All-on-4® FAQ

Who is not a candidate for All-on-4 dental implants?

Dental patients who do not make good candidates for All-on-4 have a history of poor oral health and have underlying conditions such as uncontrolled diabetes that would make healing after the implant surgery difficult or unusually slow. Smokers typically have a poor healing response and should quit smoking before having dental implant procedures


How painful is All-on-4?

Is all All-on-4 recovery very painful? There is a common misconception that the recovery from All-on-4 implants is very painful. This is not the case: sometimes there is a dull ache over a few days from the swelling, but the discomfort is comparatively very low compared to other surgical procedures.


Which is better All-on-4 or All-on-6 dental implants?

The difference between All-on-4 and All-on-6 dental implants is the number of implants that are placed in the mouth. Some dentists believe that the all-on-6 dental procedure provides a stronger, more stable base for the prosthetic dental arch, resulting in a longer-lasting, more comfortable smile. Dr. Kleinman will place as many implants as possible given the amount of bone available. Implants need bone in between each one, so too many can be detrimental. Dr. Kleinman carefully plans out the implant placement virtually prior to the surgical date for ideal outcomes.


What does the All-on-4 include?

The fee for an All-On-4 procedure includes everything from start to finish. Extractions, bone reduction, dental implant placement, bone grafting if necessary, and all the parts for the interim and final prosthesis are included in the flat fee.


Does food get under All-on-4 dental implants?

Unlike a crown placed on top of a tooth, there is no space where any food can get trapped under a dental implant. Implant-supported dentures are a bit different. Instead of individual crowns, the full-arch denture is fixed to all 4 titanium implants and abutments. A Water-Pik or similar appliance is needed to clean around and under the prosthesis.


How many teeth are in All-on-4?

The prosthesis fabricated on top of the implants has usually 10 to 14 teeth, and it is placed immediately. Dr. Kleinman will match the number of teeth in the prosthesis with the number of teeth in the opposing jaw.


How long does the All-On-Four procedure take?

Although the initial procedure is done in one visit, the patient will return to the general dentist for the final prosthesis after the implants have integrated into the bone (which is around 3-4 months).


Does the All-On-Four procedure have gums?

The transition line from the fixed hybrid denture must not be visible when the patient smiles, so some gingiva is fabricated into the prosthesis to hide the transition line.


What are the downsides of dental implants?

With good medical health and patients who do not use nicotine, the success rate with dental implants is 97-99%.  With underlying medical problems and tobacco/vape/nicotine patch & gum users, that percentage rate goes down dramatically. For these patients, dental implant procedures are contraindicated.  There is always a chance of dental implant failure or loss of integration, but we limit it with case and patient selection. Patients taking long-term steroids and bone-sparing drugs for osteoporosis/osteopenia may also not be good candidates for implant procedures. Luckily, there are tests to see if these patients are good candidates for these procedures.


What do All-on-4 feel like?

All-on-4 dental implants are designed to be comfortable as they do not press down on your gums as traditional dentures would. You will soon be able to bite with increased force and experience the normal sensation of enjoying hot or cold foods and all their flavors again.


What if I don’t do the All-on-4 procedure?

Progressive bone loss occurs when someone loses their teeth. Without stimulation of the bone from the roots (implants), the bone rapidly resorbs (up to 25% within the first year).  Dentures and crowns may mask the cosmetic issue, but they don’t address bone loss in the jaw, which ultimately leads to a weaker jaw bone. Over time, the patient will have the sunken-face look that is very unaesthetic. Dental implants stimulate the bone to prevent resorption and maintain good facial aesthetics.