Full-mouth reconstruction generally refers to the involved process of restoring, rebuilding or replacing many or all of a patient’s teeth in the upper and lower jaws. A team of dentists is often involved in the process to ensure each phase of reconstruction supports each subsequent phase. This series of procedures can also be referred to as full-mouth rehabilitation or full-mouth restoration.
Who Performs Full-Mouth Reconstruction?
Many dental practices that specialize in full-mouth reconstruction have assembled a team of dentists who represent all the specialties that may be needed. This can include a periodontist (to ensure gums are healthy), an endodontist (to work on tooth pulp), an orthodontist (in case any teeth are salvageable, or if there are bite issues), oral surgeons and general, cosmetic and/or restorative dentists.
Why Would Someone Need Full-Mouth Reconstruction?
Those who find themselves in need of full-mouth reconstruction come from all walks of life. Their reasons are varied, and can include:
- Tooth loss or fractures from trauma (car crash or sports injury)
- Tooth loss from decay (poor dental hygiene, lack of dental care, genetics
- Tooth erosion (long-term acid exposure from foods, beverages or acid reflux)
- Tooth damage or wear (tooth grinding, clenching or other oral habits)
- Tooth, jaw, muscle and/or headache pain (bad occlusion or bite)
William Harper, DDS, who practices at Harper Dental Care in Poquoson, VA, says, “Since a full-mouth reconstruction addresses severe functional and aesthetic issues, candidates typically suffer from an unacceptable smile, poor chewing efficiency, missing teeth and/or chronic problems with fractured teeth and tooth wear.”
Good Candidates for Full-Mouth Reconstruction
Factors that must be taken into account when considering full-mouth rehabilitation include the number of teeth that are unsalvageable, the condition of the jawbone that holds teeth in place, and the overall health of the patient. Surprisingly, the age of the patient is not always a clear indicator – the days when missing teeth or dentures were somewhat expected to go hand-in-hand with age are past.
“As my patients continue to lead longer, healthier lives with a high quality of life, they are requesting more full-mouth reconstructions to ensure that their smile and oral health continue to make them proud,” says Dr. Harper. “Baby boomers want to feel, act and show that they can continue to maintain full, active lives regardless of their numerical age. Their smile and the function of their teeth play a major role in their lives.”
Harper says patients he sees range in age from 25 to 85, but the average age is 55, adding: “These problems usually develop as a result of poor dental eruption and development, lapses in dental care, years of reactionary dentistry (instead of preventative dentistry) and grinding/clenching the teeth.”
The Full-Mouth Reconstruction Process
The condition of a patient’s mouth, teeth, jaw and gums is the primary factor involved in your dentist’s recommendation for full-mouth reconstruction. Depending on the damage, wear and decay involved, the following may be included in full-mouth restoration:
- Periodontal Treatment. Bone density and gum tissue presence are important for full-mouth rehabilitation. Soft tissue work or bone grafts may be required if there has been significant gum recession or bone loss.
- Orthodontic Treatment. If there is pain in the jaw, or migraines have been traced to an improper bite, braces or an orthotic may be needed to realign the bite before restorative work can be done.
- Endodontic Treatment. If some teeth will be salvaged, they may require root canals or other work done on the tooth pulp.
- Cosmetic/Restorative Treatment. Full dental implants are not always indicated for full mouth restoration. Some teeth may be salvageable, but may require crowns. Other possibilities include bridgework, inlays or onlays, or porcelain veneers.
A thorough examination including digital x-rays, impressions of upper and lower teeth, the creation of models of the teeth and bite and referrals to specialists may all be performed before full-mouth reconstruction is recommended. A full aesthetics workup is also advised (evaluating the color, shape, size and proportion of the patient’s teeth, and how they appear in relation to their gums, lips, mouth, side profile and face).
Once the recommendation for full-mouth restoration has been made, a team of dentists will be assembled and a comprehensive, step-by-step treatment plan developed. Most full-mouth reconstructions involve multiple phases and office visits, and the entire process can span a year or more, depending on the condition of the mouth and teeth to begin with and the number of procedures needed.
Complete Full-Mouth Reconstruction
In cases where all teeth in the mouth are in poor shape and need to be removed, full-mouth reconstruction consists of extractions, contouring of the gums if needed, implantation of posts into the supporting bone of the jaw, and then crown placement on each post (each crown made of realistic looking, lasting material and contoured like a natural tooth).
Restorative dentistry relies on a full range of specialties to return function and beauty in a clinically sound manner. Complete full-mouth restoration means the patient is left with a full mouth of natural looking teeth that should last a lifetime. Many people who would once have “just lived with” bad teeth are now considering full-mouth reconstruction.
“We see patients that are very active and can expect to live at least a decade longer,” comments Harper. “Rather than hide their smile, they spend a few weeks restoring their smiles. A common reaction from these patients is ‘Why didn’t I do this sooner?’”