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Reconstructing your smile

Smile Makeover

If you are unhappy with the appearance of your smile, and are looking to get all of your teeth fixed, the team at Advanced Dental Artistry will work with you to tailor a treatment to suit you and your oral health.

Overview

If you feel you need all of your teeth fixed, this can mean a few different things in terms of actual treatment, and it can be hard to make this diagnosis yourself. However, if you suffer from one or more of the following issues, then you may consider full teeth replacement:

  • Heavily broken down or decayed teeth
  • Uncomfortable dentures
  • Loose teeth or multiple missing teeth
  • Chronic gum and bone disease
  • Chronic Jaw and bite problems

Given the variety of causes for a full teeth replacement, there are a number of solutions available. Of course, every case is different – this is merely an overview of some of the procedures that can be involved when fixing all of someone’s teeth. For a more personal idea, then feel free to come in for a free consultation with Advanced Dental Artistry, where we will be able to discuss your individual needs further.

We see many patients that actually come into the practice with some of the most complicated dental needs. These are people that normally lost a lot of back teeth, may have some gum problems, may have loose teeth, may have broken teeth and usually have not only bite issues but also have a cosmetic need. When we’re doing cosmetic treatment, one of the most important things is planning and I suppose when we’re planning these cases it’s usually all aspects of dentistry, whether it’s implants, whether it’s cosmetic veneers in order to create the most perfect result.

Missing Teeth

All-on-4®

Suitable for:

  • Heavily broken down or decayed teeth
  • Uncomfortable dentures
  • Loose teeth or multiple missing teeth

What is All-on-4?

All-on-4 is a type of dental implant procedure that involves replacing an entire arch of teeth. The technique uses four dental implants which are strategically positioned to support a full arch of prosthetics. In the past, such extensive replacement would require many implants and would take quite some time. With the technology of All-on-4, only four implants are necessary, and placement takes only a few days.

Dental Implants

Suitable for:

  • Loose teeth or multiple missing teeth

What are dental implants?

Dental implants involve replacing missing teeth with an implant device and prosthetic. An implant, made of biocompatible material, is inserted into the place of the missing tooth. After, a prosthetic tooth (which has been shaped and coloured to your liking) is placed on the implant.

Severely Broken Down Teeth

If your teeth have passed the point where they can be saved, this means the foundations are no longer strong enough for us to build upon and restore, we would then explore the opportunity of dental implants or traditional dentures.

In some cases, however, we can find that although the teeth seem extremely broken down – they can actually be saved due to having strong foundations and healthy or treatable surroundings.

Dr. Kat: Hi. It’s Dr. Adrian Kat here from Advanced Dental Artistry here in West Perth. I want to have a chat with you today about dental implants and all-on-four treatment and what we’re really talking about here is either replacing one tooth all the way through to replacing all of the teeth. When it comes to a single missing tooth and especially a back tooth, what we normally find is that it’s usually because the tooth has been extracted and that could have been because of decay, gum problems or fracturing. And it’s also caused those here that can’t be saved because of these problems. It’s exactly the same with front teeth. Either the tooth has been lost due to trauma, or it’s a situation where a tooth has broken to the point where we can’t save the tooth anymore.

When it comes to missing all of the teeth or the teeth are unsavable, usually, if all the teeth are missing, of course, the patient will present with dentures. And we know that historically dentures have been very good, they normally fit very well when they’re first placed, but over time as the mouth changes and the dentures become bigger, the dentures become much harder to deal with. They lose suction, they move, and they become very irritating. If it comes to people that have unsavable teeth, generally, it’s patients that have broken down teeth, decay, or they’ve got very aggressive gum problems, and in these instances, it’s either removing the teeth and going to dentures or looking at another alternative.

So what are the problems with missing teeth? I took this photo of a patient who lost a lower molar around about 15 years ago and you can see how the top molar that was opposing it has actually dropped into the space. Also, the back tooth has actually started to tilt forward into this space, and I’ve also put a line here where the gum and the bone that was out towards the front of the mouth where there are teeth, and you can see that the bone in the gum has actually shrunk away. So what we’re looking at is when a tooth is lost over time, the gum and bone will start to shrink.

On a kind of mass scale is that when we see someone has had multiple teeth taken out, you can see that it’s different areas of the mouth that have got teeth missing so, therefore, they don’t have any bone, and in teeth areas that they do have teeth, there are some… there is bone actually present. So this is what it looks like with a patient that has their denture in. When they have their denture in, you can see that they have lip support, but when they take their denture out, you can see how their face actually changes. So what is the real impact of poor or missing teeth? I’d like to play you a video of Ian and in his words, he describes what it’s like to live with teeth like that.

Ian: I could have been a ventriloquist. I could have. I was getting to that point where I could talk without any movement whatsoever. Just having that…not having that conscious feeling continuously, like getting up in the morning… It loses you 24/7, you know, the fact that, are they gonna break today? Did a customer notice? At 14 jobs and inspections a day, you know, every customer has spent thousands of dollars with Trevis [SP], they’ve all got problems with it, and I’m trying to, you know, keep them happy and you know, I was just so self-conscious of it. Unbelievable. Now watch out.

