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Oceanside Dentists

Continuing Dr. Howard’s Legacy of Excellence in San Marcos & Rancho Bernardo

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Rancho Bernardo

Our Oceanside dentists at North County Aesthetics & Implants handle missing teeth, cosmetic concerns, and dental emergencies without sending patients to a different office for each one. A chip you’ve been meaning to fix, an ache that won’t quit, or a gap you’d like filled all go through the same clinical team: Dr. Khizer Hafeez, Dr. Nelson Y. Howard, and Dr. Dariyan Ayazi.

Behind that range sits more than four decades of dental care experience and digital technology that can turn a diagnosis into a finished restorative crown in a single visit. Every patient gets a personalized treatment plan built around what their mouth actually needs, not a standard script.

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Our Mission

Dental health decisions shouldn’t feel like a guess, and as the current owner, Dr. Khizer Hafeez holds this practice to that standard. He earned his Doctor of Dental Surgery from New York University College of Dentistry, and the analytical habits from his earlier work researching cardiovascular disease still shape how he reads a case: look at the whole picture before recommending anything. Dr. Nelson Y. Howard set that same expectation when he opened the doors in 1992, and Dr. Hafeez, alongside Dr. Dariyan Ayazi, has kept it in place rather than loosening it.

That approach touches every corner of the practice, from a straightforward cleaning to a full course of dental implant placement. Personalized care here means walking through what an exam actually found and why a particular treatment makes sense before anything moves forward, not handing over a plan and expecting agreement. The result is dental treatments chosen because they fit your situation, not a schedule.

North County Aesthetics & Implants

Why Choose Us

Our dentist in Oceanside earns trust one visit at a time, not through a list of features. Here’s what patients actually notice once they’re in the chair.

Three Treatment Categories, One Clinical Team

Implant surgery, cosmetic dentistry, and emergency care usually mean three separate offices and three separate intake forms. Not here. Dr. Hafeez, Dr. Howard, and Dr. Ayazi cover all three treatment categories together, so a patient dealing with a painful molar and a smile they’d like to update in the same season doesn’t need to explain their history twice.

A Finished Restoration Before You Leave

Sending a scan to an outside lab means weeks of waiting and a temporary crown that might not survive the wait. This practice keeps the entire process in-house, using dental technology that goes straight from digital impression to finished piece. You’re not scheduling a second visit just to get a piece a lab built without ever examining your mouth.

Two Careers’ Worth of Clinical Depth

Dr. Howard spent over 40 years building credentials that don’t come from a weekend course, including certification through the American Academy of Cosmetic Dentistry and a residency at the VA Medical Center in West Los Angeles. Dr. Hafeez arrived with a different kind of rigor, having studied cardiovascular disease at a level that drew national attention before he ever picked up a handpiece. Add Dr. Ayazi to that mix, and patients aren’t choosing between experience and a fresh perspective. They’re getting both.

Ready When a Problem Can’t Wait

Not every dental problem can sit on a calendar. A cracked tooth with the nerve exposed, an infection that’s spreading, or a knocked-out tooth needs attention now, and this practice keeps urgent openings and in-office crown production specifically for that reason. Patients who’ve been turned away or told to “come back next week” elsewhere tend to notice the difference the first time they call here.

The Same Team, Visit After Visit

Long-time patients here aren’t shuffled between whoever’s available that day, a pattern reflected in the practice’s patient reviews. Your history stays with the same doctors, which means less repeating yourself and a treatment plan that actually builds on what happened at your last appointment instead of starting from zero.

Meet the Doctors

Dr. Khizer Hafeez became the current owner of North County Aesthetics & Implants after training at New York University College of Dentistry, where he earned his Doctor of Dental Surgery. His path into dentistry began with cardiovascular disease research, work that earned him national and international attention before he shifted his focus to patient care. This background still informs how he treats the mouth as connected to the rest of a person’s health. 

Dr. Nelson Y. Howard opened the practice back in 1992, and over a 40-plus-year career built the kind of résumé that includes accreditation from the American Academy of Cosmetic Dentistry, a founding hand in the West Coast Society for Cosmetic Dentistry, more than 2,000 hours of continuing education, and a General Practice Residency completed at the VA Medical Center in West Los Angeles. Dr. Dariyan Ayazi is the newest name on the roster, trained to the same standard the other two have upheld for decades. If you’re looking for dentists Oceanside patients have relied on across multiple generations, this team has the track record to back it up.

