Specialized Treatments

Full Mouth Reconstruction

Full mouth reconstruction is not a single procedure. It is a coordinated sequence of treatments designed to restore the entire dentition -- upper and lower arches, the bite relationship between them, and the supporting bone and soft tissue -- to a state of health, function, and stability. The term applies when the problems are too widespread or interconnected for a piecemeal approach to succeed.

Patients who benefit most from full mouth reconstruction generally share one or more of the following conditions: extensive tooth loss across multiple areas, severe wear from long-term grinding or clenching, widespread decay that has compromised the structural integrity of many teeth, a history of failed or aging dental work, acid erosion from reflux or dietary factors, or trauma affecting multiple teeth simultaneously.

Planning and Process

Dr. Rasmussen begins with a comprehensive examination that includes full-mouth radiographs, a cone-beam CT scan when implants are being considered, detailed photographs, and impressions or digital scans of both arches. The jaw joints are evaluated for pain, clicking, limited opening, or signs of internal derangement. A facebow recording captures the relationship of the upper jaw to the skull so the case can be mounted on an articulator that simulates jaw movement.

With these records, he develops a diagnostic wax-up or digital design that maps out the final tooth positions, shapes, and bite relationship before any clinical work begins. This blueprint defines how much vertical dimension needs to be restored, where implants should be placed, which teeth can be saved and which cannot, and what the final result will look like. In many cases, provisional restorations are fabricated from this blueprint and placed in the mouth as a test drive, allowing the patient to live with the new bite and aesthetics for several weeks before the definitive restorations are committed.

Treatment is then carried out in a logical sequence: extractions and bone grafting first if needed, followed by implant placement handled by an oral surgeon or periodontist, periodontal treatment, and finally the restorative phase that Dr. Rasmussen leads. Each phase creates the foundation for the next. The timeline typically spans six to eighteen months depending on complexity, with recovery distributed across the treatment phases rather than concentrated in a single healing period.

Long-Term Maintenance

The long-term success of a full mouth reconstruction depends on regular hygiene appointments, periodic radiographs to monitor implants and restorations, and a custom nightguard for patients with grinding habits. Dr. Rasmussen follows reconstruction patients closely, particularly during the first two years, to confirm that the bite remains stable and the restorations are functioning as designed.

Bruxism & TMJ Treatment

Bruxism -- the habitual grinding or clenching of teeth -- is one of the most destructive forces a dentition can face. Many patients are unaware they grind because it occurs primarily during sleep. The signs are often discovered during a dental examination: flattened biting surfaces, cracks in enamel, fractured cusps, and tooth sensitivity that has no other obvious cause. Over years, untreated bruxism can wear teeth down to stumps, fracture crowns and fillings, and cause chronic jaw muscle pain and headaches.

Temporomandibular joint (TMJ) disorders encompass a group of conditions affecting the jaw joints and the muscles that control jaw movement. Symptoms include pain in or around the ear, jaw tenderness, clicking or popping sounds when opening or closing the mouth, difficulty chewing, and locking of the jaw in an open or closed position. TMJ problems and bruxism often coexist and reinforce each other.

Diagnosis

Dr. Rasmussen evaluates the jaw joints through a combination of clinical palpation, range-of-motion testing, occlusal analysis, and imaging when indicated. He examines the wear patterns on your teeth, the condition of your existing restorations, and the relationship between your upper and lower arches when the jaw is in its most relaxed position. Understanding the source of the problem -- whether it originates in the joint, the muscles, the bite, or a combination -- determines the appropriate treatment approach.

Treatment Options

Occlusal splint therapy. The most common first-line treatment is a custom-fabricated occlusal splint (nightguard) worn during sleep. The splint is made from hard acrylic resin and is precisely adjusted to distribute bite forces evenly across all teeth, reducing the load on individual teeth and the jaw joints. For many patients, a well-adjusted splint provides significant relief from jaw pain, headaches, and tooth sensitivity within weeks.

Occlusal adjustment. In some cases, specific points of premature contact between the upper and lower teeth create interference patterns that force the jaw muscles to work harder than necessary. Selective reshaping of these interference points -- removing fractions of a millimeter of enamel at precisely identified locations -- can restore a more harmonious bite and reduce muscle strain.

Restorative correction. When bruxism has already caused significant damage, the worn or fractured teeth may need to be rebuilt with crowns, onlays, or veneers to restore proper tooth height and bite relationships. In severe cases, this becomes a full mouth reconstruction -- the damaged teeth are rebuilt to a bite position that is both stable and comfortable for the jaw joints and muscles.

Cleft Lip & Palate Prosthetics

Cleft lip and palate are among the most common congenital birth defects, occurring when the tissues that form the lip and palate do not fuse completely during fetal development. The resulting gap can affect feeding, speech, hearing, and dental development. While surgical repair is the primary treatment, prosthodontic care plays an essential role in managing the dental and functional consequences of cleft conditions throughout the patient's life.