Female: I watched him being a really confident, outgoing person to somebody that was quite inward and quite anxious if we went out or was quite happy to stay indoors.

Ian: You know, going to… Trevis had put on a lot of parties and every single social event, you’d be going and going, “Right, now I gotta keep my lip down, got to stop. Don’t laugh too much, you know, laugh with your hand up.” And it’s just surviving. But I know now I can just laugh and not have that conscious, you know, plate and then the missing ones.

Female 2: It’s wonderful that you feel that already.

Ian: Oh, it is. It can only get better from here on out. Truly amazing.

Dr. Kat: So what is the solution? Over 50 years ago, an orthopedic surgeon learnt that if titanium was placed near the bone, the bone would actually fuse to the metal and this became like a root of a tooth. From there, they were able to place things like porcelain crowns over the top and this was really the forefront for all knee reconstructions and hip reconstructions and of course, plates when someone breaks a bone. If someone’s missing all of the teeth, it’s possible to replace all of the teeth and this is between 12 to 14 teeth by just using 4 implants. And what all-on-four is, is basically replacing teeth, but also replacing the lost gum and the lost tissue. This is a closeup photo of an all-on-four bridge and you can see the beauty in the teeth, but you can also see how we’ve copied the gum too. So when someone comes to get all-on-four treatment, the idea is to make sure that not only do we give them a beautiful smile and bite, but we also replace the gum, so they get an aesthetic looking result. The undersurface of an all-on-four is actually very, very smooth, and very polished so therefore it makes it very easy to clean.

So a bit about the practice, we’re located in the center of Perth in West Perth, but we’re on the north side near Leaderboard [SP], there’s parking on-site. The practice has been designed around patient comfort, but on the other side of that, we also have an operating theater that allows us to do everything in-house.

A bit about myself is I’ve been a dentist for over 20 years, I’ve been placing implants for almost 15. I actually hold a mastership in implant treatment, and I lecture both nationally and internationally. More important than this is I have a team behind me, and the team is there really to support the patients and without the team, it would be impossible to do this type of treatment. I want you to remember that all the photos you see on our websites or cases that you see are all our own clients, and this is very important because we don’t ever use any stock photos or we don’t ever get images from other websites. We use the latest technology here at Advanced Dental Artistry, and that includes 3D imaging and virtual surgery. That means that we can get an image in three dimensions of a patient’s jaw, and we can place where the implants actually go. We’re also able to use computer-generated surgery where we’re actually using the computer to help us guide exactly where the implant should go. This is a 3D image of a patient’s mouth, and you can see, we can tilt it in every direction and basically see everything that’s happening in the patient’s mouth.

Digital Smile Design has become a very important part of doing cosmetic dentistry and what that means is that we look at the patient’s face and we analyze the patient’s face in order to determine where the smile should actually go. And this is very important because we really want to make sure that the smile and the teeth are in harmony with the patient’s face. A very important aspect at Advanced Dental Artistry is that we have in-house specialist anaesthetists. Anaesthetists are, of course, doctors that have been qualified further, and it’s their role to ensure that a patient is safe and comfortable throughout all dental procedures. In order to ensure the best outcome for the patients, we also have in house technicians. We have two. We’ve basically got a ceramist who does all the porcelain work and the cosmetic work. And we also have a dental technician, Patrick, who actually does all the all-on-four and denture work.

We’re also affiliated with Nobel Biocare and they have over 60 years of science and research behind their dental implants. Just a few things before I go. We offer complimentary visits to see if you’re suitable for this procedure. There are financial options available. This is a warm and caring team and environment, and we’re definitely a judgment-free environment. Our team includes on-site anaesthetists for your safety and a laboratory team to make sure that the end result is perfect. We have been performing dental implants for almost 15 years. You can get permanent teeth in one to three days, which means you get an immediate bite and immediate smile. There is generally no bone grafting required with all-on-four treatment which means that your healing is faster. We are experienced in complicated, difficult, and combination cases, and there’s a proven success rate and guarantee on Nobel Biocare implants. If there’s any questions, please feel free to give us a ring on 1800SMILING. You can organize a complimentary visit, or you can email me directly at dradrian@adaperth.com.au. I look forward to seeing you in the practice.

Smile Makeover

Suitable for:

  • Multiple missing teeth

What is a full mouth reconstruction?

A full mouth reconstruction can use a combination of crowns, bridges, dental implants and veneers to rebuild the structure of the mouth.

Full mouth reconstruction: many patients have actually seen the gradual decline of their teeth over many years, and we’re probably even talking decades here where teeth have gradually been worn down because of grinding or clenching. Maybe they’ve broken some teeth and they’ve had some porcelain teeth done, maybe some restorations. Perhaps they’ve even lost a few teeth here and there.What they’re noticing over time is that every time they go and see a dentist, there’s always a new problem: maybe they need a new crown and new filling. And what happens over time is these teeth actually change in the mouth changes is a lot of the dentistry is done when the teeth have already worn down or they’ve already been damaged and what’s happening is the crowns have been done in a situation where the teeth are actually shorter than they normally would be or perhaps the mouth has actually changed a lot where patients have actually lost teeth.

