Services

General Services
Radiographic X-rays 

     Complete X-Ray Series:  A full mouth series of x-rays is the first step in a thorough dental examination.  Dr. Doche requires each patient over the age of 18 to take this series of x-rays so we can find:       

• Cavities between the teeth
• Worn-out fillings and crowns
• Tartar on the roots
• Receding bone levels and abcesses

     The dental assistant/hygienist will place 18 separate packets throughout your mouth to make a thorough evaluation.  A lead apron is draped over you to protect the rest of the body while she x-rays your mouth.

     Dental x-rays use hugh-speed film, so the amount of radiation exposure is very low.  machines vary, but a full series of x-rays only add as much radiation as you'd get from about 8 extra weeks of natural background radiation.  Even if you've recently had other x-rays taken, a full-mouth set of x-rays does not add to that exposure.

     A full-mouth set of x-rays is an important part of a thorough deental examination.  It gives Dr. Doche the vital information he can't get from any other source.

     Bitewing X-Rays:  Bitewing x-rays are the most common x-rays taken in dentisrty.  Dr. Doche uses them to:

• Find cavities between teeth
• See tartar on the roots
• Find worn-out fillings
• Locate receding bone levels from periodontal disease

     A small packet of x-ray film is placed inside your mouth.  When you bite on the tab on the side of the packet, the film becomes properly aligned to get a picture of your upper and lower teeth at the same time.

     A lead apron is draped over you to protect the rest of your body while the assistant/hygienist x-rays your mouth.

     Dental x-rays use high-speed film, so the amount of radiation exposure is very low.  Tough machines vary, bitewing x-rays only add as much radiation as you'd get from about 3 extra weeks of natural backqround radiation.  Even if you've recently had other x-rays taken, bitewing x-rays do not add to that exposure.

     Bitewing x-rays are a necessary part of a regular dental checkups.  They give Dr. Doche vital information that he can't get from any other source. 

Exams / Check-ups

     The diagnoses of periodontal disease and cavities are a two important parts of a dental examination.  Eventhough, your hygienist performs a tissue exam, Dr. Doche will determine if there are any cavities on your teeth and the options that you have to repair and save them from extrations.  The use of dental x-rays, either full mouth series or bitewing x-rays, will be taken prior to the dental examine and diagnoses by Dr. Doche.       

Sealants

     Sealants are a clear or white plastic that are placed in the grooves of the biting surface of back teeth.  Back teeth have deep grooves and pits that are very difficult to keep clean.  plaque, which is a nearly invisible film of bacteria and food, collects in these grooves.  If the tooth was stained with red dye, plaque would then be visible to the naked eye.  Every time you eat, the bacteria in plaque froms acid.  Without sealants, these acid attacks can cause enamel to break down and decay.  Then you have a cavity.

     To place sealants, first Dr. Doche or the hygienist thoroughly cleans and dries the teeth.  A conditioning solution is applied, and then the material is brushed into the grooves of the teeth.  Some types of sealants harden on their own, while others harden when exposed to a special light.  Sealants are an important part of a perventive dental care program.

Fluoride Treatments  

     The greatest breakthrough in preventive dentistry on the last fifty years has been the use of fluoride.  Almost all water naturally contains some fluoride.  About three-fourths of American cities add additional fluoride to the water supply for the prevention of tooth decay.  Flouridated water alone has decreased the cavity rate for school children by 60 percent.  However, San Diego county will only implement a fluoride supply into the water supply starting the summer of 2007. 

     There are many benefits in the use of fluoride, for people of all ages.  When children are young and their teeth are forming, fluoride joins with the enamel surface and makes it harder and more decay-resistant.

     The benefits for adults are jsut as great.  Flouride can help repair an early cavity, even before it's become visible in the mouth, by rebuilding the enamel layer of the teeth.

     Fluoride is also helpful in older adults to help solve the problem of root caries or root sensitivity.  And fluoride rinses or gels are sometimes prescribed to help eliminate germs that cause gum disease.

     Another highly effective time for fluoride application is immediately following your cleaning in the dental office.  A topical gel is applied with the use of a tray or with a cotton applicator for children that do not know how to spit-out the fluoride after the treatment.  A fluoride rinse is given to older children and adults for one minute.

     Flouride is an important part of every tooth decay prevention program.  When combined with good hygiene habits of brushing and flossing, the number of cavities in children and adults can be dramatically reduced. 

Oral Hygiene Instruction 

     The two most important aspects of an effective at-home dental hygiene program are frequency and technique.  In other words, it's important that you brush at least twice a day, floss once a day -- and do both correctly.

     Below are eight tips to make the most of your time you spend brushing and flossing:

1.      First, floss each and every day, preferably at night, to remove food and bacteria from the vulnerable areas between your teeth.  Any floss can do the job; choose one that you like.
2.      Use a toothbrush with soft bristles.  The flexible bristles of a soft toothbrush are gentler on the gums and make it much easier to remove the plaque below the gum line, where periodontal disease starts. 
3.      Angle the bristles of the brush along the gum line at a 45-degree angle.  Apply firm but gentle pressure so the bristles slide under the gum line.    Move the brush over the entire surface of two or three teeth at a time in small, circular motions.  Allow some overlap as you move to the next teeth.  Tilt the brush and use the tip to brush the backs of the front teeth.
4.      Use a toothpaste that contains fluoride.  Fluoride hardens the outer enamel layer of the teeth.  it might stop a cavity in its tracks and give you more resistance to furture cavities.
5.           It's fine to brush in any regular pattern you choose, but since the insides of the teeth tend to get less attention, you might start with the insides of the upper teeth, then go to the insides of the lower teeth.  Switch to the outsides of the upper teeth, and then the outsides of the lower teeth.  Brush the chewing surfaces of the upper teeth, then the lower teeth.  
6.      After  you've brushed your teeth, gently brush your tongue, from back to front.  Rinse your brush and then carefully brush the roof of your mouth.  This will remove a good deal of bacteria and will help to keep your breath fresh.
7.      A mouth rinse can be a good addition to your home dental hygiene program.  Just make sure the mouth rinse doesn't contain alcohol, which can dry your mouth and result in a new set of problems.  Also, rinsing should never replace flossing or brushing.
8.      Finally, here's a little known fact: you should avoid brushing immediately after ingesting acidic foods or beverages, like orange juice, soda or grapefruit juice.  reasearch has shown that when you brush after an acidic food or beverage, a small amount of the tooth enamel is worn away by the toothbrush rubbing the acids against the teeth.  in this case, it's better to rinse your mouth, then wait an hour or two before brushing.  this allows time for the saliva in your mouth to work to remineralize your teeth.    

Children’s Dentistry

     Children are growing and changing so fast that each of their six-month check-ups is essentially a new patient examination.  teeth are being lst, new ones are growing in, bones are lengthening and elongating, and the bite is being established.  Seeing your child every six months lets Dr. Doche track the progress of these events and catch any problems early, when they are easier to correct.

     Dr. Doche recommends that children be brought in for a Happy Visit as soon as their first tooth appears (usually between five and eight months, but definietly by one year) so that the parents can learn how to prevent infant tooth decay, and get the child to feel comfortable going to see the dentist for regular check-ups.  During early visits, Dr. Doche or the hygienist will count the teeth, read them a tooth story, play with Peter the puppet, brush their teeth and instruct the parent involvement on home care techniques with their child.    

  FREE CONSULTATIONS

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Restorative Procedures
All Porcelain Crowns 

     Porcelain dental crowns are an aesthetically pleasing way to prevent further damage to a tooth.  Dental crowns are used at our office to treat one or more chipped or cracked teeth by completely covering them with a natural looking porcelain dental crown.  Porcelain dental crowns have the luster of a natural, healthy tooth.

     Our porcelain tooth-colored are beautiful, and will enhance and strenghthen each tooth to which they are bonded.  Our laser-cured fillings, onlays and dental crowns are made of the newest materials and are crafted by the best lab technicians.  All porcelain crowns maintain a translucency that makes them hard to tell from natural teeth.  Without metal, the problem of the dark blue line at the edge of the gums is eliminated.  This allows Dr. Doche to place the edge of the crown above the gum line, which is healthier for your tooth and gums. 

Porcelain Fused To Metal Or Fused To Gold Crowns

Gold Crowns  

Porcelain Veneers

     If your teeth are stained, worn, chipped or misaligned, porcelian dental veneers are a highly popular way to reshape and brighten your smile.  By reshaping teeth, dental veneers can correct for mislighed teeth without the use of braces.  Procelain dental veneers most closely match the natural luster of tooth enamel, giving thenm an incredibly realistic look.  In just a few appointments, we can place prcelian dental veneers at our office in San Marcos.  Porcelain veneers can be designed to completely change the length, shape and size of your teeth.  Our spectacular, natural-looking, porcelain dental veneers are crafted by the finest laboratory technicians.  this allows us to design your smile specifically to what you want.  many of our patients have very different concerns about their smile that they would like for us the address.  During your consultation with Dr. Doche, you will discuss one-on-one what your cosmetic concerns are.  That way, he can inform you of your options and give you the best results possible. 

Tooth-colored Fillings 

     Tooth colored fillings can easliy transform smiles laden with old metal fillings.  new cosmetically pleasing materials can be used to match fillings to the natural color of your teeth, creating a uniform smile.  Tooth-colored fillings can also outlast metal fillings.  By removing old metal fillings or getting new tooth colored fillings if a cavity is discovered during your visit, Dr. Pierre Doche can prevent further decay and keep your smile metal-free.

Porcelain Fused To Metal Bridges

     If your're missing one or more teeth, dental bridges are an excellent alternative to removable partial dentures or dental implants.  By attaching natural looking artifical teeth, made of the finest porcelain, fused to metal, for stabilty and strength, between two dental crowns on the opposing teeth, Dr. Doche is able to give your smile a wonderful, functional and aesthetic improvment.  Dental bridges are not prone to slippage of removable dentures and are less invasive than dental implants.

Dental Bonding

     If you've been troubled by chipped, discolored or misaligned teeth, Dr. Doche can use dental bonding techniques to improve your smile in just one visit.  By shaping and polishing a composite resin on your teeth, Dr. Doche can easliy correct small imperfections that may have been bothering you for years.  it only takes one visit!  Dental bonding techniques can even close small gaps between teeth without the use of braces.

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Implants
Individual Tooth Replacement
Multiple Teeth Replacement
Implants Used To Anchor Partials Or Denture Appliances

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Oral Surgery
Single Tooth Extractions, simple and at times surgical

Multiple Teeth Extractions, simple and at times surgical

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Periodontal Treatment

     Peridontal disease is an infection of the teeth, gums, and the bone that surrounds the teeth.  Most people who have peridontal disease aren't even aware of it.  It's rarely painful, especially in the early stages.

     Some of the warning signs of periodontal disease are:

•      persistent bad breath
•      bleeding gums when brushing or flossing
•      soft, swollen or tender gums
•      gums pulling away from the teeth
•      loose teeth
•      changes in spaces between your teeth, which reflect   changes  in the underlying bone 

     Keep in mind, however, that you can have peridontal disease and experience none of these symptoms.  To determine if a patient has periodontal disease, the hygienist will perform a through examination using x-rays and a periodontal probe to measure bone levels around the teeth.  When the bone level falls, the gums pull away from the tooth, forming a pocket.  Your hygienist measures the depth of this pocket with a peridontal probe.  The deeper the pockets, the greater the spread of peridontal disease.

     Delaying treatment will never make periodontal disease go away.  Peridontal disease is an ongoing, degenerative condition.  Bone lost never grows back.  If too much bone is lost, teeth get loose and have to be removed.  This means you may end up wearing partial dentures or even full dentures.

     The goal of root planning is to eliminate the source of peridontal infection by removing the plaque, tartar and bacterial toxins from the surfaces of the roots.  Tartar shows up on an x-ray as small white lumps on the sides of the teeth.  Root Planning removes plaque and calculus from below the gum line.  To keep you comfortable, Dr. Doche or Hygienist usually numbs you before root planning begins.  Then, the dental hygienist carefully and meticulously planes the root surfacess with special hand and water power tools.  Once the source of infection is removed, your gums begin to heal.  As they heal, your gums will tighten around your teeth.  Homecare is the key to maintaining the healing process.  Since brushing and flossing only go about three millimeters below the gum line, sometimes an antibiotic therapy is used in combination with the root planning to clean the deeper pockets that come from peridontal disease.

     Normally, root planning is spread across two appointments.  That way your hygienist can track the healing and help you fine-tune your homecare efforts.

Periodontal Recall Maintenance

     After scaling and root planning are completed, patients are placed on a three month recall appointments.  Placing patients back to a routine six month recall would be to soon after having peridontal disease for the root planning treatment to work successfully.  Therefore, monitoring a patient's progress on plaque removal and home care efforts between visits will improve patients' teeth, oral tissue and supporting bone.

