Index / Reconstruction
Full-mouth rehabilitation
When one tooth at a time
stopped working.
A full-mouth rehabilitation is what you do when the problem is no longer a tooth. Years of wear, grinding, failing crowns and a bite that has collapsed are a single connected problem, and solving them piecemeal is what made it expensive.
Why people come here
- He teaches occlusion and full-mouth rehabilitation to other dentists
- Fellowships in three academies — FAGD, FACE and FICOI
- The complex cases other practices refer out
- A written, itemized plan before anything is scheduled
First principles
The bite is the patient, not the tooth.
Teeth wear at a predictable rate. When they wear far faster than that — short, flat, chipped, sensitive, with old restorations failing on a cycle — something is loading them beyond what they were built for. Replacing the broken tooth without changing that force replaces the symptom and leaves the cause.
A rehabilitation re-establishes the whole system: where the jaw joints sit, how far the bite closes, and how the teeth meet when it does. The restorations are then built to that, rather than to whatever the mouth had collapsed into.
What usually brings people in
- Front teeth that have worn short, and a smile that looks older than you are
- Crowns or veneers that keep chipping, debonding or breaking
- Teeth that are sensitive to cold across the whole mouth
- Jaw pain, clicking, or waking with a headache and a tight face
- A bite that has never felt right since previous dental work
- Several missing teeth and the rest of the mouth drifting into the gaps
The sequence
How a rehabilitation is actually done.
Records and diagnosis
Photographs, scans, imaging, and an assessment of the joints, the muscles and the existing bite. Nothing is prepared at this stage.
Visit oneThe written plan
The sequence, the materials, the number of visits and an itemized estimate, to take home and read.
Same weekA tested prototype
The new bite is built in provisional material first and worn, so it is proven comfortable before it is made permanent.
WeeksRefinement
Adjustments while you live with it. This is the step that gets skipped elsewhere and the one that decides the outcome.
As neededThe final restorations
Made to copy the prototype you have already approved, in ceramic. No surprises at delivery.
Several visitsThe prototype
You wear the result
before you buy it.
The single most useful thing in a rehabilitation is the provisional stage. The new bite is built in a temporary material at the proposed height, and you live in it — eating, speaking, sleeping — for as long as the case needs.
If something is wrong, it is wrong in a material that costs hours to change rather than months. By the time the ceramics are made, their shape is a copy of something you have already proved works.
Questions
Rehabilitation, answered.
How long does the whole thing take?
Most cases run several months, and the length is driven by the provisional stage rather than the laboratory. Rushing that stage is the most common reason a rehabilitation fails later.
Will I be without teeth at any point?
No. You are in provisionals from the first preparation appointment onward, and they are made to look like teeth, not like placeholders.
Does every tooth need a crown?
Not necessarily. Some teeth need full coverage, some need a partial restoration and some need nothing at all beyond being left where they are. A plan that treats all twenty-eight teeth identically has not been thought about.
What if I have had this done before and it failed?
Bring everything — records, models, photographs. A failed rehabilitation usually tells you precisely what was not addressed the first time, which makes the second attempt considerably better informed.
Keep reading
Next step
Start with an examination and a straight answer.
A consultation includes an examination, the records the case needs and a written, itemized plan. If what you are asking for is not the right treatment, Dr. Nosti will say so and tell you what is.