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Full Mouth Reconstruction

Full Mouth Reconstruction

Featuring Articles By

Keith Kelley, DDS

updated

The human mouth comprises many tissues, both soft and hard. Soft tissues include the gums, tongue, inner cheeks, and lips. Hard tissues include the teeth and jawbone. There are also connective tissues that hold the various structures of the mouth together, as well as nerves and blood vessels. The relationship between the upper and lower teeth and their relationship with the jaw joints are referred to as occlusion, or the bite. The healthy functioning of the human mouth depends on all of these systems working together in harmony. When all components do not work together in balance, oral health becomes compromised.

Reconstructive dentistry refers to the set of procedures designed to replace missing teeth, repair damaged teeth, correct improperly seated jaw joints and faulty bites, address jawbone and gum damage, replace worn-out dental work, and, in some cases, treat diseases of the mouth. Each of these reconstructive procedures may be performed independently, but when multiple oral health problems exist, full mouth reconstruction may be advised. Also known as full mouth restoration, full mouth reconstruction can include any combination of the following:

  • Restorative dental treatments: dental crowns, bridges, fillings, inlays, and onlays
  • Implant dentistry: dental implants to replace missing teeth, replicating them from root to crown
  • Cosmetic dentistry: porcelain veneers, teeth whitening, dental bonding, and gum re-contouring
  • Neuromuscular dentistry/TMD treatment : correction of problems involving the temporomandibular joints (TMJs) and the bite
  • Bruxism treatments: therapy to resolve teeth grinding and associated symptoms
  • Orthodontics: Invisalign®, traditional metal braces, spacers, expanders, and retainers
  • Oral surgery: root canal therapy, soft and hard tissue grafting, and tooth extractions
  • Periodontal treatments: scaling, root planing, and periodontal surgery

Candidates

A patient who has multiple oral health problems affecting most or all of the teeth and supporting tissues in the mouth will almost certainly be a good candidate for full mouth reconstruction. Patients who require more extensive oral surgery procedures should be healthy enough to receive local or general anesthesia. Special needs patients will want to seek out dentists experienced in handling cases similar to theirs.

Potential Concerns

Younger patients tend to respond more readily to treatments and recover quickly, though this is not always the case. However, in general, the older the patient, the more risk is involved with any medical or dental procedure. Because of this, treatment plans for older patients may involve less invasive procedures. For instance, patients over 80 years of age may fare better with mini dental implants than traditional dental implants.

In addition, patients with heart problems and those with certain autoimmune diseases may require special considerations before full mouth reconstruction. Be sure to provide your dentist with a complete and thorough health history, as well as a current list of medications you're taking, during your initial consultation.

Patients who cannot or will not maintain good oral health, and those who take illegal drugs, may not experience lasting results from dental treatments. Smoking and/or heavy alcohol consumption can also compromise oral health and the effects of full mouth reconstruction.

Costs

Cases that involve multiple oral health problems can be addressed through an appropriate combination of dental procedures. The cost of full mouth reconstruction can therefore vary widely from patient to patient.

Factors that influence cost include:

  • The types of materials used
  • The lab employed to create restorations and prosthetics
  • The number and types of procedures included in the customized treatment plan
  • Anesthesia fees
  • Whether specialists are required to complete the treatment plan

Full Mouth Reconstruction Pricing Breakdown

The following estimates provide price ranges for treatments commonly included in full mouth reconstruction plans. After your exam and consultation, a financial coordinator at your dentist's office will determine a more accurate estimate of costs for your specific treatment plan.

  • Dental implant restorations can cost $2,000 to $4,000, depending on your geographic location and the number of teeth that need to be replaced.
  • TMJ treatment can cost from $2,000 to $3,000 or more, depending on the extent of treatment required.
  • Dental bridge placement is a cost-effective alternative to dental implant restorations and may also be covered by insurance. The cost of bridges varies greatly.
  • Dental crown placement can cost from $600 to more than $1,000, and the type of material used for the restoration is a big cost factor.
  • Inlays and onlays generally cost from $650 to $1,200 per tooth, and materials are a major factor in cost.
  • Tooth-colored fillings typically cost from $150 to $200 per filling.

Dental insurance can significantly reduce out-of-pocket expenses associated with full mouth reconstruction, and financing options are available at most dental practices.

Fees from the Dentist

A financial coordinator will estimate your projected fees and help you find a payment option that suit your budget. In addition to the cost of dental visits and treatment, expect charges for lab-made restorations and prosthetics, anesthesia, and prescribed medications. You may be referred to a radiology center for special X-rays and will be billed separately for the costs incurred there.

Fees from Specialists

If you are referred to a dental specialist for treatment, the specialist's practice will bill separately from your general dentist's office. Be sure to provide insurance information to your specialist.

Payment

Most dental practices work with patients to make the care they require more affordable. During your initial consultation with any dentist, be sure that ask about available payment options and for details on the various costs associated with your treatment.