Gingival Contouring To Improve Smile Line  

     Healthy gums, tight against the neck of the teeth, are an important part of a beautiful smile.  But sometimes gums can extend onto the front surfance of the teeth, the natural balance between the length of the teeth and the height of the gums are lost.  The first step in a gum-reduction procedure is making sure that all of the involved areas are comletely numb.  Dr. Doche then carefully removes the excess gum tissue using a laser.  After a couple of days, the area will be completely healed.  A gum reduction procedure is a safe and predictable way to remove excess gum tissue and improve the natural appearance of your smile.

Periodontal Treatment Without Invasive Gum Surgeries

     Atridox: is an antibiotic gel that is placed gently into your gum pockets where bacteria thrive.  It then quickly hardens to a waxlike substance, slowly releasing the antibiotic to the infected area for seven days.  After most of the antibiotic is fully absorbed in the tissue, it continue to help arrest periodontitis in the gum pocket for 28 days.

General Cleanings

     General cleanings are scheduled routinely every six months with the hygienist.  Routine cleanings remove plaque and calculus from above the gum line using hand scale instruments in combination with water powered tools. Your hygienist measures the depth of your pockets with a peridontal probe.  The measurement is from the bottom of the pocket, pockets are notorious hiding places for plaque and bacteria, where the gum is attached to the tooth, to the top of the gums.  Probe readings in healthy gums are no greater than three millimeters.Once all the plaque and calculus has been removed, the hygienist will examine the color and shape of the gums.  Then an examination of teeth mobility and any suspecious darking of the teeth which will require Dr. Doche to examine and diagnoses.  Check-up x-rays will also be taken if needed to help in the diagnoses.  This is followed with a polish with prophylaxis paste and completed with oral hygiene instruction personally designed for each patient's needs.

Oral Cancer Screening

     A screening of all tissues outside and inside of the mouth are examined at each appointment by either Dr. Doche and/or your hygienist.  The examination includes pulling the tongue out of the mouth and gently palpating all surfaces looking for any unusual red or white patches.  Also, the cheeks and lips are pulled away from the teeth and examined for red or white patches.  In addition, all glands and lymph nodes under the tongue and under the chin are also examined for any lumps or bumps that don't seem to go away after two weeks.  Lastly, the thyroid is palpated and the patient is asked to swallow to determine proper function.      

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Orthodontics
Invisalign

     Invisalign is a revolutionary way to help yu get even, straight teeth without noticeable painful metal braces.  Virtually undectectable, Invisagiln aligners are made of strong, clear plastic that gradually guides your teeth into perfect alignment.  Unlike metal braces, they have no wires or brackets on which your lips or gums can snag.  During you first evaluation, Dr. Doche will help you determine if Invisalign is good option for you.  Invisagiln will develop aligners that slide directly over your teeth and are replaced every two weeks as your teeth shift into place.  Depending on your case, you will wear them full-time (except when eating or drinking) for 12 to 48 months -- no longer than you would wear traditional metal braces-- and see us about every six weeks for check-ups.  To learn more about Invisalign, please contact us today.

Whitening Services
Take Home Whitening Kit

     Often the difference between a good smile and a great smile is the whiteness of the teeth.  Over time most teeth lose their luster and brightness because they accumulate stains made by foods and beverages.  New whitening agents can remove these stains without harming your teeth.

     By far the best and fastest whitening solutions are offered by your dentist.  During a typical whitening procedure, Dr. Doche will fabricate a custom tray to hold whitening gel against your teeth.  You take the trays home and wear the gel-filled trays each night or for several hours during the day for several weeks.

     While you can get over-the-counter whitening kits, they usually aren't as effective as professional whitening procedures.  Because the over-the-counter trays are not custom fitted, the whitening agent may leak out and irritate your gums.  Want a whiter smile?  Ask Dr. Doche about dental whitening.

In Office 1 Hour ZOOM Whitening

     All dental whitening involves the application of a whitening agent to the teeth.  Until recently, the whitening agent was applied via soft trays (custom designed by a dentist, or bought in over-the-counter kits) that are worn overnight or during the day for two to three weeks.  But now Dr. Doche is offering a new way to whiten teeth.

     Called Zoom whitening, as seen on Extreme Makeover, it's often used in conjunction with take-home whitening procedures.  When you come in for a Zoom whitening, Dr. Doche along with his assistant will first protect your gums with a conditioning agent, and then applies a concentrated whitening agent on the surface of your teeth.

     Finally, the whitening agent is activated by directing a high-intensity light on your teeth.  The entire process takes only one hour.

Professional Power Whitening System 

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Removal Dental Appliances
Metal Free Removable Partials

Metal Cast Removable Partials

Top-of-the-line Denture Appliances