Learn About Your Doctor!

North County Aesthetics & Implants

Dr. Khizer Hafeez

Dr. Hafeez comes from a family that’s deeply rooted in medicine, which inspires him to bring his absolute best to his patients, no matter what their needs are.

Accolades:

  • Extensive Research Background That Informs Evidence-Based Care
  • New York University College of Dentistry- Doctor of Dental Surgery
  • Internationally recognized researcher published in Cardiovascular disease research with awards in both National and International Levels.
Get to Know Dr. Hafeez

Dr. Nelson Howard

Dr. Howard is happy to continue offering high-quality dental care to his existing patients and transition his practice to the capable hands of Dr. Hafeez and Dr. Ayazi.

Accolades:

  • Accredited Member of the American Academy of Cosmetic Dentistry
  • Founding Member of the West Coast Society for Cosmetic Dentistry
  • Over 2,000 Continuing Education Hours Completed
  • One-Year General Practice Residency – V.A. Medical Center in West LA
Get to Know Dr. Howard

Blue geometric tooth logo mark for North County Aesthetics & Implants

Services

Crowns

Veneers

Implants

Emergency

Dental Implants

Is dental implant treatment right for you?

Replacing a missing tooth isn’t just a cosmetic decision. It affects how your jaw functions, how neighboring teeth stay aligned, and whether the bone beneath the gap continues to shrink. The questions below help you evaluate whether implants are the right fit before you schedule an appointment.

Who is a candidate for dental implants?

We first check for adequate bone volume at the site, gum tissue free of active disease, and controlled health conditions. Most adults missing one or more teeth clear that bar. Treatment options range from a single implant crown to implant-supported dentures, implant bridges, 3 on 6, and All-on-X full-arch reconstruction. Patients who’ve already lost some bone aren’t ruled out; that detail just changes the plan.

What does the dental implant process involve?

We use the Trios 6 digital scanner to capture precise impressions without physical molds. The Dexis OP 3D imaging system gives our team a three-dimensional view of your bone structure before any surgical step begins. For patients who qualify, immediate implant placement means the implant goes in the same day the tooth comes out. SprintRay technology makes same-day restorations possible in many cases, so patients leave with a finished result rather than a gap or a temporary.

Where does dental implant treatment fit into your treatment plan?

Every step, from your first scan to your final crown, happens at this practice. Some cases are completed over several visits, while others involving full-mouth reconstruction take longer to sequence properly. Others, using same-day technology, can be completed much faster.

When is the right time to consider dental implants?

Bone loss begins within the first few months after a tooth is lost. The sooner a patient is evaluated, the more treatment options remain available. Patients who have worn dentures for years may have lost enough bone to require additional steps before implant placement can begin. Waiting doesn’t keep your options open. It narrows them.

Why Dental Implants over the alternatives?

Think about what each option is actually attached to. A bridge anchors to two neighboring teeth, which means those teeth get reshaped whether they need work or not. A denture anchors to nothing: it floats on top of the gum tissue, which is exactly why the bone underneath keeps losing volume over time, since nothing there is telling it to hold on.

An implant is the only option that goes below the surface and takes over the job a natural root used to do. That difference isn’t cosmetic marketing; it’s structural. A peer-reviewed literature review on bone loss in edentulous jaws, indexed on PubMed, examined decades of data on tooth- and implant-supported prostheses and found that jaws restored with implant-supported prostheses consistently show less bone loss than jaws with conventional dentures. No other tooth replacement option currently available reaches the bone the way an implant does.

Tooth Loss Left Unaddressed Accelerates Bone Loss and Limits Future Treatment Options

When a tooth is lost and not replaced, the jawbone beneath it starts to shrink. It no longer gets the stimulation it needs from a root. Over time, that bone loss affects neighboring teeth, changes your facial shape, and reduces which implant options are still possible. A case that could have been resolved with one implant crown can become a full reconstruction problem years later, and the effect compounds well past the first few months. A classic long-term study published in The Journal of Prosthetic Dentistry and indexed on PubMed followed complete denture wearers for 25 years and found that the anterior height of the lower ridge dropped by an average of 9 to 10 mm over that period, while the upper ridge diminished by roughly 2.5 to 3 mm. Bone loss doesn’t stop after year one. It keeps accumulating for as long as the tooth stays unreplaced.

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Prepless Veneers

Is a prepless veneer treatment right for you?

Some cosmetic concerns come down to shape, proportion, or color rather than structural damage. If your teeth are healthy but your smile doesn’t reflect that, prepless veneers may be the most direct cosmetic dentistry solution.

Who is a candidate for prepless veneers?

Prepless veneers work best for patients with structurally sound teeth that have minor cosmetic issues. Common starting points include chips, gaps, uneven edges, and discoloration that hasn’t responded to teeth whitening. Patients with deep decay, significant structural damage, or severe crowding typically need other dental treatments first, since candidacy depends on having enough healthy enamel to bond to from the outset.

What does the prepless veneer process involve?

The Trios 6 scanner captures your digital impressions without trays or physical molds. Our team then uses SprintRay Pro 2S, SprintRay Midas, and SprintRay NanoCure technology to design, print, and cure your porcelain veneers in-office, matched to your natural tooth color and contour without touching your enamel. For most patients, that means a shorter appointment, less chair time, and no anesthetic in straightforward cases.

Where does prepless ceneer treatment fit into your treatment plan?

For patients whose main concern is cosmetic, prepless veneers are often the first and only step needed. Smile consultations give you a clear picture of what’s achievable before any treatment begins. If underlying issues like gum disease or misalignment need to be addressed first, we sequence the plan so the veneer placement happens at the right point.

When is the right time to consider prepless veneers?

The right time is when your dental health is stable, and the remaining concern is cosmetic. Teeth whitening handles surface staining, but it can’t reshape a tooth, close a gap, or fix an uneven edge, and its results fade and need repeating. Prepless veneers solve several of those cosmetic issues in one step.

Why prepless veneers over the alternatives?

The tradeoff with a traditional veneer isn’t obvious until years later: bonding to ground-down enamel means the tooth is permanently committed to needing coverage, since enamel doesn’t regenerate. Prepless veneers bond directly to the enamel that’s already there, which matters for more than reversibility.

A 2024 systematic review and meta-analysis published in The Journal of Prosthetic Dentistry and indexed on PubMed compared ceramic veneers bonded to enamel with those bonded to dentin or composite resin, finding that enamel-bonded veneers had near-perfect survival rates (99%), compared with meaningfully lower rates for veneers bonded to exposed dentin. Keeping your natural enamel intact isn’t just the more conservative choice; the data suggests it’s also the more durable one.

Untreated Surface Damage Progresses Into Deeper Enamel Compromise Over Time

A small chip or worn edge may look like a cosmetic problem today. Left alone, it often becomes something more. When enamel thins or cracks and isn’t treated, the layer beneath it, called dentin, becomes exposed. Dentin is softer and more sensitive than enamel, and once exposed, it reacts to temperature and pressure and becomes more vulnerable to decay.

Longitudinal research on erosion, archived on PubMed Central, followed a cohort of patients over two years and found that the share with deep-enamel or dentine lesions rose from 4.9% at baseline to 13.1% two years later, with new or more advanced lesions appearing in 27% of the group over that span. Damage that looks minor and cosmetic at the outset tends to progress if it isn’t addressed.

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Emergency Dentistry

Is emergency dental care what you need right now?

Not every dental problem needs same-day attention. Some do. If you’re in significant pain, dealing with a broken tooth, or worried about an infection that seems to be spreading, this section will help you figure out whether your situation qualifies as a dental emergency.

Who needs emergency dental care?

Emergency dentistry is for patients who can’t safely wait for a routine appointment. Severe tooth pain, a knocked-out tooth, a cracked tooth with exposed nerve tissue, a swollen jaw or face, and any sign of abscess or spreading infection all qualify. A root canal is often necessary when infection reaches the tooth’s pulp, and we often start treatment during the emergency visit itself.

What does the emergency dentistry process involve?