Phased Treatment Plans

With reconstructive dentistry, due to the cost of and timeline for particular treatments, your dentist may discuss a phased treatment plan with you. With phased plans, groups of procedures are spread out across many months, or sometimes years. Phased treatment can significantly help in budgeting full mouth reconstruction, but it is imperative that you complete your treatment plan on time in order to see lasting results.

Financing

In addition to cash, checks, credit cards, and health savings account (HSA) payments, many dentists now accept third-party financing plans from local banks and national providers. By offering low monthly payments, modern dental financing plans can help you effectively manage the cost of full mouth reconstruction.

Insurance

If you have dental insurance coverage, you should certainly take advantage of it. Insurance may pay for all or part of various procedures included in your full mouth reconstruction plan. Be sure to take a valid insurance card to your first appointment. Your dental office's financial coordinator or insurance specialist will estimate out-of-pocket expenses after your treatment plan is determined. Then, he or she will sit down with you to explain costs and payment options. You may have to make decisions, such as whether you want to pay out of pocket for all-ceramic restorations throughout your mouth or, to reduce your personal expenses, you want to opt for metal restorations that are covered by your insurance plan. Another example is that you might want implant-retained dentures, as opposed to traditional dentures, and implants may not be covered by your insurance plan. Appropriate scenarios should be presented to you during the financial planning phase of treatment planning.

Remember, the estimate provided by your dental office is just that - an estimate. There is no guarantee that your insurance company will pay everything indicated as their portion in the estimate. However, you can certainly call your employer's human resources department or your insurance provider with questions or for clarification regarding your estimated charges for full-mouth reconstruction.

How to Choose a Dentist

Selecting the right dentist for your case is important to your overall satisfaction and comfort. Basic considerations may include:

  • Office location
  • Whether the doctor accepts your insurance and offers payment options
  • How you feel about the dentist after your initial consultation
  • Treatment the dentist recommends

If you have any trepidation about working with a dentist, the dental team, or the actual facility, keep searching. However, if you experience anxiety over dental visits of any kind, you should try to separate those feelings from other factors. Should you be a dental phobic, be certain to ask dentists, during your interview process, whether they offer nitrous oxide (laughing gas), anxiolysis (oral sedation), conscious sedation (nitrous oxide with an oral sedative), or IV sedation. Discuss your feelings of stress with the dentist. Your comfort and peace of mind should be validated and prioritized, particularly because full mouth reconstruction can take many visits over an extended time period.

Doctor Training

General dentists licensed to practice in the United States are trained to perform many procedures, including some that are also performed by specialists. For instance, a general dentist can perform root canal therapy, which is offered by endodontists, and periodontal surgery, which can be performed by a periodontist. Depending on continuing education and certifications earned, and the state in which they practice, some dentists can place and restore dental implants and offer sedation dentistry beyond nitrous oxide. However, not all general dentists offer all procedures; some prefer to work in an interdisciplinary approach to full mouth restoration by teaming with specialists for certain treatments.

Each year, dentists are required to undergo a state-mandated number of hours of continuing education (CE) courses to keep their licenses current. Dentists can select which CE courses they attend, so those who offer full mouth reconstruction may chose classes that help them develop new skills or learn about technology that will aid in full mouth cases.

Associations and Courses

Associations also offer training hands-on courses, seminars, online education opportunities, and, in some cases, special certification for training in various procedures and particular technologies. Some of the most well-known associations, postgraduate training institutions, and study clubs for non-specialist general dentists are:

  • AACD - American Academy of Cosmetic Dentistry
  • AAID - American Academy of Implant Dentistry
  • ACE - Academy of Comprehensive Esthetics
  • ADA - American Dental Association
  • AGD - Academy of General Dentistry
  • American Academy of Implant Dentistry
  • Dawson Academy
  • ICOI - International Congress of Oral Implantologists
  • Kois Center
  • Las Vegas Institute for Advanced Dental Studies
  • Nash Institute for Dental Learning
  • Pankey Institute
  • Seattle Study Clubs
  • The Hornbrook Group
  • The Scottsdale Center and Spear Education
  • WLI - World Laser Institute

Case Studies

Before consulting with a dentist, take a look at his or her website, including the smile gallery and patient testimonials. You can also ask the practitioner to review case studies of actual patients with you during your initial consultation. In essence, you're asking for a portfolio presentation of the doctor's past cases. Request to see cases similar to yours, and then ask questions about treatments performed, treatment time, cost, outcome, and whether the patient is still on record with the dentist (a current patient, in other words). Not only will this exercise provide you with visual examples of the doctor's work for review, but you will probably learn a lot about dentistry in the process. All dentists should be willing to review past cases and answer your questions during a consultation.

The Initial Consultation

Your first appointment with a dentist should involve a discussion, examination, x-rays, and perhaps diagnosis. A treatment plan and financial information may be presented at a second appointment, particularly if the dentist recommends full mouth reconstruction. Commonly, treatment does not commence until the third visit.

"Many dentists record cases by taking digital photographs of a patient's full face, as well as a close up of the patient's smile."

