Q: Dear Dr. Crapo: I’ve been a working man all my life. I own a company and work right along with my employees. During the day there’s a lot of manual labor and then lots of admin in the afternoon and early evening. This goes on day in and day out. The work is very steady and intense so I’m onsite every day.
Often weekends are needed to get the job done. Work is never off my mind. The reason for this ramble is that I’ve never looked after my teeth. If I couldn’t stand the pain I’d just have the offending tooth out. I’ve lost three teeth that way and I’ve got two more just about in that category.
My wife said to me recently, “I love you and accept you but you’ve got broken teeth and you just don’t look respectable. You’ve got a great business, you’ve got the money, go get yourself fixed up. Nobody in the company will hold it against you for taking time off to get your teeth fixed”.
Now as much as I am grateful she feels that way, I must confess I have a terrible gag reflex and that worries me more than root canals or implants or long sessions in the chair. As soon as the dentist puts his mirror in my mouth I start to gag. It’s embarrassing and is the reason I haven’t come in. The last extraction 15 years ago was quite a session with my gagging and the doc reefing. I saw a dentist and he said I had good bone, two teeth might be past saving but I needed implants or bridges and all my teeth needed crowning. He called it a full mouth construction or something like that. How am I going to get this done?
A: Full mouth rehabilitation or reconstruction is a term used to communicate that most or all of the teeth, the jaws and temporo mandibular joints, must be fitted in such a way that the function (chewing), comfort (joints and muscles), speech and esthetics, are restored to an acceptable state for a person to carry on in life without any part of the system calling attention to itself.
Complete dentures top and bottom can be a reconstruction, crowning the existing teeth, using implants to support crowns or dentures, all can be part of that as well.
There is a great deal to plan, x-rays to take, impressions of your mouth etc. If gagging is a major barrier, that can be taken care of by I.V. sedation which works wonders. While sedated, all the necessary records needed to create a plan can be taken. After you're happy with a plan, all your dentistry can be done using the same sedation technique. You're not alone; we treat a number of folks with a gag reflex similar to what you've described.