DAVID P. DE ROSIER, D.D.S. INC. · 3019 EMERSON STREET · SAN DIEGO, CALIFORNIA 92106 · 619-222-7400

David P. De Rosier, D.D.S. INC.

OUR PHILOSOPHY

 

Preventive CarePreventive Care is an approach to dentistry that is proactive instead of reactive. We look for early signs of problems so we can address them before they become bigger problems – and a bigger expense for you. Our comprehensive approach includes thorough examinations and routine check-ups – so your teeth can last a lifetime.

 

The Comprehensive ExaminationAll new patients receive a comprehensive examination. In our practice, we take the time to carefully examine all of your teeth and the structures that support them, including the bone, muscle, tissue and jaw joints. We also screen for oral cancers and periodontal disease, and evaluate your bite to determine if your teeth and jaw are properly aligned. This is YOUR time. We want to hear what you have to say about your past dental care and your expectations for the future; you are never rushed during the examination. After the examination, we discuss the findings and develop a plan together.

We take X-rays if necessary. We use the latest in digital radiograph (x-ray) technology to examine the teeth and bones, only taking what is absolutely necessary because we believe in “one size fits one” and take films according to what is appropriate for you, not what your insurance will pay for. If you provide x-rays from your previous dentist, we evaluate them and use them if they pass our quality test. By understanding what the structures of the mouth normally look like on an x-ray film, Dr. De Rosier can diagnose problems in the teeth and jaws. For adults, x-rays can:

  • Show areas of decay that Dr. De Rosier can’t see with just a visual examination, such as areas between the teeth
  • Find decay, a crack or fracture that is developing underneath an existing filling
  • Show areas of possible bone loss associated with gum or periodontal disease
  • Show lesions or infections at the root of the teeth
  • Help Dr. De Rosier plan, prepare and place tooth implants
  • Reveal areas of concern such as cysts, cancer and changes associated with systemic problems

For children, x-rays are used to detect decay and monitor tooth growth and development. Dentists use periodic x-rays to see whether there is enough space in the mouth to fit all the new teeth, and whether primary teeth are being lost quickly enough to allow permanent teeth to erupt properly.

The frequency of dental x-rays depends on your medical and dental history and current condition. Some people may need x-rays as often as every six months. For others, x-rays may not be needed for as long as two years, with a complete set every five years.

We use digital x-rays, which expose patients to 80% less radiation than standard x-rays. We also protect our patients with lead aprons.


Family DentistryWe believe that prevention is the key to health. We are absolutely committed to knowing as much as possible about you, which is why we begin every new relationship with a comprehensive exam. After the examination, we discuss the findings and develop a plan together. We offer all forms of restorative dentistry using the finest materials and latest techniques. If you need to see a dental specialist, you can be assured that we have a carefully selected group of dental specialists to help us help you.

We are also dedicated to children growing up with healthy teeth – and having a healthy feeling about going to the dentist. Far too many adults have fears of the dental office that began when they were children. We make sure kids have fun here so they beg you to bring them back! Again, prevention is the key: we prescribe fluoride as appropriate and dental sealants to prevent decay, and watch for early signs of growth issues to promote healthy, functional teeth, jaws and airways (refer to the Sleep Apnea section to see why the airway is important).

Dr. De Rosier recommends having your child in for an initial examination by age one. This is a get-acquainted exam and a chance for Dr. De Rosier to do a visual examination of your child to determine the growth and development of the teeth
and arch. He can also evaluate any visual decay or tooth damage. A gradual
introduction to the dentist – when there are no problems – helps your child have a positive view towards future appointments with Dr. De Rosier. We recommend that your child visit Dr. De Rosier every six months after the initial visit. As your child grows, we continue to monitor his or her development to make sure they are as healthy as possible.

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DENTAL AND SLEEP APNEA (SNORING) THERAPIES

 

Sleep Apnea TherapyDo you snore? Do you fall asleep easily during the day? Do you feel fatigued often? If so, you may have a sleep disorder. The medical world has ignored sleep issues for many years, yet we spend one-third of our lives sleeping. Dr. De Rosier has completed a mini-residency in sleep disorders at UCLA and has dedicated many more hours of study in this subject.

The current gold standard of treatment is continuous positive air pressure (CPAP), which is an air pump connected to a mask that you strap to your face at night. This keeps your upper airway open and prevents the throat from collapsing, which stops the flow of air to your lungs – which then causes you to wake up, thus preventing a good night’s sleep.