Personal Discussion

Before, during, or just following taking x-rays and conducting a comprehensive oral health examination, you'll sit down with the dentist to discuss your main concerns, as well as your goals for the results of treatment. The doctor will want to know about any previous negative dental experiences and whether you have physical issues that could make you uncomfortable when sitting in the dental chair for long periods of time. Be prepared to answer questions about your habits - do you smoke, how much alcohol do you consume, and what medications do you regularly take? You'll also be asked about your desired appearance. Do you want an all-white, straight, and attractive smile, or are you more concerned with a cost-effective solution, regardless of the materials used for restorations and prosthetics? How quickly do you need treatment completed? By sharing your ideas and expectations with your doctor, he or she can present treatment options that will suit your needs and preferences.

Exam and Diagnosis

In addition to a discussion, you'll undergo a comprehensive oral, head, and neck examination. Many dentists record cases by taking digital photographs of a patient's full face, as well as a close up of the patient's smile. These pictures can be compared, after treatment, with photos of results for a before-and-after presentation.

Often, dentists use a tiny camera suspended on the end of a small wand to take photos inside a patient's mouth. With a zoom feature, these intraoral mages can reveal intricacies of the teeth and gums that aren't visible to the naked eye. For instance, tiny cracks called crazing can spider-web across tooth enamel, compromising the tooth's structural integrity and causing sensitivity to temperature and pressure fluctuations. Crazing isn't usually visible, except under magnification.

During your examination, the doctor and his or her team will:

  • Review your files, records, and list of current medications
  • Feel your head and neck for any abnormalities
  • Look at all of the soft tissues in your mouth, including the exterior and interior skin of your lips, inner cheeks, all sides of your tongue, gums, and the skin on the roof and floor of your mouth
  • Determine whether you have visible symptoms of oral cancer; in some cases, dentists use luminescent technology with a tool such as VELscope or ViziLite for early oral cancer detection
  • Probe your gums to determine if pockets of .3mm or greater exist between your teeth and gums, which indicates the presence of gum disease, or periodontal disease
  • Inspect each tooth in your mouth, as well as existing dental work; in some cases, dentists use a tool such as Diagnodent or Identifi for laser cavity detection
  • Take x-rays and inspect the underlying structures of your oral cavity, including teeth roots and jawbone tissue; x-rays can also reveal cavities between teeth
  • Feel the jaw joints to determine if they're properly seated; neuromuscular dentists may use a TENS unit and K7 or J5 technology if temporomandibular joint dysfunction (TMJ or TMD) is suspected
  • Check occlusion, or how upper and lower teeth fit together when the jaws are closed
  • Some dentists administer saliva tests that assess for HPV, periodontal disease proclivity and type of bacteria, and other potential health concerns
  • Your dentist may take a 2D or 3D x-ray, or refer you to a radiology center for this type of image, which can help in diagnosis and treatment planning
  • Ask you questions relating to findings, such as do you suffer from headaches, do your jaws pop and click, or are your dentures comfortable

After your exam is compete, the dentist will have a good understanding of what your full mouth reconstruction will entail. He may present preliminary findings at this appointment, but will probably need time to thoroughly review his notes, along with your records and models, before recommending a treatment plan.

Records and Models

As noted above, your doctor will capture x-rays, either with traditional radiography or digital radiography, and he or she may also take a panoramic x-ray and 2D or 3D x-ray. In some cases, a dentist who does not have a 2D or 3D x-ray capability in the office will refer a patient to a radiography center. Your dentist may also take molds of your mouth, either using the traditional putty method or an intraoral scan, then create wax models of your teeth and jaws.

Though not employed by all dentists, waxups give a reconstructive dentist a physical model on which to apply and evaluate treatments, as well as restorations and prosthetics. By using waxups for treatment planning and preliminary fittings of restorations and prosthetics, dentists can base their treatments on facts, as opposed to assumptions. In theory, this reduces the potential for errors and the consequential lab remakes. A dentist who employs 2D and 3D imaging with case planning may achieve the same fact-based work ups digitally, without a waxup.

Creating the Treatment Plan

Once your dentist has studied your case, including your personal preferences and needs, dental and health records, images, and models, he will meet with you to present a treatment plan. You will probably have options for various treatments. The following chart shows examples of how a single treatment may be implemented to address different symptoms or correct multiple problems.

