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Full Mouth Rehabilitation Process - An Overview

Full mouth rehabilitation (FMR) is a comprehensive approach that involves multiple procedures to overhaul the teeth in both the upper and lower arches. FMR begins with a thorough examination, including full dental photography and assessments of the mouth and jaw joints to identify any functional issues. X-rays help assess bone health. Further, reviewing patients' dental histories, including previous restorative work such as fillings, crowns, and root canals, helps plan treatment. Dentists also measure how the jaw and teeth fit together to ensure proper alignment.

Dental restorations are vital components of FMR. Bridges bond artificial teeth to adjacent natural teeth. Implants entail surgically placing artificial roots into the jawbone to anchor replacement teeth or dentures. Inlays and onlays of resin or amalgam are fillings shaped like teeth. Dentists fit and glue them to a tooth to fix its structure and function when a cavity is too big for a regular filling.

Cosmetic procedures in full mouth reconstruction may include teeth whitening and dental crowns - tooth-shaped caps placed over damaged teeth for structural support. Porcelain veneers, thin shells bonded to the front of teeth, help improve appearance. After taking diagnostic impressions, dentists design custom veneers to integrate seamlessly with the patient's surrounding tooth color, size, and shape.

FMR may also involve procedures to augment deficient jawbone areas and facilitate future implant placement. In bone grafting, dental surgeons take bone material from another body part or from an animal or synthetic source to assist with augmentation. Grafted material fuses with the native bone over time, strengthening the bone to support dental implants. Sinus augmentation elevates the maxillary sinus floor, an air-filled space in the bones of the upper jaw, with a similar grafting technique.

In FMR, dentists may recommend braces for patients seeking to correct misaligned but otherwise healthy teeth. Conventional bracket-and-wire braces remain popular, though complete treatment for tooth alignment may take a year or two. Clear aligner therapy such as Invisalign provides an esthetic alternative, with treatment averaging 12 to 18 months. Patients can also remove aligners while eating or brushing, unlike traditional braces.

Post-operative care helps ensure long-term success and preservation of the improved dental state. This care encompasses regular dental visits for professional cleanings and examinations, daily brushing and flossing, and adherence to prescribed treatment regimens and nutrition.

The overall timeframe for completing FMR can range from one to three years, depending on the case's complexity and procedures. Implants alone may take six months; sinus lifts and bone grafts may add another three to four months. Smaller procedures such as veneers, crowns, and bridges may take only a few weeks. Likewise, FMR costs differ and can be significant. To defray expenses, patients may use dental insurance or a payment plan with the dental clinic.

FMR requires dentists skilled in many procedures. Reputation is crucial; checking patient reviews and testimonials may help patients understand the resources, financial options, and overall care and alleviate some anxieties. Ensuring the dentist follows sterilization protocols and safety and hygiene standards may prevent complications.

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An Overview of ADA Recommendations for Antibiotic Prophylaxis

The American Dental Association (ADA) gives dental professionals the resources to elevate oral health in America. To this end, the ADA offers dentists and the public educational resources covering various oral health topics, including antibiotic prophylaxis, a preventive measure taken ahead of certain dental procedures for at-risk patients. Antibiotic prophylaxis is an antimicrobial therapy that destroys or hinders the growth of microorganisms, including bacteria and fungi. Antibiotic prophylaxis is almost exclusive to dental surgeries.

Dentists use antibiotic prophylaxis to prevent bacteria from entering the bloodstream, a risk during certain procedures, even if dentists have observed proper sterilization techniques. Bacteria in the bloodstream can lead to bacteremia, with symptoms such as elevated heart rate and abdominal pain. These and other symptoms are usually mild but can manifest microbial infections and more serious diseases.

Historically, two primary patient groups have received evaluations for antibiotic prophylaxis before dental procedures - those with prosthetic joints and those with a heart condition that increases their risk of infective endocarditis (inner lining of the heart inflammation). Complications associated with infective endocarditis include damage to the heart valve and heart failure. Patients with prosthetic joints are at an increased risk of hematogenous infections, which occur when bacteria in the bloodstream flow into the bone and, ultimately, to the implant. The National Institutes of Health describes hematogenous infection as a “devastating complication” and potentially fatal.

