What All-on-4 means in plain words
All-on-4 is a way to replace a whole row of teeth using only a few implants. A full set of fixed teeth, called a full-arch bridge, is attached on top. You do not take it out at night like a denture.
The name comes from the idea of using four implants to hold one arch, which is the whole upper row or the whole lower row. Many offices now use four to six implants, depending on your bone and your bite. Dentists also call this a full-arch or full implant fixed restoration. At KDA, the service is listed as Full Implant Fixed Restorations.
How it is different from one implant per tooth
If you replaced every missing tooth with its own implant, you would need many implants. That means more surgery, more healing and a higher cost. A full-arch plan spreads the chewing load across a smaller number of well-placed implants.
Some of the implants are often placed at an angle. That lets the dentist use the denser bone in the front of the jaw and avoid areas where bone is thin or where there are sinuses (air spaces) or nerves. Careful planning from a 3D scan is what makes this possible.
The result is a fixed bridge of teeth. It is screwed onto the implants, so it feels and works much more like natural teeth than a loose denture.
Who is a good fit, and who may need another plan
Full-arch implants are usually for people who are missing most or all of their teeth in one or both arches, or who have teeth that are failing and cannot be saved. They are also a common answer for people whose dentures have never felt right.
A good candidate usually has:
Enough healthy jawbone, or a plan to build more with a graft; Gums that are healthy, or treated first; Good enough general health to heal from surgery; A willingness to keep up daily cleaning and regular visits.
Cleveland Clinic lists several things that may make implants a poor fit, including active or untreated gum disease, extensive tooth decay, poor oral hygiene, severe bone loss, bone disorders, some autoimmune diseases and unmanaged diabetes. It also says smoking or vaping can disrupt healing.
None of these automatically close the door. Many can be treated first. A person with gum disease can have it treated and then return to the plan. A person with thin bone might need a graft. A person with diabetes may do well once it is under control. The point is that your dentist needs to look at all of this before saying yes.
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What the process looks like
Every office has its own steps, but a typical path looks like this:
- Exam and 3D scan. We look at your gums, your bite and your bone.
- Treatment plan. You see the plan, the timing, the choices and the cost before you decide.
- Any needed prep, such as removing teeth that cannot be saved or treating gum disease.
- Implant surgery, often guided by a surgical guide made from your scan.
- A temporary set of teeth in some cases, so you are not without teeth while the bone heals.
- The final fixed bridge, once the bone has fused to the implants.
Healing, cleaning and what to expect
As with any implant, the jawbone needs time to grow around the posts. Cleveland Clinic says this takes about three to nine months. Soreness and swelling in the first week are normal and can be eased with store-bought pain relievers.
In some cases, a temporary bridge can be attached sooner so you leave with teeth. Whether that is right for you depends on how strong your bone is and how stable the implants feel on the day of surgery. Your dentist decides that after seeing your scan and the surgery itself, so be careful with any office that promises a fixed result for everyone before examining you.
While you heal, you will eat soft foods. Later, you will clean around and under the bridge with a floss threader, small brushes or a water flosser. A fixed bridge is not a set-and-forget fix. It needs daily cleaning and regular checkups, just like natural teeth.
Because the bridge is fixed, you clean it in place. Brush it twice a day like you would natural teeth. Then clean underneath it once a day. A floss threader, super floss, small interdental brushes or a water flosser can reach the space between the bridge and your gum.
Plan to see your dentist for checkups, and expect your hygienist to clean around each implant with gentle tools. Over time, the bridge itself may need a service, as the screws and the teeth can wear.
If you grind your teeth, a night guard can protect the bridge. Tell your dentist if you notice any cracks, chips or a loose feeling.
Questions to ask any dentist before you say yes
A full-arch plan is a big decision. Ask these things at your consultation, and expect clear answers:
- Who will place my implants, and how many have they done?
- Will you take a 3D scan, and will I see it?
- How many implants do you recommend, and why?
- Do I need a bone graft or any teeth removed first?
- What will I wear while I heal?
- What is the full cost, including the scan, the surgery, the temporary teeth and the final teeth?
- What happens if something goes wrong, and who do I call?
How it compares with dentures
Many people look at full-arch implants because their dentures have been a daily struggle. A removable denture can slip when you eat or speak. It can rub the gums. And it rests on the bone, which does not get the signal to stay strong, so the jaw can keep shrinking over the years.
Implants send chewing force into the bone, which helps keep it in place. A fixed bridge also does not need adhesive, and most people say it feels more like their own teeth.
Still, dentures are a valid choice. They cost less up front, need no surgery and can be a good answer for some people. We cover the comparison in our guide to implants, bridges and dentures.
Full-arch implants at KDA
KDA offers full implant fixed restorations at our office in the Kendall Mall. We take a 3D scan (CBCT) in the office and use surgical guides made from your scan. Dr. Alfredo Calderon has over 15 years of experience in both the surgical and the prosthetic side of implants.
Not sure whether this fits you? Call 305-271-1421 and ask about a free implant evaluation. We are at 8833 SW 107th Ave in Miami, open Monday to Friday, 8:00 AM to 5:00 PM. Financing is available, and we accept most dental insurances and most Medicare supplemental plans.
Common questions
Is All-on-4 the same as a denture?
No. A denture rests on your gums and is taken out. A full-arch implant bridge is held by implants and stays in your mouth.
How many implants are used?
The name says four, and many cases use four to six. Your dentist decides from your bone and bite.
Can I get All-on-4 if I wear dentures now?
Often, yes. Many people choose it after years of loose dentures. A 3D scan shows whether you have enough bone.
Does All-on-4 always mean teeth on the same day?
No. It depends on your bone and how stable the implants are. Your dentist can tell you after the exam and scan.
How do I clean a fixed bridge?
You brush it and clean underneath with tools like a floss threader, small brushes or a water flosser. You also keep regular checkups.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: my.clevelandclinic.org, mouthhealthy.org.