Read Keith Kelley, DDS's Take: Planning a Full Mouth Reconstruction Treatment

Because no two patients' needs are exactly the same, extensive planning and preparation is essential. Read Full Article

Treatment

 

Cosmetic

 

Restorative

 

Prosthetic

Bonding

 

Tooth-colored restoration that corrects tooth decay, chips, stains, old metal fillings, malformation or misshapenness, wide spacing between teeth

 

Tooth-colored or metal restoration that corrects tooth decay, old fillings with a tooth-colored restoration

 

 

Crown

 

Tooth-colored restoration that corrects tooth decay, chips, cracks, malformation or misshapenness, wide spacing between teeth

 

Tooth-colored or metal restoration that corrects tooth decay, damage, and worn out fillings, inlays, onlays, or crowns; corrects malocclusion by equilibrating bite

 

Replace missing tooth via dental implant restoration

Veneer

 

Tooth-colored restoration that corrects chips, malformation or misshapenness, stains, wide spacing between teeth

 

 

Bridge

 

Replaces one or a few missing teeth in a row

 

Replaces missing teeth, reduces risk of shifting

 

Replaces one or a few missing teeth in a row

Partial or Full Denture

 

Replaces a few or all missing teeth

 

Replaces missing teeth, reduces risk for shifting (partial)

 

Replaces a few or all missing teeth

Dental Implant

 

Replaces one, a few, or all missing teeth

 

Replaces missing teeth, reduces risk of shifting (bridge, partial), reduces risk of bone degeneration in jaw

 

Replaces one, a few, or all missing teeth

Orthodontics (any)

 

Corrects crooked teeth

 

Corrects malocclusion

 

Working with the Lab

As previously mentioned, a dentist will refer to x-rays, images, and notes from the exam and consultation to create a treatment plan. Included in the case files will be blueprints, of sort, for any restorations (crowns, inlays, onlays) and prosthetics (bridges, partials, dentures, implant restorations) that the patient needs to complete full mouth reconstruction. A dental laboratory technician will follow the doctor's guidelines to fabricate precision-fitting restorations and prosthetics. The materials used to design the restorations and prosthetics will be dictated by the doctor. For optimal esthetics, tooth-colored ceramics or zirconia are the best choice. However, metal or porcelain-fused-to-metal may be necessary in the posterior part of the mouth, where teeth endure significant forces. Once the lab-made restorations and prosthetics are ready, they'll be shipped to the dentist's office. Then, the patient will return for placement of the new dental work.

Working with Specialists

In cases in which a dentist teams up with outside specialists, the patient's treatment plan is created by the general dentist, and the pertinent portions are submitted to a specialist. The dentist can refer patients to specialists he trusts, or a patient can select his preferred specialist, if the general dentist agrees. Under the guidance of the full mouth reconstruction plan, the specialist will perform his or her part of treatment. As the patient, you'll probably need to travel to the specialist's office. In some practices, specialists are on staff or available to perform treatment in the general dentist's office. In rare cases, procedures are performed in a hospital, though practitioners must have official hospital privileges to perform procedures in any hospital.

There are nine dental specialties recognized by the American Dental Association (ADA). Specialists are general dentists who have advanced coursework and internship to receive certificate in a particular area of expertise. The following are dental specialists. All but the last, dental public health, may be involved in a full mouth reconstruction plan.

  • Orthodontist and Dentofacial Orthopedist (braces, retainers, spacers, expanders)
  • Endodontist (root canal therapy, internal tooth bleaching, etc.)
  • Periodontist (gum surgery, gum and bone grafting, and other gum procedures)
  • Prosthodontist (dentures, partials, bridges, implants, and related procedures)
  • Pedodontist (children's dentistry)
  • Oral and Maxillofacial Surgeon (oral and facial surgery)
  • Oral and Maxillofacial Radiologist (oral and facial x-rays)
  • Oral and Maxillofacial Pathologist (oral and facial disease diagnostics)
  • Dental Public Health

Commonly Combined Treatments

Though any combination of dental procedures may be included in a full mouth reconstruction treatment plan, some are commonly performed together.

Gum Disease Treatments

Full mouth reconstruction is often necessary due to poor oral health and/or old, failing dental work. Because of this, gum disease is often present. Gum disease occurs when bacteria, bacterial plaque, and hardened plaque (called tartar or calculus) build up on teeth and irritate gum tissue. What often begins as mild gum irritation can quickly escalate to gum disease. The primary indicator of gum disease is periodontal pockets of infection at the base of teeth. These pockets occur when bacteria destroy the bond between teeth and gums, creating dark, wet, warm pockets where infection thrives.

Gum disease is a chronic condition that can be treated, but not cured. The disease affects half of the American population and increases the potential for heart attack, stroke, dementia, lung conditions, diabetes complications, low-weight births, and Alzheimer's disease. Treatment is necessary to ensure new dental restorations and prosthetics have a healthy foundation. Periodontal treatment, then, is often a prerequisite to, or administered in conjunction with, all other dental procedures.

Bone Grafting and Dental Implants

When teeth are missing for years, jawbone tissue can lose density and bulk. Our bodies are highly efficient. When connective tissues between teeth roots and jawbone sockets create vibrations, the body responds by supplying the jaw with calcium and phosphorus, two minerals that keep the jaw strong. When teeth roots and connective tissues are missing, the body senses that the nutrients aren't necessary in that area and diverts minerals to other areas of the body.

For dental implants to adequately fuse to the jaw during the osseointegration process, the jawbone must be healthy. Jawbone tissue that has lost density cannot adequately support osseointegration with implants. A procedure known as bone grafting may be advised to restore adequate bone density in the jaw and improve a patient's candidacy for dental implants.