Fortunately, ADA research indicates that the number of patient subpopulations that require antibiotic prophylaxis is much lower than previously believed. The organization investigated the subject in 2012 and 2013 for the official guideline Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. The ADA Council on Scientific Affairs assembled an expert panel to review findings about antibiotic prophylaxis.

Experts found no direct association between dental procedures and an increased risk of joint infections in normal patient populations. However, a few key exceptions still exist, such as patients with a history of complications following joint replacement surgery. Antibiotic prophylaxis may also be beneficial for medically compromised patients with joint replacements who are preparing for oral surgeries involving gingival manipulation or mucosal inclusion. Finally, immunocompromised individuals with prosthetic joints should be evaluated for antibiotic prophylaxis.

After consulting with the ADA, the American Heart Association updated infective endocarditis guidelines in 2021. The guidelines, which adhere to ADA recommendations first made in 2007, state that antibiotic prophylaxis should only be used as a preventive measure against infective endocarditis for highly at-risk patients. Outside these small patient groups, the risks associated with antibiotic prophylaxis outweigh the benefits.

The primary risk associated with the use of prophylactic antibiotics is antibiotic resistance. Antibiotic resistance occurs when bacteria or fungi adapt to the antibiotics and eventually become resistant to their effects. Once the bacteria and fungi become resistant to antibiotic treatments, they become very difficult to treat. This means a dental patient may inadvertently develop antibiotic resistance during a procedure that does not require prophylactic antibiotics. The patient may later be at increased risk for infection during situations where antibiotics are of critical importance, such as treatment for a chronic disease or as part of an organ transplant procedure.

Patients can learn more about their eligibility for antibiotic prophylaxis by speaking to their dentist or visiting the ADA website, www.ada.org.

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An Overview of Full Mouth Rehabilitation

Medical professionals suggest that Americans of all ages should see their dentists once every six to 12 months. However, studies suggest only 75 percent of Americans have plans to see a dentist in the next 12 months; an even lower percentage saw a dentist during the preceding 12 months. Failing to keep up with good oral health practices can lead to dental complications that require more advanced treatments, including full-mouth rehabilitation or full-mouth reconstruction.

Full mouth reconstruction, an umbrella term, refers to a series of procedures and treatments designed to restore oral health by completely rebuilding a patient's teeth in the upper and lower jaw. Edentulous patients, or individuals missing all of their teeth, often require full mouth reconstruction in the form of full dentures. Individuals may also require full mouth rehabilitation if they exhibit complex dental problems.

Full mouth reconstruction begins with a conversation as dentists outline the details of the procedures for patients. They may also provide patients with a clear picture of multiple complex procedures. Unsurprisingly, there is no one-size-fits-all approach to full mouth reconstruction, as each patient’s needs are specific to their condition. Early discussions allow dentists and patients to feel comfortable with the overall strategy for rehabilitation.

Dental professionals examine the oral health state of their patients to develop a strategy that addresses the patient’s oral health problems. For example, patients who experience traumas from accidents or physical injuries to the face or head benefit from a full mouth rehabilitation. During trauma, an individual's teeth and jaw may also sustain damage, including multiple chipped and lost teeth. Dental professionals may need to remove the teeth and perform additional procedures to restore the mouth to normal functionality and appearance.

Individuals should immediately receive medical attention if they suffer a traumatic injury, especially to the face or head. In an emergency room setting, nurses and physicians can only provide so much help in restoring damaged or missing teeth. They can treat the primary wounds. Then, patients must seek the opinion of a dental professional capable of providing full mouth rehabilitation services.

Traumatic injuries typically come as a surprise. However, other factors behind full mouth rehabilitation, such as oral infections, become more apparent, even gradually. Untreated tooth decay can quickly spread throughout the mouth, resulting in the loss of multiple teeth. For example, gum disease can damage tissue in the mouth. Moreover, individuals who do not regularly brush and floss elevate their risk for oral infections.

Regular dental appointments are critical for spotting early signs of infection. Patients have several options for addressing infected teeth, including dental fillings and implants.

Finally, some patients require full mouth rehabilitation due to long-term use and general wear and tear. Diets can impact teeth, especially those with high citrus and acid diets. Unconscious behaviors, such as grinding teeth or jaw clenching, can also weaken teeth to the point that professional help is required.

Since some individuals experience multiple dental health emergencies simultaneously, each may require its own treatment. People with oral health problems should discuss matters with their dentist and determine whether full mouth reconstruction may be an option.