What Full Mouth Reconstruction Actually Involves

By Dr. Nojan Jahedmanesh, DDS · Reviewed by Dr. Masih Rezaei, DDS · Published September 23, 2026 · Implants · 9 minute read · More articles

Full mouth reconstruction is not one long appointment. It is a sequence of decisions spread over months. At each one you see what is settled and what is open. This article covers the shape of that sequence at Pearl32 Dentistry and Wellness in Laguna Hills. What is decided at each stage, and what you agree to.

This is part of the implant dentistry we offer at Pearl32 Dentistry and Wellness in Laguna Hills.

Why it is planned as one problem, not twenty-eight

Most mouths that need rebuilding got there slowly. Teeth worn short by years of night-time grinding. Crowns and large fillings placed decades ago and now leaking. Back teeth lost and never replaced, so the front teeth took the chewing load and wore down in turn. As the teeth shortened, the bite closed. The jaw now shuts further than it used to.

Repairing one broken tooth at a time in a mouth like that means building each new crown to fit the collapsed bite. The new crown is made short to match its worn neighbors, and it meets the opposite jaw at the same angles that wore the original tooth away. It is a bit like re-tiling one square of a floor that has sunk. The tile fits the sunken floor, not the level one.

A reconstruction levels the floor first. The bite height and the position of the jaw are decided before any tooth is prepared, and every crown, onlay, veneer and implant that follows is made to that one position. That is the whole difference, and it is why the planning takes longer than the drilling.

The first two visits decide almost everything

Nothing is drilled at the first visit. We take a 3D cone beam scan, a digital scan of both jaws, photographs, a record of how your teeth meet, and a measurement of the gum around every tooth. We look at how far the bite has closed, how the jaw joints move, and what the wear patterns say about how you grind.

Every tooth is then sorted into one of three groups: sound and left alone, repairable, or not worth saving. That tooth-by-tooth prognosis is the foundation of the plan. It is also the first thing to ask for if you have been told elsewhere that everything needs to come out, because some of those mouths do better with full arch implants and some have been over-diagnosed. Our second opinion page explains how we handle that.

At the second visit you see the proposed plan, split into phases. Each phase has its own list of procedures, its own fee and its own decision point. You take it home. Three questions are worth asking before you agree to anything: which parts cannot wait, what order the phases run in and why, and what happens if you stop after a given phase. A good plan has a clear answer to all three.

The trial run, in temporary teeth

Before any final ceramic is made, the new teeth are designed digitally and shown to you as a mock-up in your own mouth. Length, shape and how much tooth shows when you speak are settled here, while changing them costs nothing but a little time.

Then, in most cases, you wear provisional restorations at the new bite height for several weeks. This is the part people are least prepared for. For the first few days your speech sounds different to you, particularly the S and F sounds, because your tongue and lips are meeting teeth in new places. Chewing feels bigger than it did. Your jaw muscles, which had shortened to fit the collapsed bite, have to stretch to the new height and can ache in the mornings for a week or two. All of this usually settles, and while it settles we adjust the provisionals: a little off here, a little added there.

The provisionals are acrylic, softer than the final ceramics, so very hard or sticky food is worth avoiding. If one loosens, call the office on the day and we refit it, usually the same day. The point of this stage is simple. A change in acrylic takes minutes. The same change in finished porcelain means remaking the tooth. So we would much rather find out now that a front tooth is a millimeter too long.

The long middle, and why nothing seems to be happening

Between the trial run and the final teeth there is often a stretch of months in which, from the outside, not much appears to change. That is by design, and it is where most of the calendar goes.

Active disease is dealt with first. Gum treatment where the gums bleed or the bone has receded, a root canal where a nerve is involved, and extraction of teeth in the third group. Rebuilding over untreated disease is how reconstructions fail, so this is not the stage to hurry.

Where back teeth are missing, implants usually go in next, planned on the 3D scan and placed through a surgical guide. Then they are left alone. Bone bonds to titanium over three to six months, and there is no way to speed that up. You keep wearing your provisionals, you come in for hygiene visits and provisional checks, and the implants heal quietly under the gum. Our article on how a single implant is planned from a 3D scan covers what the scan decides.

Put together, the whole process usually runs 16 to 72 weeks from first consultation to finished result. Worn teeth with healthy gums and no implants sit at the short end. Extractions, gum treatment and implant healing sit at the long end. We put a realistic range in writing once the records have been read, and we would rather quote you eighteen months and finish in twelve than the other way round.