Bone grafting requires donor bone, either from a donor bank, the patient's own hard palate, or a manmade graft. The donor bone is surgically implanted onto weak spots in the jaw, along with a bone growth stimulant. During the healing process, the graft fuses with existing bone tissue to improved density and strength. After recovery, the patient can be reassessed for implant candidacy.

Dental implants are small metal screws or posts secured to the jaw. One implant post can hold a dental crown to replace a single tooth. A few implant posts can hold a denture, partial, or bridge in place. Implant surgery is performed on outpatient bases, and recovery takes approximately three to six months. After osseointegration, the implants are firmly attached to the jaw, so the final prosthetics may be secured.

Oral Surgery and Orthodontics

Prior to attaching orthodontic braces to the teeth, an orthodontist may advise oral surgery to remove teeth that do not fit properly in the mouth and could interfere with the treatment plan. More rarely, surgery is required to expose an impacted tooth that will not erupt naturally. If a tooth is missing, the orthodontist may suggest replacing it with a dental implant at some point in the treatment process so that the new tooth can be integrated into the overall plan for alignment and occlusion.

Restorative and Cosmetic Dentistry

Modern dental patients are more concerned with appearance than previous generations, whose smiles were riddled with metallic restorations. In response to a demand for esthetic dentistry, most general dentists consider all restorative dentistry cosmetic and try to use tooth-colored restorations when possible. For instance, instead of metal crowns to restore structurally damaged teeth or secure a dental bridge, dentists often rely on zirconia or custom tinted ceramic crowns that resembles natural tooth enamel. Commonly, dental fillings are made with white composite resin instead of metal amalgam. Prosthetic dentistry can involve cosmetics, as well; partial dentures are often fabricated with clear or hidden clasps, instead of obvious metal attachments.

Porcelain Veneers or Bonding and Teeth Whitening

Porcelain veneers are thin, durable shells of ceramic that cover the front surface of anterior teeth (those in the front of the mouth). Veneers can correct the appearance of unsightly tooth stains, gaps between teeth, chips, or misshapen teeth. However, veneers require a minimum of two office visits, in most cases, because they are an indirect restoration. They're made in a dental lab and placed in a dentist's office. Bonding, however, corrects the same types of dental problems but is a direct restoration, placed in one visit. Veneers are more durable and thus last longer than cosmetic bonding. Both of these procedures involve using manmade materials, custom-shaded to match teeth adjacent to the teeth being treated.

Many cosmetic dentists suggest teeth whitening prior to applying veneers or bonding, because manmade restorations won't bleach like natural enamel. By whitening teeth prior to placing veneers or bonding, the new restorations can be crafted to blend with teeth at their whitest. If whitening is performed only after restorations are placed, bleaching can cause natural tooth enamel to become whiter than existing restorations.

To maintain the results of whitened teeth, the patient can wear home whitening trays when a touchup is needed. The natural, un-restored teeth should only be bleached to the same shade as restorations, or the restorations will appear discolored.

Crown Lengthening and Dental Crowns

A dental crown is a ceramic restoration placed over the portion of a natural tooth that extends outside the gums - the part of the tooth visible to the naked eye. A crown is also called a cap because it caps, or is secured to the top of, a natural tooth. Dental crowns can restore structural integrity, shape, and a natural appearance to teeth damaged by chips, cracks, permanent stains, tooth decay, or failing dental fillings, inlays, and onlays. In some cases, gum tissue must be reshaped to accommodate a dental crown. The procedure of trimming back gum tissue is called crown lengthening, and it may be performed with a scalpel and sutures or with a soft-tissue laser.

Timeline

If you need full mouth reconstruction completed on a specific timeline, tell your dentist. For instance, if you're leaving the country, getting married, or losing your dental insurance in coming months or next year, your dentist may be able to complete treatment prior to your deadline. The following are timeline considerations for full mouth reconstruction.

"After surgical placement of dental implants, the natural process of jawbone tissue bonding to the biocompatible metal posts will take three to six months."

Phased Treatment Plans

As it sounds, phased treatment involves breaking up a treatment plan into smaller parts. Full mouth reconstruction might be divided into two to five parts, or more. Phased treatment can provide the patient with recovery periods between phases, while also assisting with payment planning. Your dentist may allow you to pay for each phase as it begins, rather than paying for the full treatment plan up front, in one bulk payment.

Dental Implant Recovery

After surgical placement of dental implants, the natural process of jawbone tissue bonding to the biocompatible metal posts will take three to six months. This phase is called osseointegration, and while temporaries may be worn, final prosthetics cannot be secured until recover is complete. Your dentist may plan to work on other areas of your mouth during your osseointegration phase.

Orthodontics

If your treatment plan involves moving teeth with orthodontics, whether traditional or removable (like Invisalign or ClearCorrect), completion of your full mouth reconstruction plan must factor in orthodontic treatment time. Traditional braces may require six to 24 months or longer, and removable orthodontic aligners generally require treatment of nine to 18 months. A retainer should be worn regularly, as advised, after orthodontic treatment. If restorative and prosthetic dentistry alters the patient's bite after orthodontic treatment, new retainers will be necessary.

