REFLECTION 4: GRAY’S PERIODONTAL CENTER 11 March, 2021

I completed a periodontal office observation on March 11th, 2021 at Gray’s Periodontal

Center in Virginia Beach. This was not the original office I was supposed to shadow at, and I

was thankful to finally find an office willing to have bystanders. Upon entering the office at 9:00

a.m., I immediately noticed the minimal amount of staff. There were three people which included

Sabrina, Dr. Gray, and a new front desk staff member. Dr. Gray mentioned his one of two

assistants abruptly quit recently, and that they were looking for a front desk receptionist ongoing.

The team worked around these obstacles together and found a way to complete all services even

with the reduced staff. Dr. Gray’s main assistant, Sabrina, has been working alongside Dr. Gray

since he opened up the practice. She knows everything about all aspects of that office. When

there is not a receptionist, Sabrina would walk around with the hand-held phone and talk to

patients while continuing her duties in the back. She is grateful for her job as an assistant and

talked very highly of her doctor.

The first surgery I observed was an osseous surgery, or pocket reduction surgery. The

patient presented with evident signs of periodontal disease and was in need of this surgery to

remove the disease-causing bacteria. The ultimate goal is to reduce or eliminate the periodontal

pockets that cause this disease. Dr. Gray completed two quads of osseous surgery, two

extractions, and ridge preservation. While placing the bone graft, Dr. Gray was precise and

thorough. He made sure all materials and tools maintained a sterile state while completing the

osseous surgery. Towards the end of this procedure, Dr. Gray completed Guided Regeneration

Therapy as a mechanism of bone regeneration. This procedure is helpful for gaining tooth

support and stability. GTR uses a resorbable or non-resorbable artificial membrane that blocks

soft tissue growth, allowing for slower-growing bone cells to grow instead. I also observed two

scaling and root planing procedures that were completed by Dr. Gray himself. During these
REFLECTION 4: GRAY’S PERIODONTAL CENTER 11 March, 2021

procedures, I noticed the moderate pressure and movement he was making within the pockets. I

am so used to using a light grasp with my patients that I was caught off guard by the force used

and all the patient’s head movement as a result. Since this observation, I’ve completed SRP’s on

multiple deposit four patients and I can now understand the pressure that can be needed to

remove deeper, more tenacious calculus. During procedures where local anesthesia has been

administered, the provider should take full advantage of utilizing all methods of calculus removal

because the patient temporarily has a high pain tolerance. In addition to Dr. Gray’s technique

used during the SRP’s, I was also impressed with his speed. He promptly completed two

quadrants of scaling and root planing before moving directly to the next procedure scheduled for

the day. At the end of the day, I observed a gingivectomy completed on an adolescent patient

currently undergoing orthodontics. The patient had severe, localized gingival hyperplasia located

at the gingival margin of the facial surfaces on the mandibular anterior teeth. It was apparent that

the patient’s poor oral hygiene was the primary cause of this diagnosis. The tissue was enlarged

and edematous with a diffuse, shiny surface. After doing research, I found the term related to

these symptoms is named orthodontic induced gingival hyperplasia. Dr. Gray made sure to

review oral health techniques for the patient to utilize upon healing of the area.

What made my observation a great experience was Dr. Gray’s knowledge and passion for

his work. His educational background includes a doctorate in pharmacy and dental surgery.

During his studies, he earned awards such as the Annual Student Award and the Outstanding

Senior Award from Howard University. He took the time to make eye contact and talk to each of

his patient’s, giving advice and encouraging questions about treatment plans. At Gray’s

Periodontal Center, the staff makes it a priority to offer professional care for the functionality

and aesthetics of the patient’s teeth, and ensure a strong foundation for the teeth to remain stable.