All-on-4 Dental Implants: Procedure and Costs

What are All-on-4 Dental Implants?

If someone has missing teeth or teeth that need to be removed, they might consider implants. Implants are artificial tooth roots that are surgically inserted into the jawbone. They can work as standalone teeth or as stable bases for permanent dentures and bridges. With appropriate care, permanent dentures last longer than standard removable dentures.

According to the American Dental Association (ADA), implants are one the biggest advancements in dentistry in the last 40 years.¹ They are strong and effective alternatives to traditional removable dentures.

Traditional dental implants either use one small titanium screw per single tooth or 6 to 8 screws per jaw.² All-on-4 dental implants use only four dental implants to secure a bridge or overdenture in place. 

How Do All-on-4 Dental Implants Work?

The All-on-4 implants replace natural teeth using only four implants, including two angled implants. This is particularly beneficial for people with a lot of bone loss towards the back areas of the mouth.^3,4

During the procedure, a dentist places two implants vertically at the front of the jaw and two towards the back of the jaw at an angle of up to 45 degrees. 

The tooth portion of the dental implant is typically made of one of three main materials:

1. Acrylic — also known as resin, acrylic teeth are typically the least expensive.
2. Porcelain — this is the most durable type, but can cause wear to natural teeth. They are usually the most expensive option.
3. Zirconia — zirconium oxide is described as ‘ceramic steel’ due to its strength and wear properties. 

The exact cost varies depending on where you receive treatment.

Who is a Candidate for All-on-4 Dental Implants? 

All-on-4 candidates include people who have lost teeth due to:

• Tooth decay
• Injury or accident
• Gum disease
• Damage to the face and teeth, such as from mouth cancer

Full-mouth dental implants are a permanent, sometimes more comfortable alternative to regular dentures. 

All-on-4 dental implants are usually only suitable for people who have many missing teeth. This is because they involve removing whatever teeth are left.

Alternatively, if someone has multiple unhealthy teeth, a dentist might recommend removing only the unhealthy ones and replacing them with implants.

Certain people may not be a good candidate for All-on-4 dental implants. These include people who have:

• A current or present history of smoking
• Uncontrolled diabetes
• Significant jawbone loss
• Had radiation therapy to the head and neck
• Only one tooth that needs to be replaced

All-on-4 Dental Implants Procedure: What to Expect

For most people, the All-on-4 dental implant procedure is a safe and effective way to replace missing natural teeth. Expect the following before, during, and after the procedure:

Before

Before the procedure, talk to your dentist about any concerns you have, your expectations, and your budget. Your dentist will take several scans of your mouth to ensure you have appropriate bone heights for treatment.

If you smoke or consume alcohol frequently, your dentist will likely advise you to try to stop before surgery, as these habits can slow wound healing.

Some people are eligible for ‘same-day implants,’ where the entire procedure happens in one visit. Your dentist will help you manage expectations. It is common for people to have temporary teeth until the permanent replacement teeth are ready.

During

The All-on-4 dental implants procedure usually follows the same steps regardless of the provider:⁵

1. The dentist will remove any remaining teeth before placing the implants.
2. Then, they will surgically place the implants into the jawbone. You will most likely receive local anesthesia so you don’t feel pain.
3. The bone around the implant will need to heal. This process is called osseointegration, which means ‘combines with bone’ and can take several months.
4. While the implants heal, the dentist will typically place temporary replacement teeth onto special abutments.⁶
5. The dentist will require you to follow a special diet while the gums heal and osseointegration takes place.
6. They will take impressions of the mouth to ensure the permanent teeth fit perfectly.
7. After around 6 months, when the gums have fully healed and the implants have bonded with the natural bone, the dentist will place permanent replacement teeth.

After

Your dentist will provide appropriate aftercare instructions. After the procedure, stick to soft foods, such as:

• Warm (not hot) soups
• Scrambled eggs
• Oatmeal.

Soft foods help prevent you from putting too much pressure on your new implants while they heal. 

You should also limit citrus-based drinks, such as orange juice. Acidic drinks can irritate the wounds and damage new implants. 

Also, try to avoid carbonated beverages during the first few weeks after surgery. Evidence suggests that drinking these can disrupt oral wound healing.⁷

For the first week or so after the implants are surgically placed, your dentist may give you antibiotics. Take them as prescribed.

After your dentist places the permanent replacement teeth, you can return to your regular diet. Your dentist will instruct you on any specific foods or drinks to avoid.

Dental implants can’t get cavities, but gum disease can still develop. Practicing good oral hygiene helps maintain healthy gums, teeth, and mouths. 

How Much Do All-on-4 Dental Implants Cost?

The price of All-on-4 varies but generally costs between $12,000 and $25,000 per arch. 

Factors that impact the price of implants include:

• Geography — depending on where you live, the cost of living may be higher or lower, and therefore dental care costs may vary. Additionally, treatment in a city may cost more than it would in a smaller town.
• Practitioner experience — the experience level of the dentist performing the procedure will impact the cost. Newer dentists usually charge less than those with more experience. Always weigh the risks and benefits of choosing a newer, cheaper dentist. 
• Implant material — different materials cost different amounts so it depends on what type of material your dentist makes the implant out of.

Discuss your payment options with your dentist. Some dentists offer a payment plan, which can make treatment more affordable.

Does Dental Insurance Cover Implants?

Typically, insurance does not cover dental implants. This is because insurance companies don’t consider them a medically necessary procedure, but rather, a cosmetic treatment.

However, some insurance companies might cover part of the treatment cost. Speak to your insurance provider to find out what dental care they cover.

All-on-4 vs. Traditional Implants vs. Snap-On Dentures

Some people may be better candidates for traditional implants than All-on-4 implants. Others may prefer traditional dentures, also known as snap-on dentures. 

Below are the main differences between these three treatment types:

Everyone requires a different treatment plan, so it’s important to discuss options with your dentist.

Summary

All-on-4 dental implants are a relatively safe technique for replacing a person’s teeth. For some people, new implants will last the rest of their lives.

Not everyone is a good candidate for dental implants. Discuss your treatment options with your dentist to find out which one is best for you.