All-on-4 Dental Implants: Cost, Procedure and Other Useful Information
If you need full mouth implants to replace lost teeth, you’ll almost certainly be looking at ways to save money on your treatment. All-on-4 implants offer a more cost-effective solution as they require fewer implants in the jaw than traditional methods.
In this article we’ll answer questions you might have about getting All-on-4 dental implants such as:
- How much does the All-on-4 procedure cost in the US and the UK?
- What does it involve?
- Is this type of implant safe?
- Where can I find an All-on-4 dentist?
- Are there ways to lower the cost further?
- What’s the difference between implants and dentures?
Table of contents
- 1 What are All-on-4 implants?
- 2 The fitting procedure
- 3 Where can I get All-on-4 dental implants?
- 4 How much do All-on-4 dental implants cost?
- 5 All-on-4 reviews and studies
What are All-on-4 implants?
All-on-4, a registered trademark of Nobel Biocare, is a technique for replacing teeth using fewer implants than traditional methods. This technique carries the following three traits:
1. As few as four implants per jaw
Whereas a full mouth of implants using traditional methods would require 8-10 implants per jaw, the All-on-4 technique uses just four. Sometimes five or six are needed on the upper jaw due to lower bone density.
2. Angled rear implants for optimum strength
Rather than being inserted vertically, the rear implants are at a 30-45 degree angle. This means even patients who have suffered bone loss should be eligible for All-on-4 without having to go through the costly and lengthy process of a bone graft.
3. The ability to be implanted and fitted in a day
This last trait has earned them the nickname ‘teeth in a day’, ‘smile in a day’ or ‘same day teeth’. This is a drastic improvement on traditional implant procedures which can take six months or more to complete with extensive recovery time at each step of the progress.
The following animation shows how All-on-4 treatment works:
All-on-4 dental implants offer many benefits over conventional implants and removable dentures. These include:
- Short treatment and recovery time
- Implants placed on the same day as extraction
- Comfortable and stable structure to support crowns and bridges
- Fixed in place – no need to remove for cleaning
- Don’t slip or fall out
- Suitable for patients with jaw bone loss
- Cheaper than traditional techniques that use 8-10 implants
Of course, there are also some drawbacks to this type of implant:
- Results may not be as good as with traditional implants
- Some people report problems with spitting or hissing while speaking
- Some dentists see it as a ‘short cut’ to replacing teeth properly
- Not a fully customised solution
- A single implant failing can cause problems with the whole jaw
- The artificial gum bridge may feel bulky in your mouth
Keep reading for more information about each of these pros and cons and how they might affect you.
All-on-4 vs. dentures
The traditional way to replace a full jaw of teeth is with removable dentures. Also known as “false teeth”, these consist of a gum-coloured acrylic base and teeth made from resin or porcelain.
Dentures fit over the gums and stay in place either with suction alone, or with a dental adhesive. Properly fitting dentures shouldn’t require any adhesive.
However, the supporting bone shrinks over time as there are no teeth for it to hold in place, and this change of shape will cause dentures to become loose. This means they need to be replaced regularly to avoid discomfort and problems eating.
Removable dentures are custom-made to precisely fit the patient’s mouth. The upper denture covers the roof of the mouth and the lower one is a horseshoe shape to allow room for the tongue. They must be removed for cleaning, usually overnight (hence the cliché of false teeth in a glass on the bedside table).
In contrast, All-on-4 implants are fixed in place and should act just like natural teeth in terms of appearance, chewing and comfort. There is no risk of them slipping out of place while the wearer is talking or eating.
Although the prosthetic teeth are fixed to an artificial gum, this covers only a small area of the real gum when compared to dentures. The join is hidden far enough behind the lips that it won’t be visible when you smile.
Dentures offer a clear cost benefit over any kind of implants but they do need to be replaced every five years on average.
All-on-4 vs. regular implants
The conventional way to replace a full jaw of teeth with implants would be with a combination of single-tooth implants and implant-supported dental bridges. Bridges allow several ‘teeth’ to be supported by one implant at each end instead of one implant per tooth. This technique usually requires 8-10 implants per jaw for a full set of replacement teeth.
You can read more about how traditional implants are fitted here.
While both techniques involve drilling sockets in the jaw bone, All-on-4 requires fewer implants. This makes the process quicker, easier and more comfortable for the patient. It can also be considerably cheaper because of the reduction in time and materials required.
Aside from the lower cost, a big advantage of All-on-4 is the reduced treatment time. Dentures can be affixed as soon as the implants have been placed, rather than the patient having to wait six months or more for healing as is the case with traditional implants. Usually temporary dentures are placed on the day of surgery and permanent ones are added a few months later.
The following table shows the key differences between dentures, regular implants and All-on-4:
|Placement||Attached to 4-6 titanium implants in the jaw bone||Attached to 8-10 titanium implants in the jaw bone||Rest on the gums; may require adhesive|
|Eligibility||Suitable for patients with bone loss||May require a bone graft||Suitable for most patients|
|Eating||Fixed in place; act like natural teeth; few eating restrictions once healed||Fixed in place; act like natural teeth; few eating restrictions once healed||Can move when you chew; certain foods must be avoided|
|Longevity||10+ years||10-15 years||Will need to be replaced as the gums change shape (every 5 years on average)|
|Bone loss||Implants help maintain the bone||Implants help maintain the bone||Continued bone loss is inevitable, causing the denture to loosen|
|Coverage in the mouth||Artificial gums with minimal contact||Crowns attached directly to existing gums||Acrylic plate covers much of the gums and roof of the mouth|
|Appearance||Like natural teeth; gum join hidden behind lips||Like natural teeth; no artificial gum||Like natural teeth; loss of bone may cause face to sag over time|
|Cleaning||Cleaned like normal teeth||Cleaned like normal teeth||Must be removed for cleaning (usually overnight)|
|Cost per jaw (UK)||£4,000 - £14,000||£8,000 - £21,000||Often available on the NHS; £400 - £2,500 privately|
|Cost per jaw (US)||$12,000 - $25,000||$20,000 - $45,000||$300 - $8,000 depending on material|
The fitting procedure
Your first step in the procedure will be a consultation with your chosen dentist. During this consultation they will examine your mouth and do a CT scan. This scan lets them assess your suitability for implants. They can check your existing jaw bone density to determine precisely where the implants should be inserted.
