Full-Mouth Rehabilitation — What I Learned

By: Devin Hodell

In the course of my dental residency, I completed a full-mouth rehabilitation over the course of this time, working closely with my supervisor, Dr. Nicholas Fontana, and a number of specialists.

The case was definitely complex — I’ve been told that full-mouth rehabilitations like these are reserved almost exclusively for graduate students and dentists with years of experience.

It’s almost unheard of for someone at my level to take on a case like this!

Full-Mouth Rehabilitation: What It Entailed

As we all know as dentists and dental students, full mouth rehabilitation consists of rebuilding and/or replacing all of the teeth in a patient’s mouth.

My Patients Case Involved:

  • Crown lengthening for both upper and lower anterior teeth
  • An apicoectomy
  • Periodontal surgery

…over the course of almost a year. If this patient hadn’t come to us at the university, he would have needed to see a variety of specialists; I think we saved him about $70,000 in medical bills!

Full-Mouth Rehabilitation: The Process

He was a great patient. He did everything he needed to do without complaints and was very cooperative, so the process was relatively streamlined.

There was just one problem: he only spoke Spanish!

Over the course of the case, we had to use an interpreter to communicate and work everything out.

While at first I was worried that it might slow the case down, it actually made me more aware of the best ways to communicate. Of course, I emphasize transparency with every case, but the language barrier made me express what we were doing very deliberately. 

Finally, as I mentioned, there were a number of specialized aspects to this case — so of course, I had to work with a number of specialists.

Integrating the various experts into one case is completely different from dental school where you study specific procedures, so I learned so much about the value of planning and transparency within a team. 

Every specialist acted as a mentor, too, so I could learn more about the particular field of dentistry they work in.

However, my main supervisor, Dr. Nicholas Fontana, was more of a mentor than anyone else. His philosophy toward dentistry is truly amazing. The most valuable thing he said to me was this:

Stay committed to excellence.

Dr. Nicholas Fontana

It’s easy to waver and accept, good enough, but we have a responsibility — both personal and professional — to work with standards of absolute quality.

Achieving a Standard of Excellence

Getting to that standard of excellence obviously involves a lot of things.

For one, Dr. Fontana insisted on finding the perfect results with virtual imaging and temporary crowns before moving on to the final work.

He emphasized communication, too — we were lucky that the patient was very cooperative and ready to do things right, but the case really emphasized the importance of transparency with the patient and with my team. 

I was really fortunate to meet Dr. Fontana and work with him so closely. He made it clear that mentorship is central in dentistry, and not just for the student.

Dr. Fontana told me that,

Dentistry is like a well — in your early years, you take others’ experiences from the well and learn from it. But the well has to be replenished. Once you have some seniority, you’re responsible for ensuring that the people joining our profession have some guidance.

Dr. Fontana

At every step of the case, he made sure that I was doing quality work; but he also made sure that I was learning everything I could.

Challenging myself with this case was extremely rewarding — it taught me the practical value of planning and communication, and left me with professional standards which I plan to hold for the rest of my career.

Photo by Andrea Piacquadio

Devin Hodell

Devin Hodell

Devin Hodell is a general dentist in Chesterfield, MI. She graduated with honors from the University of Detroit Mercy School of Dentistry in the class of 2021. Dr. Hodell went on to complete a one-year, general practice residency at St. Joseph Mercy Oakland Hospital in Pontiac, where she earned an award for Clinical Excellence and Professionalism in Dentistry.