Full-mouth reconstruction

What it is

When many teeth need work, fixing them one at a time can miss the bigger picture. Your teeth work as a set. If they’re worn down, broken, or missing in several places, your bite (the way your upper and lower teeth meet) can change, and fixing one tooth may put more strain on another.

A full-mouth reconstruction starts by looking at your whole mouth. Then your dentist puts the treatments you need in a sensible order, so each step supports the next. A plan might include fillings, crowns, bridges, implants, dentures, gum treatment, or a night guard, and the mix is different for everyone.

Who it helps

A full-mouth plan may help if you have:

• many teeth worn down by grinding, or by acid from reflux or sour drinks
• several broken, cracked, or decayed teeth
• missing teeth along with others that need repair
• old dental work that is failing in several places
• a bite that has changed as teeth wore down or were lost

It’s also a way forward if you’ve put off dental care for years. A plan breaks the work into steps you can see and pace.

What happens

1. A thorough exam. Your dentist looks at every tooth, your gums, your bite, and your jaw joints. Expect a full set of X-rays, photos, and impressions or scans of your teeth.
2. Relief first, if you need it. Pain or infection is treated right away, before the rest of the plan.
3. Your plan, explained. Your dentist goes over what they found and lays out the plan in phases: what each step involves, roughly how long it takes, and what it costs. There are usually choices, and you decide what happens and when.
4. A healthy base. Decay and gum disease are treated early, because crowns and bridges need healthy teeth and gums to last.
5. Rebuilding. The main work, such as crowns, bridges, implants, or dentures, is done in a set order. If your bite is changing, your dentist may first test it with temporary crowns, so you can try it before anything is final.
6. Protecting your teeth. Afterward, a night guard may be suggested if you grind, and regular checkups help catch small problems early.

Recovery and aftercare

Recovery depends on the treatments in your plan, and each one has its own aftercare. Spacing the work out gives your mouth time to heal between steps.

If the shape or height of your teeth changes, your bite will feel different at first. Most people adjust within a few weeks. After that, the care is the same as for any healthy mouth: brushing, cleaning between your teeth, and regular checkups.

Cost and insurance

The cost depends on what your plan includes: the number of teeth, the treatments and materials, and whether you need implants, gum treatment, or extractions. Because every plan is different, your dentist can only estimate the cost after an exam.

Dental plans usually cover each treatment by its own rules, up to a yearly maximum. Because the work is done in phases, some people spread it across more than one plan year. You may also be able to use a health savings account or flexible spending account. See insurance and financing for ways to pay.

Alternatives

• One problem at a time. You can fix the most urgent teeth now and decide on the rest later. This spreads out the cost, but without a full plan, some work may need redoing later.
• Replacing instead of rebuilding. If most teeth can’t be saved, dentures or implant-supported dentures may be simpler than rebuilding each tooth.
• Waiting. You can put off treatment. Worn and broken teeth usually get worse over time, though, and the work needed tends to grow.