Our telephone number: (760) 741-4061

Our FAX number: (760) 432-8764

You can reach us 24 hours a day, seven days a week. If we are not available, our Answering Service will take your message. For all our patients of record, if you are in pain or have a dental emergency, the Answering Service will immediately contact us, and either a doctor or a trained staff member will call you back within a short time. For critical medical emergencies, please call 911, or visit your closest emergency room. If you are leaving a message, please leave us as much information as you can about the reason for your call. If the doctors do not have information about the reason for your call, they will want to review your entire chart first so that they are prepared to answer any questions you might have.

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This is perhaps the single most important appointment you will have with us and we want to give you the attention you deserve. This is a "consultation" appointment - and "consultation" means to give expert advice in a particular field. Our goal is that at the end of the appointment, you will understand why your health professional referred you to our care, why this matter compromises your dental health and/or your medical health, what the options are for treatment, and the pluses and minuses of each of these options.

When you come in our door, we try very hard to welcome you and make your visit with us as comfortable as possible. If you have questions or concerns at any time, please immediately let us know. Your first visit with us will last from 60 to 90 minutes, and you will get to meet several of us. We'll be giving you a lot of information, because in most instances, you will have choices about how you want to restore your mouth to health, and we want you to have all the information you need to make your dental decisions. Feel free to take notes - or bring someone along with you to help you remember to ask all those important questions you may have.

If you have been referred by another doctor, we already know quite a bit about the reason you have been referred to us. Your dentist or physician may have spoken to us personally, sent a referral letter, and/or also sent x-rays or other diagnostic information to us; but if that is not the case, we will try to gather as much information from your previously-treating doctor as we can. In some cases, we may even have met with them first. Sometimes, this "professional consultation" takes place without your need to come in for examination; but in most situations, a thorough examination must take place before you can be given a complete diagnosis and learn about the options you have for treatment.

When your initial appointment was made, we sent you a "welcome" letter and a Patient Health Record. That Health Record contains really important information, and the Registered Dental Assistant who will work with you at this appointment will go over it very carefully with you. Please understand that even though you will go over this with the assistant first, your periodontist may - and probably will - want to ask a few more questions about your information. Maintaining and improving your general health is very important to us, and we want to make absolutely sure we know and understand any contraindications you might have to possible treatment.

After your periodontist has reviewed with you the questionnaire, the referral from your health professional and any x-rays or other treatment information we have accumulated, he will want to make a complete examination of your mouth, teeth and gums. Even if you have been referred for a particular area of concern, it is extremely important to make sure the other areas of your mouth are healthy and not in danger of disease or tooth loss.

Once the immediate physical findings have been determined and your periodontist has discussed with you what you want in terms of function and esthetics, he and the assistant will give you information on your current dental health status, your problem areas and what can be done to return your mouth to the form and function you want. In complicated cases, your periodontist may suggest a joint meeting with you and any family members you want to bring along, as well as your restoring dentist. That way, you can see the "big picture" of what the result of your dental treatment will be.

If your dental treatment involves therapy in our office as well as in your restoring dentist's office, please be sure that we will coordinate and communicate with them throughout your time with us. We take that responsibility seriously.

Once you have chosen the option that fits within your goals for your overall dental health and function, we will be able to give you complete financial information. Our Financial Coordinator can research your insurance if you have it, and also give you information on some other choices you might have to pay for your dental care, such as using credit cards or perhaps Care Credit or another payment system.

When you have the dental information and the financial information related to your choice of therapy, we are ready to give you scheduling choices that fit best with your time commitments. We all have busy lives, and we understand that the more flexibility we can offer will make it easier for you. But please understand that Initial Consultations and some treatment appointments are scheduled at the times of day our staff and doctors are at their absolute best. We will not compromise patient care, and we ask your understanding if, for this reason, we cannot be as accommodating to your schedule as you may want.

Shortly after your appointment, we will send a complete report to your referring doctor that outlines our findings, our recommendations for your care, and your decision on which of the choices you prefer. If you have not had all your questions answered, or if you find that you have more questions about the information you have been given, please feel free at any time to call us for clarification or more information. And, as your referring health professional will be fully informed, please feel free to contact them also.

Aside from the Patient Health Record, if you have any previous dental records or medical information that might give us more insight on your current problems, please bring them along. We will want to know the current medications you are taking as well as the medical reasons for those medications. Bring a spouse, friend or family member if you would feel more comfortable. If you have dental insurance, bringing along the plan or company information is very helpful. If you have had treatment in other dental offices in the recent past, having the dentist's name and address would be helpful so that we can contact them for any information we might need. Your current calendar or times you might be available for treatment appointments would also help. And, don't forget a list of questions or concerns! We want to make sure all your questions are answered.

We are not on any closed panel dental plans; but we can help you with any fee for service dental insurance. Dental insurance works differently than medical insurance - one major difference being the "cap" on the yearly benefits the insurance company will pay out. If you have the name of your plan and the plan information, we can find out what your yearly benefits are, the procedures (types of therapy) that are covered by your plan, and then contact the insurance company to find out what benefits you have available at this time. With that information, we can give you a pretty good estimate of what your coverage is (e.g. 80% coverage with $1349.65 in benefits remaining). If you want a more definite idea, we can ask for a "pre-determination" from the insurance company, in which they will give you an estimate of their coverage. Please understand this is not a "promise to pay" from the insurance company, as even though their predetermination says they will pay a certain amount, that amount is always contingent upon other factors, such as the amount of benefits remaining.

We will give you a financial sheet that outlines the fees for your treatment in our office and the estimated benefits that your dental insurance company will pay towards those services. If you "sign over" those benefits to our office (assignment of benefits), that means the insurance company will pay us directly when the treatment is done. We will make financial arrangements with you for the amount that the insurance company is not expected to pay, but please understand that if the insurance company does not pay as much as the estimate, then you will be responsible for any amount the insurance company does not cover. If the insurance company pays more than expected, you will be refunded the credit balance as soon as it occurs.

If you prefer that the insurance company reimburse you for the treatment, then we will make financial arrangements with you for the entire amount.

We have several plans that you might find helpful. We offer discount courtesy for payment in full as treatment starts, and we accept most major credit cards. There is Care Credit, which can allow you to stretch payments over many months. We also offer "phases of treatment" where your treatment is broken up into stages, with a fee for each stage. For example, if you need gingival grafting on your lower left canine tooth, a dental implant to replace your upper right first bicuspid, and root planing for your upper right molar teeth, you may prefer that the treatment be done in three stages - with the fees charged separately as each part of your mouth is treated. Please let us know your concerns, as the more we know, the more we can research the choices that might help you. Our Financial Coordinator will be happy to answer any questions you might have, and can be reached at (760) 741-4061 during normal office hours.

• We take your dental health very seriously. For over thirty years, we have put your safety, comfort and treatment first.
• We believe communication between and among you, your referring doctor, and all of us is critical, and we go to great lengths to keep communication open and flowing.
• Being a professional, full-service periodontal office is very important to us, so we keep up with new techniques and new equipment.
• We follow our patients closely so that we can provide you with the best possible treatment results.

"Periodontal" means "around the teeth - so "periodontal disease" is a bacterial infection around teeth, which attacks the gums and then goes on to destroy the supporting bone around the tooth. Left to continue without treatment, teeth will eventually be lost because the bone support is no longer there. Unfortunately, this bacterial infection is also systemic in that the bacteria can enter the bloodstream easily - and a continued infection anywhere in the body will continue to further compromise your health. It can and does lead to health problems for pregnant women, people with diabetes or compromised medical status, people with organ transplants or artificial joints, and those with heart conditions.

There are several indicators in determining that you have periodontal disease. Often, your general dentist has intervened early in the process, and has offered you treatment to delay or stop progression of periodontal infection. Your dentist or your regular hygienist is trained to look for signs that periodontal disease is starting to progress and is no longer under good control. Sometimes, a change in your overall medical condition can be enough to get the disease progressing again by lowering your resistance. And smoking cigarettes, by itself, can increase damage done by any periodontal infection and make it more difficult to treat. When your dentist or hygienist suspects your periodontal disease is starting to worsen, it's time for a referral to a periodontal office.

