If vertical dimension has been lost to wear, restoring it lengthens the lower face and supports the lips, and most people find the change favourable. This is precisely why it is tested in provisionals first, where you can see it in your own face and live with it before anything becomes permanent.

The appointments themselves are done under local anaesthetic and are long rather than painful. Adapting to a new bite position commonly involves some muscle soreness and speech adjustment over the first weeks, which is expected and settles.

What if I do not like how the provisionals look?

That is what they are for. Provisionals are meant to be adjusted, remade and argued with — it is far better to resolve a disagreement about shape, length or shade at that stage than after definitive restorations are fitted.

Bite Reconstruction

Full-mouth reconstruction rebuilds the biting surfaces of most or all of the teeth to a deliberately determined jaw position. It is the most involved treatment offered here, and the part that determines whether it lasts is not the ceramics — it is the planning and the provisional phase that precede them.

When it is genuinely indicated

The clear indications are severe generalised wear that has shortened the teeth and reduced facial height, widespread failing restorations reaching the end of their life together, a collapsed bite following tooth loss where remaining teeth have drifted and over-erupted, and severe erosion. What is not an indication on its own is dissatisfaction with appearance — that is usually addressable far more conservatively, and reconstruction is a poor way to buy an aesthetic change.

Establishing the position to build to

The central question is which jaw position the new teeth should meet in. Where wear has reduced vertical dimension the position must often be reopened, and the amount is a clinical judgement based on facial proportions, speech, the available restorative space and joint comfort. Records are mounted so the position is reproducible in the laboratory. Getting this wrong is what produces work that looks acceptable and never feels right.

The staged sequence

Stabilisation and joint treatment come first, followed by records, planning and a diagnostic wax-up showing the proposed result. Provisional restorations are then placed in that design and worn — this is the test drive, and it is where adjustments happen. Only once the provisional bite is comfortable, functional and looks right is it copied into definitive restorations. Periodontal treatment and any necessary extractions or implants happen before this sequence, not during it.

Living with the result

Reconstructed teeth need protecting. A properly designed appliance worn at night is not optional afterwards — the parafunctional forces that destroyed the original teeth have not disappeared, and ceramic is harder and more brittle than enamel. Regular review checks the restorations, the joint and the appliance fit. Well planned, well maintained and protected, this work lasts many years; unprotected, it can fail within a small fraction of that.

Common questions

Will my face change?: If vertical dimension has been lost to wear, restoring it lengthens the lower face and supports the lips, and most people find the change favourable. This is precisely why it is tested in provisionals first, where you can see it in your own face and live with it before anything becomes permanent.
Is it painful?: The appointments themselves are done under local anaesthetic and are long rather than painful. Adapting to a new bite position commonly involves some muscle soreness and speech adjustment over the first weeks, which is expected and settles.
What if I do not like how the provisionals look?: That is what they are for. Provisionals are meant to be adjusted, remade and argued with — it is far better to resolve a disagreement about shape, length or shade at that stage than after definitive restorations are fitted.

Not sure where to start?

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Related Care

All Reconstruction