What Is A Full Mouth Rehabilitation?
Our teeth undergo wear and tear just by functioning throughout our lives. However, dental diseases such as tooth decay or gum disease cause them to break down even faster than they naturally would. Once a tooth is drilled into for a filling, the lifespan of that tooth begins to shorten. Over time, if the filling has to be redone due to new decay, or if the tooth needs additional procedures such as a root canal filling or a crown, the tooth may eventually fail and need to be removed. Losing one or a few teeth is not a big problem these days since they can be replaced fairly easily (see “Options For Missing Teeth”). It is only when multiple segments in the mouth are compromised or missing that a full mouth rehabilitation is recommended.
A full mouth rehabilitation or reconstruction is a dental treatment that involves every single tooth in the mouth. Often, this involves multiple onlays, veneers, crowns, or bridges. When the natural teeth are unable to support the reconstruction due to extensive damage, implants are often employed instead. They are also preferable in patients who have very high tooth decay recurrence rates since they are made of titanium and cannot be broken down by bacteria or acid. When used, implants act as a foundation and the overlying crowns and bridges are screwed onto them to replace the missing teeth.
Large reconstructions involving multiple teeth or implants are naturally very difficult to carry out and may involve multiple specialists. Prosthodontists have extensive training in managing such treatments due to at least 3 years of advanced education beyond dental school. This ensures they are most qualified to carry out full mouth rehabilitations when they are needed. It is important that the specialist you are visiting presents you with all the available options for your situation; not just limited options based on what the offer in their practice.
Who needs a full mouth rehabilitation?
The first category of patients that need rehabilitations are those who have lost all their teeth and are looking for a more comfortable, functional alternative to complete dentures. Such patients can be managed with full implant reconstructions where 4-8 implants are placed in each jaw. Once they have stabilized, large bridges are then installed over the implants to replace the missing teeth and gums. Many different materials can be used for the bridges now – the most common are zirconia or a hybrid of acrylic and titanium.
Another category of patients are those who have undergone multiple rounds of dental treatment over the years. These patients often begin restorative work at a young age and have high rates of dental decay. Over time, restorations fail and need to be replaced due to new decay or fractures. After a certain point, restorations can no longer be redone and the affected teeth need to be extracted. A full mouth rehabilitation may be indicated at this point in order to replace all the failing restorations in one shot or to replace the failing teeth entirely. Such reconstructions can be done on a mix of natural teeth and implants, depending on the status and location of the remaining teeth.
Sometimes, patients do not suffer from dental decay but nevertheless need to have rehabilitations done. This third category of patients often show signs of severe tooth grinding and have worn through their teeth to the point where they are now short, un-esthetic, and potentially sensitive. If the wear has not progressed too far, the reconstruction may be carried out on teeth using a mix of veneers, onlays or crowns. Modern technology allows us to predictably bond high-strength ceramics to teeth, leading to a more conservative approach and helping us preserve whatever tooth structure remains.
There may be other situations that call for a full mouth reconstruction; for example, young patients born with missing teeth, congenital conditions like amelogenesis and dentinogenesis imperfecta or patients who have undergone resection of teeth and oral structures after trauma or oral cancer treatment. If you identify with any of the scenarios listed above, get a detailed consultation with a prosthodontist to determine if a reconstruction is the right treatment for you.
How long will my treatment take?
Full mouth rehabilitations require a significant investment in time. The exact length of a full treatment plan varies, depending on what is required. Typically, the fastest reconstructions involve only restoring teeth with no surgeries required. Even then, it may take anywhere from six to nine months from start to finish. Larger treatment plans involving implants may take 3 additional months while we wait for them to integrate before they can bear load. The slowest plans typically involve a combination of extracting teeth, grafting sites with deficient bone, placing implants and waiting for everything to heal before restorations can be placed. These plans can take upwards of a year before they are completed. Often, the limiting factor in our work is how fast a patient heals. It is not possible to rush biology, and any time spent waiting for healing is done with a patient’s best interest at heart.
As can be expected, full mouth rehabilitations also tend to be a huge financial investment. Sometimes, the entire sequence can be split up into individual phases to make it more affordable over a few years. Treatment can progress to a stable “rest point”, where patients can take a break before moving on to the next phase when they are ready. Whatever the case may be, rest assured that you will have teeth throughout the entire treatment. A variety of provisional restorations can be used along the way to ensure you always leave the office with a smile.
Remember, the questions listed above are meant to give you an idea of what is involved in a full mouth rehabilitation. Embarking on one is always a big commitment and is not to be taken lightly. The best way to know for sure how your reconstruction will be done (or if you even need one) is to see a prosthodontist for a detailed examination and to discuss your concerns. Our office offers complimentary consultation – feel free to schedule an appointment with Dr. Tan if you want to know more about full mouth rehabilitations!