Oral Surgery Recovery

Whether your oral surgery involves extractions, exposures, bone or gum grafting, or maxillofacial surgery, you will need time to recover. When planning a full mouth reconstruction case, your general dentist will factor in generalities, in regards to recovery times. However, people heal at different rates. Your treatment plan may be affected based on how your recovery progresses.

Results of Full Mouth Reconstruction

Before starting your full mouth reconstruction plan, you and your dentist will determine a goal of achieving certain results. Your compliance with the treatment schedule, home care, and recovery requirements will have an effect on treatment outcome. Also, how quickly your body heals and whether you encounter any unpredicted issues, such as an infection, will also affect results. If you follow the dentist's instructions and treatment progresses as expected, full mouth reconstruction should achieve the results you desired.

Aesthetic Benefits

A full mouth reconstruction plan can address all of your aesthetic concerns by correcting:

  • Missing teeth
  • Overgrown or insufficient gum tissue
  • Misshapen teeth
  • Misaligned teeth or malocclusion
  • Spacing or crowding issues with teeth
  • Broken, chipped, or cracked teeth
  • Decayed teeth
  • Sharp or jagged teeth edges
  • Discolored or otherwise stained teeth
  • Metal dental work
  • Failing dental restorations or prosthetics

Oral Health Benefits

Full mouth reconstruction will address gum disease, decay, bacteria, plaque, calculus (tartar), and old dental work, all of which can contribute to bad breath and poor oral health. Removing these stumbling blocks will significantly improve oral health.

Functional Benefits

In addition, a patient whose treatment includes correcting malocclusion (improperly positioned bite), bruxism (teeth grinding), or TMJ disorder/TMD should find relief from associated headaches, migraines, jaw/head/neck/shoulder/back pain, bruxism, popping/clicking jaw, impaired jaw movement, jaw sticking, tingling extremities, and, in some cases, carpel tunnel syndrome symptoms. Furthermore, replacing missing teeth will balance the workload of chewing and pre-digestion, and can improve the ability to pronounce sounds when speaking. After repairing decay, cracks, chips, internal tooth infection, and/or gum disease, patients no longer experience pain related to these oral health issues.

Quality of Life and Emotional Benefits

One of the greatest benefits of full mouth reconstruction is the patient's renewed confidence, comfort, and quality of life after treatment is completed. Because a smile looks more attractive and bad breath is eliminated (or reduced), full mouth reconstruction can make a person feel more confident in social and professional situations. Reduction or elimination of pain associated with poor oral health has a positive impact on quality of life, particularly if the pain was constant or intense. Patients who opt for dental implant-retained dentures to replace missing teeth no longer have to endure time-consuming care routines, messy adhesive, and embarrassing slippage they may have formerly experienced with traditional dentures.

Risks

All medical and dental procedures come with risks, but the risks today are much less than they were in previous years.

General Risks

Patient infection and cross contamination are always risks in a medical facility. Improvements in sanitizing protocols, technology, and disinfectants have had a significant positive impact on reducing the risk for cross contamination. Dentists use an autoclave to heat-sterilize and seal reusable instruments; in addition, many products used during a dental appointment are disposable. Dentists, hygienists, and assistants also wear gloves, as an additional precaution. Occupational Safety and Health Association (OSHA) certification is required for clinical team members, as well. Because water contamination posed significant risk to the patient just a few decades ago, today a fresh water source is required in operatories.

Better dental materials, and the use of microscopes and digital imaging, have improved both diagnoses and treatment outcomes. Dentists now tend to appreciate conservative treatment and often try to preserve as much natural, healthy tissue as possible when preparing teeth for restorations.

Reducing Risk

Provide your dentist with a complete list of medications you currently take, and be thorough in your medical history. If you're a heart patient, antibiotics may be administered prior to procedures as a precaution against infection.

If you wear removable dental prosthetics, follow daily cleaning instructions. Let your dentist know if the prosthetics do not fit properly. Over time, teeth may shift and gum ridges can become smooth. These changes can necessitate the need for adjustments to your prosthetics.

Orthodontic patients should brush teeth after each meal, attend appointments as often as instructed, and wear a retainer following treatment completion. Not wearing a retainer can allow teeth to move out of alignment, which can create a need for additional orthodontic procedures.

If you experience oral pain or believe that your dental work may need attention, do not hesitate making a dental appointment. In addition to homecare, keeping your six-month exam and cleaning schedule is vital to maintaining oral health. Your doctor may suggest more frequent visits, particularly for patients who have gum disease, are wearing orthodontics, or have new dental implants.

Oral Health Maintenance

Much of the risk associated with full mouth reconstruction depends upon patient compliance. During treatment, follow the dentist's instructions for daily oral hygiene, particularly postoperatively, while your mouth heals.

Your dentist and dental specialists will give you specific instructions for homecare after certain procedures. Following the instructions is imperative to a positive recovery experience and overall treatment success.

