A dentist can fix severely damaged teeth, regardless of the cause, such as neglect, trauma, or genetic issues. Modern dentistry focuses on comprehensive repair and rehabilitation of the entire mouth. The goal is to restore appearance, full function, and the long-term health of the chewing system. Severe dental deterioration is treatable using a combination of restorative techniques and advanced replacement options.
Initial Assessment and Treatment Planning
Treating severe dental issues begins with a comprehensive diagnostic evaluation, which serves as the roadmap for repair. This detailed examination starts with a thorough visual inspection of the teeth, gums, and surrounding soft tissues. Dentists also perform periodontal probing to measure the depth of gum pockets, assessing the foundational health of the bone and gums supporting the teeth.
Specialized images are taken to reveal issues hidden beneath the surface. Standard digital X-rays provide two-dimensional views of bone loss and decay. A three-dimensional cone-beam computed tomography (CBCT) scan offers a complete view of jawbone density, nerve pathways, and sinus location. The data gathered from the exam and imaging is used to create a phased treatment plan, prioritizing infection control before permanent restorations. This plan outlines the sequence of procedures over time, ensuring a systematic approach to rebuilding oral health.
Restoring Teeth That Are Severely Damaged
When a tooth is compromised by deep decay or fracture but is salvageable, the focus is on preserving its natural structure. Teeth with infected internal pulp tissue require endodontic treatment, commonly known as a root canal. This involves cleaning, disinfecting, and sealing the root canal system to eliminate infection while maintaining the tooth’s root structure within the jawbone.
After endodontic therapy, a tooth often lacks enough structure above the gum line to support a traditional restoration. A post and core procedure is performed, where a fiber or metal post is cemented deep into the cleaned root canal space. A core buildup material, often composite resin, is molded around the post, effectively creating a new foundation. This stable core is then shaped to receive a custom-fabricated ceramic crown or onlay, which encases the tooth structure to protect it from fracture and restore the chewing surface.
Periodontal therapy is often a necessary precursor to restoration, stabilizing the gums and bone surrounding the teeth. Addressing severe gum disease through deep cleaning procedures, known as scaling and root planing, ensures the foundation is healthy enough to support restorative work. Without a stable foundation, crowns and fillings are likely to fail over time due to progressive bone loss.
Options for Replacing Missing Teeth
For teeth that must be extracted, or for existing gaps, modern dentistry offers several replacement options. The most stable solution is the dental implant, which involves surgically placing a titanium post directly into the jawbone to mimic a natural tooth root. This post fuses with the bone through osseointegration, providing an anchor for a single crown or an entire dental bridge. Implants offer superior stability, can last 25 years or more, and prevent the jawbone deterioration that occurs after tooth loss.
A fixed dental bridge is a non-removable alternative that spans the gap created by missing teeth. This restoration uses crowns placed on adjacent natural teeth, which act as anchors to support an artificial tooth called a pontic. Bridges are a durable solution that can function for 10 to 15 years, but they require the permanent alteration of the supporting natural teeth.
Removable partial or full dentures are the most cost-effective option for replacing multiple missing teeth or an entire arch. Partial dentures use clasps to attach to remaining natural teeth, while full dentures rest directly on the gum tissue. They typically require replacement every five to ten years and offer less chewing force than fixed options, but modern materials provide a comfortable fit and natural appearance.
Understanding Full Mouth Reconstruction
When nearly every tooth is decayed, damaged, or missing, the coordinated effort required is a full mouth reconstruction (FMR). This is not a single procedure but a customized treatment plan integrating multiple dental disciplines. The process focuses on rebuilding the optimal relationship between the teeth, jaw joints (TMJ), and chewing muscles.
An FMR plan often requires the expertise of specialized dentists. These include a prosthodontist to manage the overall restoration design, and an oral surgeon to handle complex extractions, bone grafting, or implant placements. A periodontist may also be involved to prepare the gum and bone tissues before final restorations. Full mouth reconstruction is always phased, often taking many months to complete, to allow for biological healing time.