Many people have understandable challenges with CPAP and are seeking another solution. Dr. De Rosier has found great success with a custom oral appliance that’s fabricated to hold the jaw forward and prevent the airway from collapsing. No more mask!

In our endeavor to prevent problems, we also evaluate children for airway development issues due to allergies, asthma, enlarged tonsils, and thumb/finger habits. These conditions can cause a narrowed airway, which can cause breathing problems later in life.

There are of course other factors, but we do all we can to limit them.

 

TMJ Disorder TherapyThe Temporomandibular Joint is a big word for your jaw joint. It seems pretty simple, but this joint is associated with a host of problems — like jaw, neck, and shoulder pain, clicking when you open your mouth, chew, or yawn, and the feeling that your teeth aren’t in the right place when you bite.

TMJ problems can be caused by tooth clenching or grinding, growth and development problems, or trauma.

We help resolve these problems by prescribing medications for acute pain, creating a splint that you can use to relax the jaw muscles, or by making small adjustments to how your teeth come together when you bite.

 

 

Bite TherapyRegaining Jaw Joint Stability and Harmony

If you have experienced pain, wear, excessive breakdown of your teeth – or all of the above, you may need to have your bite corrected. Before we consider making any changes to your bite, we spend a lot of time looking at how your teeth fit together, how your jaw joints function, and how your head and neck muscles work. We want to be absolutely sure of the cause of your dental problems before we make permanent changes to your teeth.

Bite therapy begins by stabilizing the jaw joints with an orthotic, an acrylic appliance that you wear on your lower teeth. The orthotic basically overrides your bite and reduces the stress on your teeth, jaw joints, muscles and bone, which also reduces head and neck pain and protects the teeth.

An orthotic should not be confused with a simple night guard that only provides plastic to grind on; an orthotic device is custom-made to your bite; we adjust it as your muscles respond to the therapy.

After your bite has stabilized on the orthotic, we can see the “shift” from where the teeth meet without the orthotic to where they meet with the orthotic. Because we want you to function comfortably without the orthotic, we alleviate the bite shift by balancing the bite in a process called equilibration. Equilibration balances your bite by gently reshaping the tops of the teeth. Occasionally, we may need to restore some of your teeth so you can have optimal function. This is typically identified earlier in the process when we’re analyzing the study models of your teeth.

After your bite is thoroughly balanced, you wear the orthotic while sleeping to prevent damage from teeth grinding (bruxing). Over time, we usually make occasional adjustments of both the teeth and the orthotic to keep you functioning and comfortable.

 

Periodontal Disease and TherapyAn estimated 80 percent of American adults currently have some form of periodontal (gum) disease. The risk of periodontal disease rises with age, but can happen at any age. Risk factors include smoking, diabetes, hormonal changes, stress, illnesses such as cancer and genetic conditions. Most commonly, this disease is caused by bacteria due to poor oral hygiene.

Periodontal diseases range from simple gum inflammation to serious diseases that can result in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth and supporting bone are lost.

Periodontitis

The bacteria found in your mouth constantly forms a sticky, colorless film on teeth known as plaque. Without good oral hygiene, which includes brushing, flossing, and visiting your dental hygienist when recommended, this plaque turns into a hard, cement-like material that adheres strongly to the roots of your teeth, pushing the healthy gum tissue away from the root and opening up a “pocket” where food can get trapped and attract bacteria. This alerts the immune system to fight the bacteria as it spreads and grows below the gum line. Bacterial toxins and the body’s enzymes fighting the infection actually start to break down the bone and gum tissue that hold teeth in the jaw. Without prompt treatment, the bones and gums that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

How is Periodontal Disease treated?

The main goal of treatment is to control the infection. The type of treatment varies depending upon the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home, adjust his or her diet to cut down on sugars and processed foods and quitting smoking if possible.

Scaling and root planing

In addition to antibiotics, Dr. De Rosier recommends scaling and root planing as the first line of defense against periodontal disease. Our hygienist, Melissa, is specially trained to remove the rough areas below the gum line where bacterium have set up colonies contributing to the disease process. After Melissa has removed the calculus (tartar), the tissue can reattach to the root surface. If you have been diagnosed with periodontal disease, it is vital that you continue with Periodontal Maintenance Therapy recommended by Melissa and Dr. De Rosier. The purpose is to control the infection and monitor the disease with the goal of stabilizing it so that the damage does not continue.

