high in sugar, so remember to drink water along with your favorite snacks.

Leafy Greens
Like dairy, leafy greens are high in calcium, as well as other important minerals. Always go for seconds of spinach, kale and broccoli.

High Fiber Fruits & Vegetables
Go for crisp fresh fruits and vegetables like apples or carrots which can deliver a one-two punch of cleaning teeth as well as stimulating saliva flow.

Water is an essential part of a healthy diet. It will keep you hydrated, promote healthy saliva flow, neutralize acids and rinse the teeth and mouth.

June is National Men’s Health Month

As you probably know, heart disease is the leading cause of death in men. What you may be surprised to learn, however, is that most systemic disease – including heart disease, hypertension and diabetes – have oral symptoms.

Oral Health is About More Than a Pretty Smile

“Men, as well as women, who suffer from gum disease are two times as likely to suffer from heart disease,” says Philadelphia dentist Dr. Pamela Doray. “There is strong scientific evidence to support the link between oral infections and systemic diseases. It is as important to visit your dentist as it is to visit your doctor. Your dentist can actually help you identify potential health risks and possibly avoid chronic disease or oral cancer.”

Of Mice and Men…

Now, there’s new research from the American Society for Microbiology supporting a causal link between the periodontal disease and heart disease. At the ASM annual conference, researchers presented a preliminary report that showed how mice infected with gum disease displayed increased risk factors for heart disease including inflammation and cholesterol levels.

Scientists have been trying to prove how mouth disease can cause disease elsewhere in the body. Whether it is through brushing, flossing or simply chewing, bacteria from the mouth enters the bloodstream. Plaque that builds up along the teeth can also build up in the arteries and blood vessels. That build up can lead to heart attack and stroke.

Another theory is that oral bacteria in the blood stream causes an immune system response which can weaken the walls of blood vessels or cause blood clots.

Can Visiting The Dentist Lower Your Risk?

A 2011 study from Taiwan suggested that patients who had their teeth professionally cleaned at least once a year lowered their risk of heart attack and stroke. The study followed more than 100,000 participants for an average of seven years and found that patients who had their teeth professionally cleaned had a 24% lower risk of heart attack and 13% lower risk of stroke.

“We have yet to prove a causal relationship, but the evidence is clear that there is a link,” says Dr. Doray. “Without a doubt, you can reduce your health risks by adopting healthy habits, including visiting the dentist.”

How to Prevent Gum Disease:

  • Brush teeth for two – three minutes, twice a day
  • Floss every day to remove plaque from between teeth
  • Visit the dentist at least every 6 months for dental cleanings & exams
  • Eat a healthy diet with fresh fruits and vegetables and drink plenty of water
  • Avoid tobacco products

Healthy Smile Recipes from the American Academy of Cosmetic Dentistry

Crunchy Chopped Salad

The ingredients in this simple salad help to promote healthy gums and reduce bacteria and inflammation in the mouth.

Celery: activates saliva production which assists in cleansing food particles from the teeth. It also dilutes sugars or acids in the mouth. Chewing celery massages gums.
Onions: contain sulfur compounds that have been show to kill tooth decay causing bacteria.
Basil: is a natural antibiotic, fighting off oral infection and reducing bacteria in the mouth.

  • 1 cup of celery, chopped
  • ¼ cup red pepper, chopped
  • 1 tablespoon onion (red, green or white), finely chopped
  • 4 leaves fresh basil, chopped (substitute ¼ teaspoon of dried basil)
  • 1 teaspoon honey, to taste (substitute 2 drops stevia)
  • 1 teaspoon raspberry vinegar
  • 1 teaspoon cold pressed extra virgin olive oil
  • Sea salt, to taste
  • Fresh ground pepper, to taste
  1. Combine chopped vegetables and fresh basil in a medium bowl. If using dried basil, keep in separate bowl.
  2. In a small bowl, combine vinegar, honey, salt, pepper, olive oil and 2 teaspoons of water. Add dried basil if using instead of fresh basil.
  3. Pour mixture over vegetables and toss to coat. Divide into two equal servings.

The American Academy of Cosmetic Dentistry is launching the first ever “Smile Story Contest”. A Smile Makeover by Philadelphia dentist Dr. Pamela Doray was selected as the featured photo for the contest.

