Full Mouth Reconstruction/Rehabilitation involves rebuilding every tooth in the mouth to a new bite position that improves the over all health and bite relationship to the whole body. Using a Neuromuscular approach to find the ideal bite relationship of the upper and lower jaws alignment allows for an ideal physiologic starting point. The whole body is astutely interconnected so the importance of finding an ideal bite relationship of the upper and lower jaws is critical to placing the patient's bite in a natural physiologic zone. This physiologic zone is important because not being in that physiologic zone can affect the patent in so many different ways. From headaches, airway, forward head posture, cervical neck and shoulder issues, ringing of the ears, pressure behind the eyes, TMJ , tinnitus, dizzyness, and facial asymmetry ......... the list goes on. Not all patients have these symptoms but many do.Many patients don't realize the relationship of the bite and these many symptoms.Some patients are totally asymptomatic but have cracked,worn, broken down and decayed teeth which directly affects the upper and lower jaw relationship (vertical dimension). This lack of vertical dimension can contribute to potential pain and decreased function.One of the many overlooked problems with the lack of vertical dimension is the decreased room for the tongue.The tongue is the only available appendage in our body to help the body achieve airway by posturing.This posturing is good because it allows us to put our body in a position to gain air, but it also causes our body to contort in ways that are extremely detrimental to the overall health of the total stomatognathic system. There is a reason that patients that lack proper vertical dimension have numerous cervical neck and airway issues.Forward head posture to gain airway puts the body is a precarious position as it has to balance and support the head that is in the forward position. The sternocleidomastoid, trapezius and scalene muscles have to fire to balance the head.This is why there is an extremely high correlation between TMJ. airway and cervical neck pain.
Full mouth reconstruction involves a highly trained dentist that understands this jaw relationship and how that relationship can affect the TMJ, airway and cervical position (C1/C2). This is a multidisciplinary approach which can involve other specialist like periodontists (specializing in the gums), oral surgeons, orthodontists (specializing in tooth movements and positions) and endodontists (specializing in the tooth pulp health).
The need for full mouth reconstruction may result from:
Tooth loss due to decay, trauma, injury or fracture.
Teeth that are severely worn due to acid reflux, foods, drinks, bruxing and grinding.
Headache, jaw, TMJ and muscle pain associated with poor jaw alignment and bite position.
A comprehensive dental exam will be the first step in the process. The teeth, Peridontal gum tissue, Bone, TMJ (jaw joints), Muscles, Bite, Airway, Posture,Function and Cosmetics will be examined, reviewed and the best treatment plan will be decided to place the jaws/bite in the most ideal physiologic position. This position will take into consideration the joints, muscles,teeth and airway and their relationship to the C1/ C2 cervical area. The comprehensive examination requires records of your mouth such as Digital X-rays and photographs, impressions of your upper and lower teeth, models of your teeth that are made from the impressions and a bite registration. Since this is a multidisciplinary approach other specialists may be needed to develop a treatment plan that is best for you.
Once your dentist has obtained all information relevant to your case, he or she will develop a comprehensive, step-by-step treatment plan to correct all of the problems in your mouth and complete your reconstruction. If you do not understand the procedure being described to you, ask for a detailed written description of the proposed treatment plan so you can review it. This can be helpful if you want to get a second opinion. Be sure you understand the risks and benefits of the recommended procedures and treatments.
What Procedures Are Needed?
Your dentist and the team of specialists working on your full mouth reconstruction can determine what procedures are needed for your specific case. Other treatments may also be available, so ask your dentist about all possible procedures that might be required for your case and under what circumstances.
Most full mouth reconstructions involve multiple phases and office visits. It is not unusual to expect treatment to take 6 to 12 months or more, depending on each patient's unique situation. The following procedures may be involved, depending on your needs:
- Prophylactic teeth cleaning and periodontal care.
- Crown lengthening to expose healthy, sound tooth structure for possible crowns or bridges.
- Orthognathic surgery to reposition the jaw.
- Contouring of the gum tissue with a Diode laser to create balance and harmony in your smile.
- Preparation (reduction) of your natural tooth structure so crowns, bridges or veneers can be placed.
- Placement of temporary restorations so you can become accustomed to your new teeth and the feel of your new mouth or bite alignment.
- Placement of permanent restorations, such as crowns, veneers, inlays/onlays or bridges, made from ceramic, ceramic supported by metal or a combination of both.
- Orthodontics (braces) in order to move your teeth into the optimal position for reconstruction.
- Implant placement and restoration to replace missing teeth and/or anchor bridge restorations.
- Bone or soft tissue grafting to enhance the stability of your teeth, proposed implants and/or other restorations.
- Endodontic (root canal therapy) to address any unhealthy teeth or infected teeth.
Full Mouth Reconstruction vs. Smile Makeover
How does full mouth reconstruction differ from smile makeover? A smile makeover is something that you elect to have performed to improve esthetics or form, while a full mouth reconstruction is something that you need to improve both form and function.Many times they overlap since it is difficult to separate form and function.
It is also important to note that a smile makeover – though performed primarily to improve the esthetic appearance of the smile – requires the use of clinically proven dental materials and treatment techniques, as well as exceptional knowledge, training and skill on the part of the dentist. Many of the same techniques and equipment used for full mouth reconstruction are also used to ensure the success and long-term stability of smile makeover treatments.
In summary, any dental treatment that affects all teeth in the mouth is called full mouth reconstruction or full mouth rehabilitation. Some treatment options for oral cancer may require the patient to undergo a unique type of full mouth reconstruction that not only involves the replacement of missing teeth, but potentially restoration of missing bone and tissue in the oral cavity. The treatments for full mouth reconstruction usually includes onlays, crowns, bridges, dental implants, veneers and dentures.