During and after full mouth reconstruction, practice excellent oral hygiene by brushing your teeth twice a day, for two minutes each session, and use fluoridated toothpaste. Rinse your mouth with antibacterial mouthwash after brushing. Either with morning or evening brushing, floss your teeth once a day. You can use traditional string floss or handheld flossers, if they're more effective for you.

FAQs

What is full mouth reconstruction?

Also called full mouth restoration or rejuvenation, full mouth reconstruction involves a treatment plan for completely restoring oral health, comfortable oral function, and, in some cases, esthetics. Treatment can include restorative, cosmetic, prosthetic, periodontal, and TMJ procedures, as well as specialized care, such as root canals, orthodontics, oral surgery, and implant placement. Each full mouth restoration treatment plan is unique, because it's based upon the patient's needs and desired outcome.

Who offers full mouth reconstruction?

Many general dentists offer full mouth reconstruction. If your dentist does not provide comprehensive full mouth treatment plans, he or she may refer you to a colleague who does. Often, treatment involves particular procedures performed by a dental specialist, such as an endodontist, periodontist, prosthodontist, oral surgeon, or, for children who have experienced oral trauma, a pediatric dentist, called a pedodontist.

What type of dentists offer full mouth reconstruction?

General, restorative, and cosmetic dentists can offer full mouth reconstruction, though not all do. Your dentist may send you to a trusted colleague if you need full mouth reconstruction.

Can my general dentist perform full mouth reconstruction?

Often, a general or family dentist will offer full mouth reconstruction. In some cases, however, a dentist may refer a patient to a colleague for full mouth reconstruction, simply because the general practitioner believes that the patient would be better served by a doctor who has more experience and training in full mouth reconstruction.

How long does full mouth reconstruction take?

Treatment time depends upon the scope of the treatment plan, patient compliance, and how quickly a patient recovers after procedures. After a thorough oral evaluation and discussion, your dentist should be able to provide a treatment timeframe. If you need treatment completed in a particular amount of time, be sure to let your dentist know your expectations at your consultation.

Will I have to take time off work?

Of course you'll have to be available for dental appointments, though many dentists will schedule procedures after regular office hours. If your work schedule is an issue, be sure to discuss it with your dentist. Chair time required for treatment will depend on the procedures in your full mouth reconstruction treatment plan. Should you need multiple procedures performed in a short time period, your dentist may suggest a sedative so that you can relax during extended appointments. The dentist may be able to combine multiple procedures in one, or a few, long appointments.

If your treatment plan involves oral surgery, you may need to take time off work for recovery. Tell your dentist about your work commitments so that he or she may factor that into your treatment plan.

How much does full mouth reconstruction cost?

Because each patient's treatment plan is unique, cost of treatment varies greatly. If finances are an issue, consider a phased treatment plan or financing. Some patient financing companies offer low- and no-interest loans for qualified applicants. You can use dental insurance and health savings accounts to help with full mouth reconstruction costs. If finances are an issue, be sure to tell your dentist. The doctor may have the option to use dental materials and procedures that can make your treatment more affordable. Of course, less esthetic materials (metal instead of natural looking) and alternate materials (bonding instead of veneers) come with some concessions. Discuss the pros and cons of various dental materials and treatment options with your doctor before undergoing treatment.

Will insurance cover full mouth reconstruction?

Dental insurance may pay for part of your full mouth reconstruction plan. Your dentist's financial coordinator can help you find ways to pay the portion not covered by insurance, if you don't have available funds on hand or in your health savings account (HSA).

What are my payment options?

Choices may include phased treatment or using third-party or in-house financing. Phased treatment plans allow a large treatment plan to be divided into affordable, practical segments. Third party or in-house financing may be available for qualified applicants. In some cases, low- or no-interesting financing options exist.

Am I too old for full mouth reconstruction?

No one is "too old" for good oral health and comfortable oral function. Age can, however, be an important factor in treatment planning, because elderly patients often have health issues that must be considered in a full mouth reconstruction plan. For instance, if the doctor determines that a patient may not do well undergoing surgery, he or she may recommend mini dental implants, instead of traditional implants, for denture retention. Don't allow age to keep you from a healthy mouth and comfortable oral function. A competent dentist will be able to work with you to develop an appropriate, effective treatment plan, regardless of your age.

What if I'm afraid of the dentist?

Dental phobia is a common, and very real, problem for many patients who need full mouth reconstruction. Years of avoiding professional dental care due to dental anxiety, stress, or phobia can result in deteriorated oral health. Regardless of your oral health condition, if you don't like dental visits, tell your dentist. Today, anxious dental patients have access to nitrous oxide (laughing gas), anxiolysis (oral sedation), oral conscious sedation (nitrous oxide with oral sedation), and IV sedation (intravenously administered drugs). These sedation options can make an anxious or extremely phobic dental patient find peace of mind and body during dental procedures. Don't allow being afraid of the dentist to stand between you and optimal oral health.

Does full mouth reconstruction hurt?