The finish, one section at a time

The final crowns, onlays and ceramics are fitted in sections, usually a quadrant or an arch at a visit, so you always have teeth to eat with. Back teeth are often made on the CAD/CAM milling unit in our own office and fitted the same day. Front teeth go more slowly, because layered all-ceramic work from the laboratory gives a more natural result where it shows. Each section is checked against the bite position that was tested in the provisionals, so the new teeth meet the way the temporary ones did.

Reconstruction appointments run longer than a normal visit, so we build in breaks, and sedation is available for people who want it. Some tenderness in the teeth and jaw muscles for a few days after a long session is normal.

The last item is almost always a night guard. If grinding caused the damage, it does not stop because the teeth are new, and ceramic chips the way enamel does. The guard, and a hygiene and review schedule, are what make the result last. This part is not optional, and we say so at the start rather than at the end.

What you agree to, and when

You agree to one phase at a time, in writing. The itemized estimate you receive after the records visit lists every procedure separately with its own fee, grouped by phase, and states what is included and what is not. There is no single fee for a reconstruction and we do not quote one over the phone, because until the records are read nobody knows which teeth need what.

Dental insurance rarely covers work of this size in full. Crowns, root canals and gum treatment are usually covered benefits, but annual maximums are modest against a whole mouth, so phasing treatment across two benefit years sometimes helps. Our insurance page lists the plans we accept. Third party financing is available through outside lenders, each subject to credit approval, and the practice is not the creditor. Our financing page covers what applying involves.

Full mouth reconstruction is prosthodontic work at its core: rebuilding tooth structure, replacing what is missing and making the two jaws meet correctly. Dr. Nojan Jahedmanesh holds a certificate in prosthodontics from UCLA and practices as a general dentist. His profile has the detail.

Questions people ask

How long does full mouth reconstruction take from start to finish?

Usually 16 to 72 weeks, roughly four to eighteen months. Worn teeth with healthy gums and no implants sit at the short end. Extractions, gum treatment and implant healing push the timeline toward the long end. You receive a realistic range in writing after the records visit.

Will I have teeth the whole time?

Yes. From the trial stage onward you wear provisional crowns that look and work like teeth, and you eat and talk normally. They are softer than the final ceramics, so very hard or sticky food is worth avoiding. If one loosens, call the office and we refit it, usually the same day.

Can I stop partway through a full mouth reconstruction?

Yes. Treatment is quoted and agreed one phase at a time, and the plan tells you which parts cannot wait, such as active infection or a cracked tooth, and which can. Stopping after a completed phase leaves you with finished teeth in that section, not half-prepared ones.

Do I need implants for a full mouth reconstruction?

Only if teeth are missing and the plan calls for replacing them. Many reconstructions are crowns, onlays and bite correction on teeth that are all still present. Where back teeth are gone, implants often hold the rebuilt bite together, and the 3D scan shows whether the bone will support them.

Will my speech change with the provisional teeth?

Yes, for the first few days. The S and F sounds in particular sound different to you, because your tongue and lips meet teeth in new places. Chewing feels bigger than it did. Jaw muscles that had shortened to fit the collapsed bite have to stretch, and can ache in the mornings for a week or two. All of this usually settles, and we adjust the provisionals while it does.

Does dental insurance cover full mouth reconstruction?

Rarely in full. Crowns, root canals and gum treatment are usually covered benefits, but annual maximums are modest against a whole mouth. Phasing treatment across two benefit years sometimes helps. We are in network with most PPO plans, including Delta Dental, Aetna, Cigna, MetLife and Guardian. Third party financing is available through outside lenders, each subject to credit approval, and the practice is not the creditor. Every phase is quoted in writing, itemized.

Why do I need a night guard after reconstruction?

Because grinding does not stop when the teeth are new. If grinding caused the damage, the same force now lands on ceramic, and ceramic chips the way enamel does. The guard, with a hygiene and review schedule, is what makes the result last. It is almost always the last item in the plan. This part is not optional, and we say so at the start rather than at the end.

Who plans full mouth reconstruction at Pearl32?

Dr. Nojan Jahedmanesh, DDS, who holds a certificate in prosthodontics from UCLA and practices as a general dentist. Full mouth reconstruction is prosthodontic work at its core: rebuilding tooth structure, replacing what is missing and making the two jaws meet correctly. All three dentists at Pearl32 hold a DDS from Loma Linda University. Back teeth are often milled on the CAD/CAM unit in the office and fitted the same day.

This article is general information, not a diagnosis. What is right for you can only be decided after an examination.