Smile Makeover by Philadelphia Dentist Dr. Pamela Doray

Tawanda’s case was also included in the Showcase of Excellence at the 2013 AACD Conference in Seattle, WA, where Dr. Doray was awarded her Accreditation status with the Academy.

Transform Your Smile…Your Confidence

This Smile Makeover provided not just an aesthetic transformation, but a dramatic improvement in Tawanda’s self confidence. She had a congenitally missing lateral incisor tooth, which means the permanent tooth never developed. The space created by the missing tooth was not only a source of embarrassment, but a health concern. Missing teeth increase the risk of gum disease, tooth decay and bone loss, as well as alignment problems with neighboring teeth.

Dr. Doray designed a treatment plan to restore Tawanda’s missing tooth using a dental implant with custom abutment and emax press ceramic dental crown. The result is clear: a radiant, natural looking smile that transforms Tawanda’s face and lets her inner beauty shine through.

Your Smile Becomes You

The Smile Story Contest, launched by the AACD at this year’s Scientific Seminar in Orlando, FL, will award a Smile Makeover to one lucky winner. Entries have a chance to upload a photo and tell their Smile Story and why they deserve a smile makeover. The entry with the most votes will win!

Enter the AACD Smile Makeover Contest

Everyone deserves the best smile – if you’re unhappy with the appearance of your smile, give us a call to schedule a cosmetic dentistry consultation with Dr. Doray.

Many people think oral cancer is a rare disease. In fact, it is not. The Oral Cancer Foundation estimates that more than 43,000 people will be diagnosed with oral cancer in 2014. What’s more staggering are the estimates that oral cancer will cause over 8,000 deaths.

Oral cancer is not a difficult cancer to detect or diagnose, yet the death rate is higher than cancers that receive more attention like cervical cancer, skin cancer and Hodgkin’s lymphoma.

The reason for the low survival rate (about 57%) is because of the fact that most oral cancer is discovered late in its development. The survival rate increases dramatically (more than 80%) when it is diagnosed in the early stages.

You Don’t Have To Be A Smoker To Get Oral Cancer

The most obvious risk factors for oral cancer are tobacco use and alcohol consumption. The Oral Cancer Foundation states that, “tobacco use remains the single most important and preventable cause of this disease.”

A growing area of concern is the number of oral cancers diagnosed in young, non-smoking adults. HPV is now the leading cause of oropharyngeal cancers, in the very back of the mouth and throat.

What makes HPV related oral and oropharyngeal cancer difficult to diagnose is individuals may not realize they have the HPV virus and symptoms of HPV related oral cancer can be very subtle and painless.

Oral Cancer Screening is Quick and Painless

Is five minutes too much time to spare for something that could save your life?

An oral cancer screening from a dental health professional is the best way to prevent the progression of the disease.

Philadelphia dentist Dr. Pamela Doray says one of the most important components of the screening is a conversation between the dentist and patient. “It is critical that the dentist review your medical history and ask you questions about problems you may be experiencing or changes you may have noticed. The signs patients tend to ignore or painless symptoms are the ones that actually raise the red flags.”

What can you expect?

  • A series of questions to find out if you’ve noticed any changes in swallowing or speaking, noticed any lumps, chronic hoarseness, chronic earaches or sores in your mouth.
  • Your dentist or hygienist will perform an exam of the face, neck, lips and mouth to look for signs of cancers.
  • It is important that the dentist use his or her hands (with rubber gloves) to feel the external area of the jaw and neck as well as the inside of the mouth.
  • The dentist will also examine the tongue and floor of the mouth, inside of the cheeks, roof of the mouth and back of the throat.
  • Some dental offices will also use a special light that illuminates abnormal cells, making it easier to detect signs of cancer.

April is Oral Cancer Awareness Month, Schedule Your Screening Today

Dr. Doray wants you to know that an oral cancer screening is part of every comprehensive and every hygiene exam at our practice. We also offer the Microlux/DL oral cancer screening for patients as an option for an additional fee. To learn more or schedule your appointment, call our office at 215-395-6076 or visit our website drdoray.com.

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