With modern dental anesthetics and sedation, no dental procedure has to hurt. Your dentist will recommend the appropriate level of medication for your comfort. Some patients experience short-term oral discomfort following a procedure. Your dentist may suggest over-the-counter or prescription pain relievers to take after treatment, for your comfort.

What if I have a sensitive gag reflex?

Tell the dentist if you know that you have a sensitive gag reflex, clinically known as laryngeal spasm. The dentist can take measures to reduce your risk for gagging, and to optimize your comfort.

What if local anesthetic doesn't work for me?

If you know that local anesthesia does not sufficiently numb your mouth, tell your dentist during your initial consultation so that he or she can note your chart accordingly. The dentist can administer nitrous oxide, oral sedation, or oral conscious sedation to keep you comfortable during dental treatments.

What if my back pain won't allow me to sit in a dental chair for more than a few minutes at a time?

Discomfort in the dental chair is a common issue, but it can be easily overcome with medication. Nitrous oxide, oral sedation, or oral conscious sedation can help you remain comfortable.

Can special needs patients, including Alzheimer's patients, undergo full mouth reconstruction?

Yes. If your general dentist believes that you would be better suited under the care of a doctor with more experience treating special needs patients, he or she may refer you to a respected colleague. Often, a dentist administers sedation so that a special needs patient can comfortably undergo treatments for full mouth reconstruction.

How long will full mouth reconstruction last?

The longevity of treatment results will depend greatly upon your oral health, overall health, oral hygiene, and compliance with doctor's instructions. Dental materials are also a factor. Porcelain veneers, for instance, may last two decades or more; dental bonding to correct the same issue may only last five to ten years.

Will full mouth restoration address my jaw pain and stop my headaches?

If you suffer from chronic migraines, headaches, pain in the jaw, head, neck, shoulders, or back, tell your dentist. He or she can assess your occlusion and jaw joints to determine whether TMJ disorder (TMD) is causing your symptoms. Other common symptoms of TMJ disorder include: popping or clicking jaw joints, inability to open and close the mouth completely, tingling fingers and toes, chronic teeth grinding (bruxism), and unexplained tooth wear.

How can I stop grinding my teeth during my sleep?

Habitual teeth grinding is clinically known as bruxism. Commonly, bruxism is caused by stressed jaw joints or when a person's upper and lower teeth don't fit together, which we call malocclusion. Over time, teeth grinding takes a tool on teeth by wearing down molars or causing chips and fractures. Therefore, bruxism should be treated so that the results of full mouth reconstruction are preserved. A simple oral appliance called a mouth guard can prevent teeth grinding, but the underlying cause should also be treated. Your dentist can identify the cause of your teeth grinding and prescribe treatment.

Do kids ever need full mouth reconstruction?

Children can require full mouth reconstruction. Common causes are baby bottle mouth (decay across front teeth) and injury. A child who needs full mouth reconstruction should see a pedodontist (children's dentist).

What will happen if the dentist finds oral cancer in my mouth?

Oral cancer is a serious and common disease that can affect people with no high-risk factors. If your dentist finds cause for an oral biopsy, he or she may refer you to an oral surgeon. Rest assured, your dentist will answer all of your questions and explain next steps if you ask.

What will happen if I have gum disease?

Your dental hygienist or dentist will suggest appropriate treatment, based on your level of gum disease. Also called periodontal disease, gum disease is a chronic condition that has no cure, but it can be treated.

Early gum disease is known as gingivitis, and few symptoms are expressed. In fact, some patients with gingivitis experience no symptoms. Treating gingivitis may simply involve changing your oral homecare routine and using special mouthwash. However, a deep cleaning may also be suggested if gingivitis has progressed.

Deep cleaning takes a few hours and is often performed in two visits. It involves scaling, which is removing hardened plaque (tartar or calculus) from below the gum line, and root planing, which is smoothing rough areas on teeth roots. Root planing eliminates areas where plaque tends to accumulate on teeth roots. Antibiotics may also be prescribed to fight infection in periodontal pockets. You will attend periodontal checkups every few months, at which time the dentist or hygienist will chart your gum pocket depth. Gum pockets are the pockets of infection that form at the gum line. After deep cleaning, gum pocket depth should be reduced, as gums heal and reattach to teeth.

If you have periodontitis, the advanced stage of gum disease, you may need surgery. Necrotic (dead) gum tissue must be removed so that new, healthy tissue can grow in its place. If a significant amount of gum tissue has been lost, gum grafting may be required. A periodontist is a dental specialist who treats the supporting structures of the teeth: gums, bone, and connective tissues. Often, a general dentist will refer patients with periodontitis to a periodontist for treatment.

Do dentists use laser surgery during full mouth reconstruction?

Some, not all, dentists employ lasers for minimally invasive dental and periodontal procedures. A soft tissue laser can treat periodontitis, reduce gum tissue for cosmetic purposes, and perform biopsies. Hard tissue lasers can prepare teeth for restorations, clean a tooth's root canal, and trim bone tissue. Patients tend to heal promptly following laser surgery, and lasers offer an unparalleled level of precision.

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