 

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RESTORATIVE AND COSMETIC SERVICES

Dental ImplantsToday’s implant looks like a threaded screw that’s the size of a tooth’s natural root. Made of titanium, the implant fuses with living bone and mimics the roots of natural teeth. A crown, bridge abutment, or denture is then attached to the implant using a screw.

Being able to attach something to the implant is key. If, for example, you are missing a tooth, the conventional method is to put crowns on the adjacent teeth so we can attach the artificial tooth to it. The artificial tooth then sits on top of the gum, in what is called a bridge.

When we put in a bridge, we have to cut down the natural tooth – something we’d rather avoid if we can. By placing an implant in the space and attaching the crown to the implant, we don’t have to cut down the adjacent teeth. This gives you a more natural look.

In cases where partial or full dentures are required, implants allow us to fix the denture to the implant. For a partial denture, the usual method is to attach the denture to a clasp on adjacent teeth. With implants, the attachment goes on the implant itself. Conventional full dentures simply sit on the gums and require denture cream to stay in place. Implants provide a solid anchor for the denture, so denture wearers can “snap” the denture into place and throw their denture creams away for good.

To be a candidate for an implant, you must be in good health and have good healing capacity. Bone mass and quality is also an issue, although oral surgeons have made great strides in increasing bone density using grafts and other techniques.

 

 

Porcelain VeneersVeneers are very thin pieces of specially-shaped porcelain cemented over the front portion of the tooth. They are the solution for teeth that are severely stained or chipped, have small holes or pits, are misshapen or crooked, or for correcting unwanted or uneven spaces. Unlike crowns, veneers don’t require Dr. De Rosier to remove much of the tooth in most cases.

 

Porcelain Veneers - Before and After
(Roll your mouse over the smile)


This woman’s teeth were worn from grinding.
Dr. De Rosier restored her beautiful smile with porcelain veneers.

 


Beautiful porcelain veneers brighten this patient’s smile.

Before we replaced her failing, chipped porcelain veneers with natural-looking ones, this patient was embarrassed to smile. Now – she smiles with confidence.

 

 

CrownsCrowns are necessary when there is no longer enough tooth structure remaining to support a filling or other restoration. Crowning the tooth enables you to chew food correctly and evenly distributes the forces of the bite.

Dr. De Rosier makes crowns with precision and with the finest materials such as high noble metals, strong fracture-resistant porcelain, and gold. Constructing a crown usually takes two visits about two weeks apart.

 

 

Composite Resin Fillings
& Bonding
Composite resin dental fillings were created as an alternative to traditional metal or amalgam dental fillings.

Tooth fillings colored to look like a natural tooth are known as Composite Resin Dental Fillings, and are made of a plastic dental resin. Fillings made from these materials are strong, durable, and provide a very natural looking smile. Dr. De Rosier replaced the silver fillings shown above with natural looking fillings in just one visit.

(Hover mouse over the teeth to see before and after)

When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding makes a great tooth-colored filling for
small cavities and broken or chipped surfaces.
It can also be used to close spaces between teeth. Additionally, it is used to cover the entire outside surface of a tooth to change its color and shape. Because of the superior strength and bonding ability of these materials, Dr. De Rosier no longer provides amalgam (mercury mixed with silver and other metals) fillings.



Dental Reshaping and ContouringDental reshaping and contouring is a procedure used to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth. It’s also used to alter the length, shape and position of your teeth and correct small problems with your bite. With just a small amount of contouring and tooth-colored resin, Dr. De Rosier can create a beautiful smile in just one session.



BridgesBridges are used to replace one or more missing teeth. A bridge must have other structures to support it, which can include natural teeth, implants or a combination of implants and natural teeth.

A traditional bridge is made by creating a crown for the teeth on either side of the space and placing the replacement tooth or teeth between the crowns. The entire piece is cast together as a single unit. The teeth supporting the bridge must be healthy enough to withstand the forces of chewing.

Dr. De Rosier replaced this woman’s missing teeth with a natural-looking bridge.
(Roll your mouse over the smile)

 

 

Dentures andPartial DenturesDentures and partial dentures are prosthetics designed to replace missing teeth. Traditional dentures and partial dentures are usually removable and fit on top of the existing tissue and bone. Many patients have trouble keeping them in their mouth and eating with them. They can be painful if they slip out of place when the patient is trying to eat.

A better alternative and now the standard of care is the implant-supported denture or partial, which snaps on to the implant attachment in the jaw for a superior fit and much improved chewing ability. Dr. De Rosier provides these services and can guide you in choosing the best treatment option for you.

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