Prosthetic Appliances

Palatal obturators. When surgical closure of a palatal cleft is incomplete or not possible, a palatal obturator -- a custom prosthesis that covers the defect -- restores the separation between the oral and nasal cavities. This allows the patient to eat and drink without nasal regurgitation and provides the seal necessary for normal speech resonance. Obturators are designed to be removable for cleaning and are adjusted periodically as the patient grows or as tissue changes occur.

Speech bulb prostheses. Some cleft palate patients have a soft palate that is too short or too immobile to contact the back wall of the throat during speech, resulting in hypernasality. A speech bulb prosthesis extends from a palatal plate into the pharyngeal space, providing a surface against which the pharyngeal muscles can close. Speech therapy in conjunction with the prosthesis often produces significant improvement in speech clarity.

Nasoalveolar molding (NAM). In infants with wide clefts, a custom molding appliance can be placed shortly after birth to gradually reshape the alveolar segments and nasal cartilage before the first surgical repair. This reduces the width of the cleft and improves the symmetry of the nose and lip, leading to better surgical outcomes and often reducing the number of surgeries required.

Dental Rehabilitation

Patients with cleft conditions frequently have missing teeth, malformed teeth, or teeth that have erupted in abnormal positions within the cleft site. Dr. Rasmussen coordinates with the patient's orthodontist and oral surgeon to plan dental rehabilitation that may include implants, bridges, or removable prostheses to replace missing teeth and restore normal function and appearance. This multidisciplinary approach ensures that each specialist's work supports the overall treatment goals.

Pre-Prosthetic Surgery

Pre-prosthetic surgery refers to surgical procedures performed to prepare the mouth for a dental prosthesis -- typically a denture, implant, or bridge. The goal is to create an oral environment that provides optimal support, retention, and comfort for the planned restoration.

Common Pre-Prosthetic Procedures

Alveoloplasty. After tooth extraction, the remaining bone ridge may have irregular contours, sharp edges, or bony prominences that would create pressure points under a denture. Alveoloplasty smooths and reshapes the ridge to create a uniform surface that distributes the forces of a denture evenly across the tissue.

Torus removal. Tori are benign bony growths that occur on the palate (torus palatinus) or on the inner surface of the lower jaw (torus mandibularis). While harmless, they can interfere with the fit and comfort of a denture or other prosthesis. Surgical removal creates a smoother surface that allows the prosthesis to seat properly.

Soft tissue recontouring. Excess or poorly positioned soft tissue -- including fibrous tissue from long-term denture wear, enlarged tuberosities, or redundant tissue folds -- can interfere with prosthesis fit. Surgical recontouring removes or repositions this tissue to create a stable foundation for the prosthesis.

Ridge augmentation. When the jawbone has resorbed significantly after tooth loss, the remaining ridge may be too narrow or too flat to support a denture or implant. Bone grafting or guided bone regeneration can rebuild the ridge to a height and width that accommodates the planned prosthesis.

Coordination with Prosthetic Treatment

Dr. Rasmussen plans pre-prosthetic surgery in coordination with the oral surgeon, with the final prosthesis in mind. The surgical goals -- how much bone to remove, where to augment, what soft tissue changes are needed -- are defined by the requirements of the restoration that will follow. This integrated approach avoids the problem of performing surgery without a clear prosthetic plan, which can result in an oral environment that is technically healed but poorly suited to the prosthesis the patient needs.

Dental Fillings

Dental fillings remain the most common restorative procedure in dentistry. When tooth decay creates a cavity, the decayed material is removed and the resulting space is filled with a restorative material that seals the tooth against further bacterial invasion and restores its structural integrity.

Composite Resin Fillings

Composite resin is the material of choice for most fillings placed at our practice. It is tooth-colored, bonds directly to the tooth structure, and allows for a more conservative preparation than traditional amalgam -- only the decayed material needs to be removed, without the additional removal of healthy tooth structure required to create mechanical retention for an amalgam filling.

The placement technique involves isolating the tooth, removing decay, etching the enamel and dentin surfaces with phosphoric acid, applying a bonding agent, and placing the composite in small increments that are individually light-cured. Each layer is shaped and adapted to the cavity walls before curing. The result is a restoration that is virtually invisible within the tooth and reinforces the remaining structure through the adhesive bond.

When a Filling Is Not Enough

Not every cavity can be addressed with a filling. When the area of decay is extensive -- particularly on molars where heavy chewing forces are concentrated -- the remaining tooth structure after decay removal may be too thin to support a filling reliably. In these situations, Dr. Rasmussen may recommend an inlay, onlay, or crown instead, depending on how much tooth structure remains. The goal is always to choose the most conservative restoration that will hold up long-term under the forces that particular tooth must bear.

Existing fillings also have a finite lifespan. Over years of thermal cycling, chewing forces, and chemical exposure, the seal between the filling and the tooth can break down, allowing bacteria to penetrate the margin and cause recurrent decay underneath the filling. During your regular check-ups, Dr. Rasmussen monitors the condition of all existing restorations and will advise you when a filling needs to be replaced or upgraded to a more durable restoration.