Your dentist should also discuss alternative treatment options with you before you commit to anything.
If you are a suitable candidate and decide to go ahead, the next step will be dental impressions. These are sent to a lab where your new dental bridge is designed to fit and look just like natural teeth.
Your dentist may also take some x-rays to help with planning your treatment.
If you need to have teeth extracted before your implants are inserted, this can usually be done on the same day.
Your dentist or oral surgeon will probably offer you a sedative to help you relax during the procedure. Then they will anaesthetise you so you don’t feel any pain. If you would prefer to have a general anaesthetic for your All-on-4 treatment, ask your dentist about this at your initial consultation.
After any remaining teeth are extracted your mouth will be thoroughly cleaned to remove any damaged tissue and bacteria.
The dentist drills two or more holes at the front of your jaw to hold the front implants. Two holes at the rear – one on each side – are angled to offer greater support to the rear of the bridge.
Once the implants are placed, your mouth is cleaned again and any incisions are stitched up. It’s common for dentists to use dissolvable stitches which disappear after a week or two.
Either the same day or the following day you’ll be fitted with your new teeth. Some dentists create a temporary overdenture at this stage which is then replaced a few months later. This is often made from resin – a lighter but less durable material – which puts less pressure on your implants while they heal.
Patients usually experience some bruising, swelling and general discomfort in the days after their surgery. You’ll probably want to take a couple of days off work to recover fully and get used to your new teeth.
Your dentist will advise you on the type of foods you can and cannot eat in the months after your treatment. For the first few months you’ll probably have to stick to very soft foods so you don’t disturb the process of the implants fusing with your bone. You might also be advised to avoid things like smoking and heavy exercise for a while.
These implants are cleaned just like your normal teeth – by brushing once a day. Your dentist will also show you how to floss with special tools. You might want to invest in a water flosser with special attachments designed to clean around implants.
Final checks and fitting
6-9 months after surgery your implants should be ready to support a permanent overdenture. This is usually made from porcelain or some other durable and high-quality material.
If you look after your new teeth carefully, they should last for ten years or longer.
You’ll need to return to your dentist for regular checkups and maintenance. Check whether these visits are included in your treatment cost or whether you’ll have to pay for them separately.
Where can I get All-on-4 dental implants?
In the UK
In some very rare cases, NHS patients may be eligible. For this to happen you would need to meet these conditions:
- Prosthetic teeth are deemed medically necessary (probably true if you have lost all your teeth through trauma or cancer)
- You’re unable to wear conventional dentures for some reason
- Your local NHS Trust provides funding for All-on-4
- Your dentist provides these implants
All in all, the chances are pretty slim. More often than not, where a full set of replacement teeth is required, only dentures will be available on the NHS.
The alternative is to find a dentist who offers All-on-4 treatment privately. You may need to look around, since not all dentists are trained to fit implants and not all those trained in implantology will offer All-on-4.
Once you have found a suitable dentist, they will discuss the treatment with you and create a treatment plan. If they feel a different treatment would be more appropriate for you they will recommend an alternative solution.
In the US
Look for an implantologist who specializes in All-on-4 treatment. Make sure they have some experience with this type of implant, since not all dentists use the same systems.
They will discuss your treatment plan at your initial consultation. Remember, if you’re not a suitable candidate for All-on-4 they will recommend an alternative.
Many Americans travel to Central America or other destinations to take advantage of cheaper dental work. If you live near the Mexico border this can be very convenient and extremely cost-effective. Find out more about US dental tourism here.
How much do All-on-4 dental implants cost?
If you’re eligible for implants on the NHS (which, as explained above, is unlikely) you’ll pay the band 3 charge of £244.30.
It’s most likely that you’ll need to pay for private treatment. All-on-4 costs from around £4,000 to £8,000 per jaw with a UK dentist and from $12,000 to $25,000 per jaw in the US. This depends on the number of implants you need and the material you choose for your permanent All-on-4 dentures.
As with any private dental work, it’s a good idea to shop around and get quotes from several All-on-4 clinics in your area. Prices can vary considerably from one to another. However, you shouldn’t get implants based on price alone. It’s more important to find a trained professional who has experience carrying out the procedure you require.
If you find that All-on-4 costs too much with a UK dentist, you might consider visiting a dentist abroad. Countries like Hungary and Poland have earned a good reputation for offering excellent dental care at a much lower cost.
You can find out about other ways to save money on implants here.
All-on-4 reviews and studies
You might be wondering “Are All-on-4 dental implants safe?” or “How long do they last?”. As this is a relatively new technology, existing studies have only looked as far as the 10-year survival rate. The results are promising, with 99.2% of prostheses lasting longer than 10 years and 94.8% of implants themselves.
There is every reason to believe that these implants can last 15 years, 20 years or longer – provided you follow your dentist’s instructions for taking care of them.
There are plenty of All-on-4 before and after photos and videos to be found online. Many patients record their journeys as they get full mouth implants. Here you can view one user’s review of his experience a few months after having his implants fitted: