Pamela Doray, DMD, has been elected to the American Academy of Cosmetic
Dentistry (AACD) Board of Directors. Her term began at the AACD’s 28th Annual
Scientific Session in Washington, DC, May 2-5.

 Dr. Doray, an AACD Accreditation candidate, has served on the AACD Board of Directors since May 2010. Her private practice in Philadelphia is devoted to comprehensive cosmetic, restorative and implant dentistry. Dr. Doray lectures for Biomet 3i dental implant company and 3M-ESPE dental division, and also serves on 3M-ESPE’s Council for Innovative Dentistry.

She is actively involved in teaching, research and consulting, reflecting her commitment to practicing dentistry with the latest technology and at the highest level of technical expertise. Dr. Doray received her DMD degree from the University of Pennsylvania in 1984, where she is also on faculty. Since 1994, Dr. Doray has also been on faculty at the University of Texas Health Science Center at Houston.

“I am honored to serve on the Board of Directors of the AACD,” Doray said. “The AACD is the premier organization for advancing excellence in cosmetic dentistry, and I am excited to help lead this profession into the future.”

The AACD Board of Directors is comprised of 15 elected officials from varying cosmetic dental backgrounds. Its chief responsibilities include:  Determining the direction of the AACD, creating board policy and actively linking with membership to maintain exceptional member value.

About the AACD

The AACD is the world’s largest non-profit membership organization dedicated to advancing excellence in comprehensive oral care combining art and science to optimally improve dental health, function, and esthetics. Comprised of more than 6,300 cosmetic dental professionals in more than 70 countries around the globe, the AACD fulfills its mission by offering superior educational opportunities, promoting and supporting a respected 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.

For more information regarding the AACD, please visit www.aacd.com, send an e-mail to pr@aacd.com, or call 800.543.9220.

Most dentists offer teeth whitening procedures, so it extremely likely that your current dentist does too. However, there are several different types of teeth whitening procedures that a patient can choose from.

Firstly, many dentists recommend a procedure called deep bleaching to their patients who want to achieve whiter teeth. Deep bleaching works by restoring your teeth’s ability to absorb oxygen. This causes the bleach from the whitening gel that the dentists uses to be absorbed deeply into the tooth. In turn, stain molecules will be dissolved and the teeth will be whitened several of shades. This procedure usually involves two to three in office treatments and is perfect for those who have extremely stained teeth. Many patients say that their teeth whiten to levels that they did not think was possible.

Secondly, laser whitening is another procedure that many dentists use to whiten their patients teeth. Laser whitening is preferred by many patients because it is fast and effective. Often times, the entire laser whitening procedure can be performed in about one hour. Laser whitening works by using a diode laser that activates whitening of the teeth. Dentists simply place protective coating on the patient’s gum tissue, then apply Target Chromophore In-phase Accelerated-activation gel that is activated when it is exposed to the laser’s wavelength. The laser needs to activate the gel for at least twenty four minutes and then the procedure is finished. The patient is then able to show off their whiter smile without having to revisit the office for any additional procedures. The results of laser whitening are not as dramatic as deep bleaching, however, the procedure is much more convenient.

Philadelphia Magazine compiles their top dentist list each year from the results of a survey that is sent to several thousand dentists throughout Philadelphia and the surrounding seven county area. Out of 4,400 nominations, Philadelphia Magazine selects the top 20 dentists in each category for its feature.

The categories include: General Dentistry, Cosmetic Dentistry, Orthodontics, Endodontics, Prosthodontics, Pediatric Dentistry, Periodontics, Oral Medicine, and Oral & Maxillofacial Surgery.

Dr. Doray is regularly nominated by here peers in multiple categories, including Cosmetic Dentistry, General Dentistry and Prosthodontics. The Top Dentist award is limited to a single category.

“I am extremely honored to have been selected by my peers and I appreciate their recognition of excellence in the care that I provide,” says Dr. Pamela Doray, “My staff and I pledge to continue to deliver uncompromising care and exquisite results for our patients.”

Since 1984, Dr. Doray has been building a reputation as a leading Philadelphia cosmetic dentist. Her focus is on adult patients who have complex problems, working to not only provide beautiful aesthetics, but results that are healthy, comfortable and long lasting.

Dr. Doray’s office is conveniently located in center city Philadelphia. We accept out of town patients and have special concierge services available to make your stay in Philadelphia as comfortable as possible.

To learn more about Dr. Pamela Doray or to schedule a
consultation, contact us at 215-395-6067. We look forward to meeting you!

There are many ways cosmetic dentistry can help a person attain a dazzling smile

Teeth Whitening

While most people are born with white teeth, through the years food and drink can stain the teeth, making them seem yellowish and dull. There are home whitening systems that can whiten teeth without discomfort. Special trays are molded to fit the teeth, and are worn with a bleaching gel for an hour a day. Clients can see whiter teeth in as little as two weeks with no pain and little fuss.

Porcelain Veneers

Teeth are often chipped or broken, crooked, or uneven. Porcelain veneers can fix these problems, along with spaces between the teeth or teeth that are so severely discolored that whitening solutions will not work. A translucent shell that is made of materials resembling teeth is applied to the teeth to hide any imperfections. The color of the veneer will match the teeth perfectly. Once applied, the veneers are bonded to the teeth using bonding cement and a curing light. The process will hide many imperfections of the teeth.

Inlays or Onlays

Sometimes the tooth structure needs support, but it is not severe enough to require a tooth crown yet it is insufficient for a filling. Porcelain inlays or onlays can fill in or fit over the tooth to make it look like a natural tooth. The porcelain is strong enough to resemble a real tooth, and is matched to the color of the rest of the teeth. The inlays or onlays will last a long time with proper care and maintenance, and make it easy to smile again.

A Smile Makeover

Cosmetic dentistry can provide a smile makeover. There are crowns, implants, bridges, or even dentures that can make a person proud to give a really big grin. A consultation with a cosmetic dentistry specialist can help you regain the smile that will brighten the day.

Crowns can be metal, porcelain fused to metal, all-resin, all-porcelain or all-ceramic. Metal crowns are the most durable without causing problems to opposing teeth. Temporary crowns made of steel or acrylic may be used while the permanent ones are made by the lab.

The procedure for a crown begins with an x-ray to see the condition of the tooth’s root and to assess the bone surrounding it. A root canal may be required if there is a lot of decay. The dentist will numb the area around the tooth and file it down to make room for the new crown. If a lot of the tooth is missing, it may need to be built up a bit before receiving the crown.

The next step is making an impression of the tooth for the crown. Impressions of the opposing tooth are also made to determine a proper fit for the bite. If a porcelain crown is to be used, the dentist will pick a color that matches the other teeth. A temporary crown will be fitted at this time to protect the tooth until the new one is ready.

The following visit entails the fitting and checking the color of the new crown. If everything is as it should be, the dentist will cement it permanently into place.

A dental crown will last anywhere from five to 15 years, with proper oral care and no bad habits such as nail biting, grinding or clenching. Cost can vary, depending on the type of crown used. The average is $500 to $900. The procedure or parts thereof may be covered by insurance and the patient should check with their carrier before proceeding.

How Invisalign works
Pamela Doray, an AACD member dentist from Philadelphia, PA, gives a quick overview of the Invisalign process: “Invisalign works through a series of clear ‘nearly invisible’ plastic aligners that the patient wears.  Aligners are worn [approximately] 22 hours a day (removing only to eat, floss and brush).”

“Typically,” Dr. Doray says, “each aligner is worn for 2 weeks, at which time the patient changes to a new aligner.  The patient receives a few sets of aligners at a time, returning to the dentist for evaluation and the next set of aligners at the appropriate interval.  Depending on the amount of orthodontic correction needed, the patient may have anywhere from 4 to 50 aligners.  The length of treatment depends on the number of aligners.”

Invisalign may be the answer for you if:

• You want to straighten teeth, close gaps or spaces, correct misalignment. “Invisalign can benefit [almost] everyone, from teenagers to the elderly and for people who may need subtle adjustments or those with more complex movements necessary, says Debra Gray King, DDS, Atlanta, GA.  “Invisalign is great for treating teeth that have spaces in between or over-crowded.  In addition, Invisalign can be used to reduce more complicated issues that include overbites, underbites, and crossbites.”

• You want a nearly clear, removable option to straighten your smile.
Many people choose the retainer-like process because, Dr. Stanley says, “The pros to Invisalign are that they are [nearly] invisible, easy to clean and can easily be removed for eating and brushing.”
“Anyone who is concerned with how their smile would look with brackets [of traditional metal braces] should at least consider seeing if they are a candidate for Invisalign,” offers Elizabeth Lowery, DDS, an AACD member dentist in Austin, TX.

• You will be dedicated to your Invisalign treatment.
If your dentist has determined that Invisalign is the right choice for you, you “will need to be dedicated to getting [your] teeth straight and will need to make sure to listen to the dentist,” says Stanley.

Agrees Doray, “The best patient candidates are those who are highly motivated and will be compliant with wearing the aligners as prescribed.”

• You have periodontal disease or are concerned about proper gum care.
Says Doray, “Invisalign is an excellent choice for patients with periodontal concerns, due to the controlled minor tooth movement and the ability to floss and clean the teeth normally with the aligners out (as long as the periodontal disease has been treated).”

• You have had braces in the past, but need a touch-up.
Another ideal candidate for Invisalign, says Dr. Lowery: “Someone who has already been through traditional braces and has relapsed a little by not wearing his or her retainer.”

• You have a complicated case that can’t be initially treated with Invisalign.
Dr. Brian LeSage, DDS, of Beverly Hills, CA, “You might be a candidate for a hybrid case—complete part of your orthodontics in [traditional bracket braces] and part in Invisalign.”

• You have had or are having cosmetic dental procedures.
“As a cosmetic dentist, “ says Doray, “I often [use] Invisalign treatment as an adjunct to my cosmetic treatment, allowing me to set up the case and align the teeth for optimal cosmetic procedures such as crowns and veneers.”

“During the holidays, we tend to indulge ourselves more than usual on sugary treats and alcoholic beverages,” says Dr. Doray. “Combining this with busy schedules and increased stress, we notice that many patients have a harder time maintaining their oral hygiene. It is important to remember that basic, routine care can combat the effects of holiday food and drinks.”

Here are some tips from Dr. Doray to keep your smile merry and bright:

Wine Wine, both red and white, can have high levels of acidity that attack the enamel of your teeth. Tooth enamel is essential for protecting teeth from decay and wear. To avoid damage, don’t swish wine around in your mouth, and drink water throughout the evening to rinse the teeth.

Sugary Treats Holiday goodies affect more than your waistline.  Candy, cookies, and chocolate stimulate acid production by bacteria and increase the likelihood for developing cavities. It is important to brush your teeth as soon as possible after eating sweet treats.  In the meantime, drinking water or chewing sugarless gum can help. This will boost saliva flow and help to wash debris and acids away.

Stress Stress levels seems to be particularly high around the holidays, leading people to knowingly or unknowingly clench or grind their teeth. Clenching and grinding lead to a host of problems including headaches, jaw pain, and tooth wear (such as chipping). While it is important to find ways to alleviate stress, many times a custom nightguard created by your dentist can save you from discomfort and long term damage to the teeth. If you already have a nightguard, be sure to wear it.

Keep a healthy smile at the top of your wish list! Remember to floss daily and brush at least twice a day and keep up with your regular maintenance visits.

“A healthy smile,” says Dr. Doray, “is one of the best gifts you can give yourself.”

“Invisalign trays are stronger, as they are designed to move teeth. Over the course treatment, the shape of the Invisalign aligners changes very subtly,” says Debra Gray King, DDS, of Atlanta, Georgia.  “Wearing the different trays in the Invisalign process creates the gradual forces that cause the teeth to move into proper alignment.”

“Aligners are worn [approximately] 22 hours a day, removing only to eat, floss and brush,” Dr. Doray explains.  “Typically each aligner is worn for 2 weeks, at which time the patient changes to a new aligner.  The patient receives a few sets of aligners at a time, returning to the dentist for evaluation and the next set of aligners at the appropriate interval.  Depending on the amount of orthodontic correction needed, the patient may have anywhere from four to 50 aligners.  The length of treatment depends on the number of aligners.”

The Invisalign Process Explained in 5 Steps

Step One: Consultation and exam with an Invisalign provider 
“The dentist can discuss with you the kind of results you may be able to achieve,” says Dr. King. If, after the initial exam, the dental practitioner determines you are a good candidate for Invisalign, he or she can then prepare a treatment plan for you.

At this point, “you have a chance to see the costs and decide whether you want to proceed with the Invisalign treatment plan,” Dr. King advises.

Step Two: Creation of Records and Treatment Plan
Once you’ve decided to get Invisalign to straighten your smile, your provider will take X-rays, photos and impressions of your teeth, says Doray. Based on these records, and the results you aim to achieve, the dental professional works with Invisalign to create your personal treatment plan.

Step Three: Your 3-D Smile from Start to Finish
Based on the information from your dentist or orthodontist, Invisalign creates digital 3-D imaging of your proposed treatment from start to finish. “The dentist will be able to see from this 3-D rendering a virtual and real representation of your teeth before, during, and after completion of the Invisalign treatment,” says King. “This is very informative, as it shows what your smile is projected to look like when your treatment is completed.”

Step Four: Custom Aligners are Created and Delivered
Next comes delivery of the first sets of aligners with instructions for use and care. “The Invisalign lab creates customized aligners for you to wear at each stage of the process,” King explains. Each Invisalign aligner is worn for approximately two weeks before being replaced with the next one, until your teeth are straight, she explains.

Step Five: Invisalign Wear, Care and Follow-Ups
You will be scheduled for periodic evaluation by the dentist, during which you’ll receive the next sets of aligners in your treatment process.  Doray advises that these visits are typically every 6-10 weeks, although may vary by case.

“During this process,” says King, “you will be able to watch your teeth, little by little, move into place. Your smile will slowly morph into what was projected—a nice, proportional smile.”

Says Doray, “At completion of the treatment—when the teeth are straight!—the dentist may need to refine the bite (minor occlusal adjustment) and then retainers are made.” These retainers, she says, are simply a stronger clear plastic aligner worn at night to maintain the corrected tooth position.

While each patient is different, the Invisalign process generally takes anywhere from a few months to a year and a half to complete.

People choose Invisalign treatment to correct severe crowding, crossbite, gaps or spacing and overbite problems.  The process involves three easy steps. First, your dentist examines you and takes x-rays, photos and impressions.  Step two is making a series of custom designed clear aligners. In step 3, you will receive your aligners.  Each set of aligners are worn for about 2 weeks.  One major benefit of Invisalign over traditional orthodontics is you can take them out to eat or brush your teeth. Approximately every 6-8 weeks you will see the doctor for a check-up.

Treatment can vary as each case is different and is custom designed for the patient.  Invisalign can help you to have a great smile in as little as 6 months depending on the amount of correction needed.  Our patients say that their new improved smiles give them the confidence they need to succeed in their personal, professional and social lives. 

So, if you want a smile you’d be proud to show off, Invisalign might be right for you.  Contact our office at 215-772-3100 to schedule an initial consultation. The sooner you start treatment, the sooner you will have your great new smile!

Aside from the obvious cosmetic problem, the changed positions of these teeth can lead to severe bite problems causing jaw pain and headaches.

Missing teeth should be replaced to keep other teeth in their normal position.  This can be done by Dr. Doray with a fixed bridge or a dental implant. Both of these treatments offer a good functional and cosmetic result.

Please call our office at (215) 772-3100 with any questions you may have about the benefits of replacing missing teeth with bridges or dental implants.