Full Mouth Reconstruction in Brookline: What It Is and Who Needs It
By Dr. Ya-Ting Yu, Periodontist & Prosthodontist | Pleasant Dental Associates
Full mouth reconstruction is one of the most complex things we do at Pleasant Dental Associates — and one of the most rewarding. Patients who come to us for reconstruction have often been told by multiple dentists that their situation is too complicated, that they'd need multiple specialists, or that there's nothing to be done. We hear that a lot. And most of the time, we can help.
What makes full mouth reconstruction different from a smile makeover or getting a few crowns is scope and coordination. It involves rebuilding the entire bite — every tooth, the gums, and often the bone — in a carefully sequenced plan that can span months to years. Done right, the result isn't just a better-looking smile. It's a healthy, functional, stable mouth.
Who Needs Full Mouth Reconstruction?
Candidates typically have one or more of the following:
Severe gum disease that has caused bone loss and tooth mobility across most of the mouth
Extensive decay affecting most or all teeth
Severe wear from grinding (bruxism) that has shortened or flattened the teeth
Multiple missing teeth with collapsed bite and altered facial appearance
Trauma that has fractured, displaced, or knocked out multiple teeth
Congenital conditions affecting tooth number, size, or enamel quality
Many patients present with a combination — for example, longstanding gum disease that led to bone loss, followed by tooth loss, followed by collapse of the bite and shifting of remaining teeth.
Why Having Both Periodontal and Prosthodontic Expertise Matters
Full mouth reconstruction requires two distinct specialties working together: periodontics (gum and bone health, implant surgery) and prosthodontics (crown, bridge, and implant restoration design). At most practices, these are separate doctors at separate offices, with the patient coordinating between them.
At Pleasant Dental Associates, all four of our doctors hold specialty board certification — and I hold dual certification in both disciplines. That means the surgical planning and the restorative planning happen in the same mind, in the same room. The bite is designed before the surgery begins, not after. The implants are positioned for optimal crown emergence, not just adequate bone. The final result is engineered from the start.
The Reconstruction Process
Phase 1: Comprehensive Evaluation
We start with a full periodontal exam, digital X-rays, CBCT scan, photographs, and bite records. For complex cases, we may fabricate diagnostic wax-ups — physical or digital models of what the final result will look like. This gives us — and you — a clear picture of the destination before we begin.
Phase 2: Foundation Work
All surgical treatment comes first. This includes treating active gum disease, extracting teeth that can't be saved, bone grafting to rebuild lost structure, and placing implants. Nothing restorative is finalized until the foundation is stable.
Phase 3: Restoration
Once healing is complete and the periodontium is stable, we build the restorations. This may include crowns, bridges, implant crowns, veneers, and sometimes complete implant-supported arches. The order and sequencing matter enormously and are planned in advance.
Phase 4: Maintenance
After reconstruction, patients transition to a customized maintenance schedule — typically every 3 months — to protect the investment made. We also address any bruxism with a custom night guard to protect crowns and implants from grinding forces.
Frequently Asked Questions
Q: How long does full mouth reconstruction take?
A: Timelines vary widely by complexity. A case involving implants with bone grafting may take 12 to 24 months from start to finish. Simpler cases without implants may complete in 3 to 6 months.
Q: How much does full mouth reconstruction cost?
A: Cost depends entirely on the scope. Cases can range from $15,000 to over $60,000. We provide a detailed itemized treatment plan with costs at your initial evaluation. Many patients phase treatment over time to spread costs.
Q: Will my insurance cover any of it?
A: Portions are often covered — particularly periodontal treatment, extractions, and crowns placed for functional reasons. Implants and cosmetic elements are less likely to be covered. We help you understand your benefits before starting.
Q: Is it too late for me to get this done?
A: Almost never. We work with patients in their 60s, 70s, and beyond. The question isn't age — it's overall health, bone availability, and realistic goals. We'll tell you honestly what's possible at your evaluation.
Ready to Schedule?
Pleasant Dental Associates is a specialist-only practice at 1318 Beacon Street Suite 20, Brookline, MA 02446. Our board-certified periodontists and prosthodontists — all faculty at Boston University and Tufts — offer complete surgical and restorative care under one roof.
New patients: $259 exam, X-rays & cleaning special. Book online at dental4.me/pleasantdental/1 or call 617-975-3399.