Periodontists and periodontal hygienists have a few more tools in their periodontal treatment tool bag, as well as the experience to evaluate which particular type of treatment best fits your disease. Please understand, you can have signs of disease in several areas of your mouth - but the treatment recommended may be different in each area based on your particular situation, your overall dental health, and the long term prognosis for the teeth in each area. This is why it is vitally important that your periodontist and your general dentist work together so that the end result of your dental treatment gives you the long term health that you want and need.

The treatment options you will be given are unique, and tailored specifically to your dental and medical status. Please also understand that the periodontal treatment also needs to take into consideration the dental health of your teeth and their long term prognosis. The goal will be to give you recommendations that will end up with the most stable and healthy conditions for the long term. You will get all the information on your current situation and the long term expectations for your treatment before you make your decisions.

Once your disease is under control, the periodontist will make a determination on what continuing treatment you will need. Some people are naturally more resistant to this type of infection, but others are not - to varying degrees. You will need to have maintenance scalings at frequent intervals to keep the bacteria causing the periodontal infection from again infecting the pockets around your teeth. The interval between your maintenance scalings and whether these scalings are to be done in our office or that of your general dentist will depend on how well you have responded to the initial therapy, and how resistant you are to disease. And, of course, how effective you are at removing the plaque around your teeth. While there are patients who are more sensitive to periodontal disease and need to continue in long term maintenance therapy with us, many more are returned either entirely or mostly to their general dental offices for this treatment. But the answer to the wider question is "No." There is no cure for periodontal disease, as the bacteria that cause it are common in the mouth. The goal of treatment is to give you a healthy mouth that is free of disease; but the periodontal infection can start again. This can be managed with good home care and periodic maintenance scalings.

Dental implants are not "new" technology, as over two thousand years ago ancient cultures tried to replace missing teeth by implanting human or animal teeth into holes drilled in the jaw bone. What changed in the last few decades are the materials that allowed the implant fixture to "integrate" into the bone into which it is placed, the design of the part that is placed into the bone, and the techniques used to place them. We have been placing implants in our office since 1987, and what used to be a novel procedure is now reliable and predictable, with implants supporting bridges, crowns and dentures with a better long term prognosis than the teeth they replaced. Because we have been able to follow the success of the implants we have placed for long periods of time, we can reliably predict the long term rate of success. We have experience with many implant systems, and have participated in long term studies designed to make implant placement and restoration better and easier.

Implants can be used to replace a missing tooth (single tooth implant), act as abutments for bridges that replace several teeth, and be used to provide stability under dentures and partial dentures (with special attachments called "locators" that anchor the denture or partial denture to the implant). Implants fuse with the bone of the jaw, and act to preserve the bone of the jaw just as do natural teeth. They do not, however, have the ligament around them that acts as a shock absorber that natural teeth have. Because of that, extreme care must be taken to make sure the implant is placed in the best position with the best possible angle. There are many new techniques that can help improve the quality of bone and the amount of bone available in the area in which the implant is to be placed; but often the periodontist and your general dentist will want a special dental radiograph to be taken that can give a three-dimensional view of the bone so that the implant size and diameter can be chosen appropriately.

Once the implant is chosen that can best be used within the type and quality of bone as well as the way the implant will be restored, the implant can be placed. If the implant is replacing an existing tooth that needs to be extracted, the implant can in most cases be placed at the same time the tooth is extracted, unless there has been extensive bone loss requiring grafting, or the infection around the tooth to be extracted is widespread.

After the implant is placed, it usually takes two to three months - and sometimes longer depending on whether bone grafting has been needed - before the final, permanent restoration can be placed; but please be sure you will not be without teeth during this time. Either your periodontist or your regular dentist will make a provisional (temporary) crown or bridge for you to wear while the implant is integrating into your jaw bone, or he will make a splint or "flipper" type of appliance to replace the missing tooth.

Like any complex technology, there are many factors that go into deciding if an implant or implants are "right" for you. Your periodontists will determine if an implant or implants can be placed, and also explain any other options you might have to replace your missing or compromised teeth. And, he will also explain the pros and cons of each option, as well as the time and number of visits involved with each choice. Your general dentist or the dentist who will be restoring the implant or implants, will also be involved and will be kept updated as your treatment progresses.