04/20/2026
Letās talk through the process of a full mouth rehab.
The most important aspect of a full mouth rehab is the evaluation. The ex*****on is what makes a case look great in the end, the evaluation is what makes sure it will last.
How did the patient get to this point? Are we dealing with erosion? Bruxism? Sleep disorder breathing? Some combination of several factors?
What is the condition of the joint? If we have instability of the joint, how can we anticipate stability of the occlusion after completion?
Once thoroughly evaluated, we deprogram the patient. This allows us to do two things. Find the patients muscle-neutral bite position, and establish our new vertical (ābite heightā).
The patient whereās his deprogrammer at night for 2 weeks and then comes to the office for records. There are 18 pictures I take at a records appointment, plus I take a scan at the new vertical that I want to build the bite at.
These records are sent to my ceramist, who I will work very closely with to design the case. I will let him know what kind of material Iām thinking. How I anticipate prepping the case. The kind of posterior anatomy I want. Dimensions of anterior teeth. Overjet and overbite. Etc.
Once I get that back we will try the design in to verify aesthetics and occlusion. Some docs will make the patient test drive the new bite, but in my experience, if Iām thorough with my evaluation an design, I trust that the new bite will work very well.
Now normally I would prep and complete the uppers first, and then tackle the lowers. But b/c the preps were pretty minimal, the patients joint was very stable, and I didnāt expect any surprises, we went ahead and prepped all upper and lowers in one day. Which makes for a longer day, but it cuts the treatment time essentially in half.
Temporaries are critical with a case like this one. Iāll bring the patent. Back the day after prep to do a comprehensive equilibration, and scan the temps. This way the lab can replicate the occlusions in the finals.
3 weeks later weāll delivery of all restorations and perform a second equilibration. Following this I see the patient one month later for a final bite verification & pictures.
