this form expires in 3 hours
DRosas Dental Clinic
DRosas Dental
Request an appointment
Patient Details
Appointment Details
Patient Details
First Name
*
Middle Name
Last Name
*
Suffix
Mobile Number
Email Address
Birth Date
*
Branch
*
Unspecified
DRosas Dental
Purpose of Visit
*
Available services
Select purpose of visit from the services below.
Bone Grafting
Procedure to rebuild jawbone structure for implants.
2 hours
Ceramic Brace
Tooth-colored braces for a less noticeable look.
2 hours
Clear Aligner
Transparent aligners used to straighten teeth discreetly
30 minutes
Deep Scaling and Root Planing
Through cleaning below the gumline to treatgum disease.
30 minutes
Dental Certificate
Issued for school, employment, medical or legal purposes
10 minutes
Dental Check-up
Comprehensive oral examination
30 minutes
Dental Crown & Bridge
Crowns restore damaged teeth, while bridges replace missing teeth.
an hour
Dental Implants
Permanent replacement for missing teeth using titanium implants
an hour
Dental Sealant
Protective coating applied to molars to prevent cavities.
30 minutes
Fluoride Application
Strengthens tooth enamel and helps prevent tooth decay.
30 minutes
Fluoride Treatment (Kids)
Strengthen developing teeth.
30 minutes
Gingivectomy/ Gingivoplasty
Surgical reshaping or removal of excess gum tissue
30 minutes
Inlay/Onlay Restoration
Custom-made restoration for moderate tooth damage.
30 minutes
Metal Brace
Tradition and effective orthodontic treatment.
2 hours
Minor Oral Surgery
Include minor surgical procedure inside the mouth.
an hour
Oral Health Consultation (Kids)
Education for parents and children on proper oral hygiene
30 minutes
Oral Prophylaxis (Cleaning)
Professional cleaning to remove plaque, tartar, and stains to prevent cavities and gum disease.
30 minutes
Orthodontic Consultation
Assessment and treatment planning for braces and aligners
30 minutes
Periodontal treatment
Comprehensive management of gum infections.
30 minutes
Post and Core
Procedure to rebuild severely damaged teeth before crown placement
an hour
Retainers
Maintain teeth alignment after braces treatment
30 minutes
Root Canal
Removes infected pulp to save and preserve the natural tooth.
an hour
Self-ligating Braces
Advanced braces system with faster adjustment and comfort.
2 hours
Smile Makeover
Customized combination of treatment to improve overall smile appearance
30 minutes
Space Maintainer (Kids)
Maintain proper spacing after early tooth loss.
30 minutes
Suture Removal
5 minutes
Teeth Recontouring
Reshaping of teeth to improve appearance and bite alignment
30 minutes
Teeth Whitening (Bleaching)
Removes stains and discoloration for a brighter smile
an hour
Temporary Filling
Short-term restoration to protect the tooth before permanent treatment
30 minutes
Tooth Extraction ( Bunot )
Safe removal of severely damaged or problematic teeth.
30 minutes
Tooth Filling For Kids
Child-friendly restoration for decayed teeth.
30 minutes
Tooth Restoration(Pasta)
Treatment for decayed or damaged teeth using tooth-colored filling materials
30 minutes
Veneers
Thin porcelain or composite shells placed on front teeth to improve aesthetic
an hour
Wisdom tooth Surgery
Surgical removal of impacted or problematic third molars.
an hour
Close
Message
Next
Patient Details
Appointment Details