The priority is relieving your pain. Our team assesses what’s happening, takes any imaging needed, and moves into treatment as quickly as the case allows. For patients who need a restorative crown after an emergency, SprintRay Midas produces same-day, 3D-printed and pressed crowns in-office.

Where does emergency dentistry fit into your treatment plan?

An emergency visit is often the start of a longer care sequence, not a one-time fix. After we resolve the immediate problem, we work with you to understand what caused it and what follow-up is needed. If an extraction is necessary, we can discuss replacement options, including dental bridges or implants, as part of the same ongoing relationship.

When is the right time to seek emergency dental care?

For a knocked-out tooth, the window for successful reimplantation is roughly one hour from the time of injury. For an infection, there’s no safe waiting period, since bacteria cause a dental abscess and spread. Early treatment can often save the tooth through a root canal.

Why see a dentist for a dental emergency instead of urgent care?

An urgent care clinic or hospital emergency room can manage pain and prescribe antibiotics. Neither can treat the underlying dental conditions causing it; they can’t drain an abscess, perform a root canal, or place a same-day crown. This isn’t just a matter of convenience; research supports it.

A peer-reviewed study on hospital-based emergency department visits for dental conditions, published in The Journal of the American Dental Association and indexed on PubMed, analyzed national data and concluded that dental conditions can be treated more effectively in a dental office setting than in hospital-based settings. Our team has the imaging equipment, in-office fabrication technology, and periodontal treatments needed to resolve most dental emergencies in a single visit. For Oceanside dental patients, when something goes wrong, we’re ready.

A Dental Infection Left Untreated Can Spread Beyond the Mouth and Become a Medical Emergency

A dental abscess doesn’t stay in one place. The bacteria causing the infection can spread to the jaw, neck, and, in serious cases, the airway. Clinical reference material published by the National Institutes of Health’s NCBI Bookshelf describes how untreated odontogenic infections that spread into the floor of the mouth and neck can lead to serious complications, noting that airway obstruction (leading cause of death), mediastinitis, aspiration pneumonia, and sepsis are among the recognized outcomes. Late-stage infections require far more extensive intervention than early ones, since extractions, bone grafts, and reconstructive work may become necessary when an earlier root canal would have resolved the problem.

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Smile Gallery

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Testimonials

Best dentist and staff I have ever visited!! I recommend everyone come to a professional place like this. The staff cares and are amazing, and Dr. Howard is amazing at his craft. I wish all dentists were like this.

Chris C.

Dr. Howard is an incredibly talented and knowledgeable dentist -- but he is more than a dentist. He's an artist. He changed my ugly smile to my best feature. It was one of the smartest things I've ever done for myself. Do it for yourself -- you will be happy you did.

Barbara M.

Dr Nelson Howard Is Beyond Excellent In Customer Service And Expert Skillmanship In Cosmetic Dentistry. I Have Been A Client Of Dr Howard's For Almost 2 Decades For Wellbeing And Cosmetics Enhancing For Fabulousness!!!
Highly Recommended If "Excellence" Is Your Goal And Desire😉👌🏾🇺🇸~

Michelle R.

Dr Howard discovered a serious crown issue and his highly skillful and thorough professional work has saved not 1 but 3 teeth for this issue. And it was a painless experience! Thank you Dr. Howard!

Linda E.

Dr. Howard Nelson has been my family dentist for over 10 years and we are very happy to have had him to take care of all of our dental concerns. You couldn't meet a nicer person who is very sensitive and tuned-in to patient needs and goes above and beyond any call of duty.

Irene M.

Your Next Appointment With Oceanside Dentists Starts Here

Our Oceanside dentists at North County Aesthetics & Implants are ready to look at whatever’s been on your list: a tooth that’s been bothering you, a gap you’ve been meaning to fill, or a smile project you’ve kept putting off. Dr. Khizer Hafeez, Dr. Nelson Y. Howard, and the rest of the team can lay out your options. Call the San Marcos office at 760.330.8146 or the Rancho Bernardo office at 858.758.4860, or request an appointment online to get started.

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FAQs

What's the difference between a crown and a veneer?

A restorative crown covers an entire tooth to protect it after damage or decay, while a veneer only covers the front surface for cosmetic purposes. Porcelain veneers are typically placed on healthy teeth that just need a change in shape, size, or color. Crowns solve structural problems; veneers solve appearance problems. Your dentist can confirm the best approach for your specific dental conditions during a consultation.

