Through the Keyhole - Dr. Perih

Dr. Joyce Perih tells Orthodontic Practice US about what makes her practice rewarding

What can you tell us about your background?

I am the oldest of six children. I was born and raised in Scranton, Pennsylvania. Yes, the same town in which the TV sitcom “The Office” is based. While I went away for my graduate education, I moved back to the Scranton area 19 years ago with my husband, Dr. James Stefanelli, a urologist, and my 6-month-old son, Michael. My parents were excited to have me return home—especially my mom, who originally suggested I pursue a career in dentistry.

When did you become a specialist and why?

I became an orthodontic resident at the University of Pennsylvania after completing my master’s degree in oral biology from Case Western Reserve University. The Bolton Growth Studies at Case furthered my interest in academic orthodontics. During the 2 years in which I studied for my master’s degree, I practiced general dentistry part time with my former clinical instructor at Case Western. This experience really helped me understand the need for proper tooth alignment in order to deliver both functional and cosmetically outstanding prosthetic dentistry. I chose the University of Pennsylvania Orthodontic Program because of the diversity of the program and its added emphasis on adult orthodontics.

Is your practice limited solely to orthodontics, or do you practice other types of dentistry?

My practice is solely orthodontics. However, because so many new procedures are evolving in orthodontics and its related fields of dentistry, one must constantly be aware of the new technologies.

Why did you decide to focus on orthodontics?

I chose orthodontics during my senior year of dental school after starting a research project on facial growth and doing a specially approved rotation in a private orthodontic office. During my time at that office I was also under comprehensive treatment myself, as a 26-year-old with temporomandibular joint (TMJ) complications. These experiences, coupled with an intense hospital maxillofacial surgical externship, reshaped my understanding and interest in the field with its complexities and challenges.

Do your patients come through referrals?

My practice thrives on referrals. Our patients come from many different referral sources. All of our patients are truly valued as people, whether they come to us from their general dentist or specialist or from a neighbor or friend. The diversity of our referral sources makes for a fun mixture of patients with many different orthodontic and orthopedic needs. Our patients and their primary care dentist deserve prompt and well-presented communication and treatment. We deliver this information utilizing Carestream Dental’s Kodak Orthodontic Imaging Software. Patients leave their exam with a collage of photos, digital x-rays and a narrative summarizing their treatment options, progress, and financial status, all in one, easy-to-read report. This allows for efficient and effective teamwork, especially in this day of excessive over-scheduling in all of our lives. When patients refer other patients, it is truly a compliment and is usually accompanied with a comment about our thorough and caring office. We know the value of such loyalty and reward it in numerous personal ways, such as prizes, refunds/discounts, tickets to local events, etc.

How long have you been practicing orthodontics and what systems do you use?

I have been practicing orthodontics since 1989. Bonded rapid palatal expanders were just coming of age due to advances in dental adhesives coupled with the growth results out of France and the University of Michigan. With the advent of surgically assisted rapid palatal expansion (RPE) procedures, I was also able to treat non-growing patients in a new and revolutionary way. I still use both procedures when diagnostically indicated. Our systems of choice are the 3M Unitek Smart Clip™ Metal and Clarity™ bracket systems. We couple these with the Forsus™ Class II Corrector system (3M Unitek) for appropriate Class II cases. Our office also enjoys the use of digital and CAT scan technology using the Kodak 9000C 3D Panoramic and Cephalometric System. These diagnostic advances, coupled with early treatment cases, have changed the results and timing of treatment in the practice. A new twist on the old problem of making adults comfortable and more willing to undergo treatment has been the advent and subsequent advances in clear aligner technology. I use the Invisalign^® technique by Align Technology when appropriate.

What training have you undertaken?

I don’t think you can ever stop training or learning. The first year after graduating from my University of Pennsylvania orthodontic residency, I began practicing with my chairman Dr. Robert Vanarsdall, as well as Dr. D. Walter Cohen and several other big names in the field of dentistry. This opportunity, along with being the assistant clinical director for 2 years, catapulted me ahead of the average graduate. Since completing my residency, every day has been a learning experience, especially when conversing with well-trained general dentists and specialists.

I also need to be a pioneer whenever I take a 3-D CAT scan. My staff and I enjoy attending numerous technique courses and meetings. Specifically, we have had intense in-office training with the acquisition of Carestream Dental’s ORTHOTRAC Practice Management Software, Kodak Orthodontic Imaging Software, along with our Kodak 9000C 3D Panoramic and Cephalometric System. We have also benefited from attending annual users’ conferences in Atlanta, Georgia.

I have also sponsored trainers and practice management seminars in the office. I am personally challenged by always having pre-dental students and second-year dental students rotate through my office. This year we are also providing a healthcare administration major at the University of Scranton with a 3-credit, 120-hour internship. We are constantly looking for a chance to educate the next generation and young students. This year I will be hosting several CE courses in-house focused on acquiring and interpreting 3-D dental scans. Soon I will also be mentoring a first-year University of Pennsylvania Orthodontic Resident’s research project.

Who has inspired you?