Full mouth reconstruction means that what we’re doing is we are restoring the entire mouth back to the most ideal bite and the most ideal aesthetics so we’re really looking at the patient from a cosmetic point of view but also a functional point of view to ensure that their bite is actually ideal. When we’re doing this type of treatment, what we’re usually using is porcelain. We’re using porcelain because we know that porcelain is around the same strength as the tooth enamel and we can use porcelain in order to reconstruct teeth best into the ideal position.

When we look at a case, for example like Brendon who’s actually come to see us you can see that his teeth are very very worn down. He’s actually grind so much that he lost the enamel of his teeth probably about 15-20 years ago and by continuing to grind he’s gradually worn more and more of his teeth away. You can also see on the upper left-hand side or upper right hand side in this photo, he’s actually lost one of his teeth he actually was grinding so much that the teeth got so weak the tooth actually ended up breaking and he lost that tooth, so now he’s got a missing tooth on that upper left-hand side.

Full mouth reconstruction means that we could have placed a new tooth into that position. He’s lost a tooth and we could put a new tooth in there. But when we see all the damages that has been done it would mean that that crown that we would put in would be in the totally wrong position for him because it would be basically in his ground down position. By using porcelain what we were able to do is actually build his teeth up into a new position.

This is very costly treatment of course, because porcelain treatment is very costly to actually do. And by reconstructing the mouth we’re really working on all of the teeth so usually we say to the patient that it’s like the cost of having a new car. But for patients that have gone through the cycle of continually having treatment done, maybe a crown over year or filling over year or losing a tooth here and there, what we’re doing is building the teeth up so that we’re looking at very very long-term treatment that is really going to not only give the patient a perfect smile, but also the best bite possible.

The other side of this treatment too of course is that there are some patients that have teeth that are so badly broken down, so badly broken down to the point that it’s really illogical to try keep doing more and more dentistry to try and save the teeth. In these situations if the foundations of the teeth are weak or there’s a lot of gum disease or there’s a lot of broken down teeth or there’s only very few sound teeth left, is that sometimes we look at replacing all of the teeth with dental implants using the all-on-four dental implant treatment.

Jaw Issues

In some people, poor teeth and/or a poor bite can lead to a condition called TMD – ‘Temporomandibular Joint Disorder’ which can cause additional problems from clenching and grinding. Providing the foundations of the teeth are good, symptoms like these can be corrected using bite reconstruction treatment or ‘neuromuscular dentistry’.

Hi, it’s Adrian Kat from Advanced Dental Artistry. I’d like to briefly talk about neuromuscular dentistry and what that term actually means. As dentists, we are often focused on problems with the teeth. For example, a broken tooth, a decayed tooth, there’s gum problems. What we’re doing is we’re fixing problems that are really individual teeth or individual problems. We have to remember though that the mouth, and the teeth, and the bite is part of a bigger system, and we know, for example, that the bite affects the jaw joint. The jaw joint and the bite also affects the muscles that actually allow this jaw to open and close. If you talk to any physio or chiro, they will actually have a chat to you about how this is a very, very tight system where, if there is imbalance in the bite or the jaw joint or the muscles of the head and neck, what will happen is it will have a detrimental effect on the rest of the spinal column. This includes pain in the neck, pain in the upper back, and sometimes going all the way down through the posterior chain.Neuromuscular dentistry is really trying to find that balance and harmony. If we have a patient for example that has worn their teeth down or is missing teeth or is grinding or clenching or has some of these symptoms that can sometimes be called temporo mandibular disorder, and that’s something that you can research yourself. There’s a lot of symptoms that this syndrome actually has. What it really is saying is that the bite is out of balance. If we can find the harmony between the teeth and balance the jaw joint and the jaw muscles correctly, most of those symptoms actually go away or can be totally eliminated.

Neuromuscular dentistry really is looking at the mouth, and the teeth, and the bite holistically and making sure that the jaw joint and the jaw muscles are in harmony when we complete dental treatment.

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Case study

Full mouth reconstruction

 

Brandon - Full mouth reconstruction

Brandon’s teeth had over time become worn down and were breaking, and this was causing an irregular bite which was further creating problems. However, the roots of his teeth and his gums were in good health, which means we used porcelain restorations to restore the appearance of his smile.

Click here to read and see his amazing transformation

 

Can I see results of others who have had all of their teeth fixed?

Please see below the examples of just some of our many happy clients who have had their dark teeth problems resolved. We thank these clients for allowing us to share their amazing results and stories.

We will assess every case closely to determine the best long-term treatment options for every client we meet.

Sometimes we need to look at the entire mouth and it’s bigger system to fix recurring or ongoing problems and create long-term dental success.

 

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If you have any further questions or queries, don't hesitate to contact us.