How often should I schedule a dental checkup?

Most people benefit from a checkup and cleaning every six months to protect their oral health and catch small issues early. Some patients with gum disease or other ongoing dental conditions may need more frequent visits. Regular checkups make it easier to catch problems while they’re still simple to treat. Your dentist will recommend a schedule based on your dental health history.

Can gum disease be treated without surgery?

Early-stage gum disease often responds well to nonsurgical periodontal treatments like Scaling and Root Planing, which clean below the gumline to remove built-up plaque and tartar. More advanced cases may eventually need surgical intervention, but catching gum disease early usually avoids that. Regular cleanings and good home care go a long way toward preventing progression, and routine checkups help catch early warning signs.

Is teeth whitening safe for sensitive teeth?

Teeth whitening is generally safe, but patients with sensitive teeth may experience mild, temporary discomfort during or after treatment. Professional dental treatments allow your dentist to adjust the strength and timing based on your comfort level, unlike over-the-counter kits. Discussing your dental health history beforehand helps avoid unnecessary sensitivity. Most patients find professional whitening more comfortable than store-bought alternatives, especially over time.

What happens if I wait too long to treat a dental problem?

Delaying treatment usually makes dental conditions more complicated and expensive to fix. A small cavity can become a root canal, and minor gum inflammation can progress to more serious gum disease. Restorative dentistry works best when problems are caught early, before they affect surrounding teeth or bone. Addressing issues promptly protects both your smile and your budget.

Why Patients Choose Us

A Legacy of Trust – Evolved

Dr. Howard established his practice for the past 40 years, and we look forward to carrying on his legacy of outstanding dentistry and service.

Technology that Improves Outcomes

Our state-of-the-art office has a warm atmosphere that will help you feel right at home. It’s equipped with the latest dental technology to ensure you receive high-quality results and have a comfortable experience.

Personalized, Comfortable Care

With a commitment to providing patient-centric, gold standard care, we make sure that you enjoy personalized and comfortable visits.

Evidence-Based Dentistry

Our dentists remain up-to-date with the latest research and are committed to using techniques and materials that offer proven success.

Continuing Our Legacy of Excellence

As I reflect on this upcoming year, it marks a meaningful milestone for me—my 40th year in dentistry and the 34th year that my dental practices have had the privilege of serving the San Marcos and Rancho Bernardo communities.

Over the past few years, many of you have asked whether I am planning to retire. While I am not retiring, I have given thoughtful consideration to how best to ensure that the level of care, trust, and excellence you have come to expect continues well into the future. With that goal in mind, I began exploring the idea of bringing in partners who share my philosophy, values, and commitment to patient-centered dentistry.

Nelson Y. Howard, DDS, AAACD

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Comprehensive Suite of Dental Services

  • Implant Dentistry
  • Cosmetic Dentistry
  • General Dentistry
  • Sedation Dentistry
  • Facial Esthetics
  • And more!

Advanced Technology. Better Dentistry.

We practice innovative dentistry that employs the latest proven technology so you can enjoy a more comfortable experience and unmatched precision in treatment planning.

  • Trios 6 Scanner
  • 3D Printers
  • Laser Dentistry
  • Intraoral Camera

Find Our Rancho Bernardo Office

  • Located near Oaks North Golf Course & Lawn Bowling Club.
  • Next to San Diego Highland Dance Academy.
  • Minutes from Rancho Bernardo Inn and Bernardo Winery.
  • A short drive from Saddle Club Estates & Maderas Golf Club.

Find Our San Marcos Office

  • At the intersection of S. Rancho Santa Fe Rd. and W. San Marcos Blvd.
  • In San Marcos Plaza shopping mall near Albertsons.
  • Across from Rancho San Marcos Village & Eugenio Italian Ristorante.
  • Close to California State University – San Marcos & Kaiser Permanente.

American Academy of Cosmetic Dentistry logo

International Congress of Oral Implantologists logo

American Board of Oral Implantology and Implant Dentistry logo

California Dental Association logo

Academy of General Dentistry logo

American Academy of Implant Dentistry logo

San Marcos
Rancho Bernardo