My biggest inspiration in my professional development came from Dr. Robert (Slick) Vanarsdall, the chairman of the University of Pennsylvania School of Dental Medicine. Dr. Vanarsdall, who is dually trained in orthodontics and periodontics, has been a pioneer in the field of orthodontics. He challenged me and gave me opportunities to explore orthodontics, orthopedics, and periodontics at a whole new level. After having been taught by Dr. Vanarsdall and the numerous instructors he brought to the University of Pennsylvania’s faculty, I was honored to accept a position as the assistant clinical director, which allowed me to teach both in the classroom and the clinic.

In addition to teaching in the orthodontic department, I had the unique opportunity to work at Children’s Hospital of Pennsylvania with Dr. Rosaro Mayro, a clinical orthodontist, and Dr. Donald LaRossa, the hospital’s former chairman of plastic surgery. Their dedication, long hours, and attention to detail not only changed my life, but also changed the lives of countless cleft palate and craniofacial children across the country.

What is the most satisfying aspect of your practice?

The most satisfying aspect of my practice is working with patients of all ages and providing them with a positive outcome. Being thorough, compassionate, and effective at what my team and I do is so satisfying. I love educating my patients and giving them the smile of a lifetime with the most modern tools and technology available. My personal sense of well-being comes from being able to establish long-term relationships with my patients and their families. I also feel that the ability to be with young people helps me to stay in touch with the times and keeps me young at heart.

Professionally what are you most proud of? 

I am most proud of the practice I have built from the ground up. All of the educational advantages I had in my professional life have given me great clinical skills. However, when you are finally on your own and make your own mistakes, you find out if you have what it takes to succeed.  

What do you think is unique about your practice?

My practice really caters to the individual needs of the patient and their personal relationship with my staff. We have six private treatment rooms. Each operatory is fully equipped so that my staff and I can efficiently take care of a patient and any of his or her special needs. The most unique part of my practice is our ability to comfortably treat medically challenged patients, those with cleft palate, craniofacial abnormalities, and children with autism and Down’s syndrome. I am so proud of the professionalism of my staff and their passion for orthodontics.

What has been your biggest challenge?

Personally and professionally my biggest challenge has been surviving the death of my two-and-a-half-year-old daughter, Simone. She passed away from a sudden-death heart attack from an undiagnosed rhabdomyoma. My family and I suffered a grave loss and a life-changing experience. My staff and patients, along with neighbors, friends, and clergy, helped my family to heal and survive. We started an endowment with Make-A-Wish in her name, and by contributing to her cause, my family, friends, patients, and local businesses have raised more than $250,000 over the past 10 years. This has allowed us to grant wishes to children who qualify in the six local counties in our community. These children not only receive their wish but many have gone on to become patients. Besides still having three children of our own, my husband and I went on to adopt a baby boy, Peter, from Guatemala. While it has been a long road to recovery, it has also been an adventure.

What would you have done if you didn’t become a dentist?

I could not imagine not being an orthodontist, but if I had gone down another road, because I am research oriented, I might have considered a PhD degree in biochemistry. Now, if I could no longer practice, I would definitely teach and pursue a career in marketing and public relations.

What is the future of orthodontics and dentistry?

Computer technology, cone-beam tomography, laser technology, and genetic and growth-related research are some of the keys to our future. With all that to deal with, the true challenge will be in affording all of these modalities and treating the patient efficiently, individually, and effectively, while hoping their oral hygiene is under control.

What are your top tips for maintaining a successful specialty orthodontic practice?

The wisdom I would impart on anyone would be work hard, play hard, love your family, build a strong team and smile, smile, smile!

What advice would you give a budding orthodontist?

Work hard, follow your vision, allow your practice to reflect your personality, don’t worry about the other guys, smile big, and laugh often. As a new orthodontist coming out of residency, it may be impossible to open a solo practice, so in that situation, pick an associateship that reflects your values and ethics.

What are your hobbies and what do you do in your spare time?

Raising my family is the joy and focus of my life. Attending my four wonderful children’s activities whether academic, athletic, or the arts keeps any spare time to a minimum. I enjoy working out when possible and playing tennis. My husband and I help raise funds for the Make-A-Wish Foundation and several other charities, like United Way, our church, and local community organizations. I also read, pray, and practice my faith. I love my life and the gifts I have been given.

Top Ten List:

1. My staff

2. Smartclip™ SL3 Self Ligating Appliance System (3M Unitek)

3. KODAK 9000C 3D Panoramic and Cephalometric System (Kodak Dental Systems)

4. ORTHOTRAC Practice Management Software (Kodak Dental Systems)

5. Maxillary Palatal Expanders

6. ProfessionalCare SmartSeries 5000 Toothbrush

7. Bonded Lingual Lower 3-3 Retainer

8. My supportive husband and children

9. My professional friends

10. My BlackBerry®

Joyce A. Perih, D.D.S., M.S.,an honors graduate with a BS in Biology from the University of Scranton, earned her doctorate in Dental Surgery and her MS degree in Oral Biology from Case Western Reserve University School of Dentistry. She received a graduate certificate in orthodontics from the University of Pennsylvania. She owns Joyce A. Perih Orthodontics in Scranton, Pennsylvania. She is married to Dr. James Stefanelli and has four children, Michael, Michelle, Julia, and Peter. Dr. Perih can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it , 570-969-9650, or www.perihsmile.com.