Hello, I'm Dr. Perry from Farmington Family Dental. Today, we're answering some of the most common questions that I see about All-on-4. All-on-X or implant-supported bridges are different names for this procedure or technique.
What are All-on-4 Dental?
All-on-4 refers to placing four implants and putting a bridge or a fixed dental prosthesis over the top of them. That's something that doesn't come in and out of the mouth; it's screwed into the implants and doesn't move. This tends to be a great restorative option for somebody who has typically six or fewer functional, good intact teeth per arch, and typically works pretty well on the bottom and on the top jaw.
What are the pros and cons of All-on-4s?
The pros of All-on-4 is it's the best high-performance restoration that I can deliver in that it doesn't move around. The alternatives that I see for it are something like a denture. Obviously, dentures have their problems. This is the Ferrari of the dental world; it's high performance. By extension, the con is the maintenance required for it. It requires maintenance, and those maintenance procedures can be anything from replacing it to repairing it to redoing things that break along the way.
Who is a good candidate for All-on-4 dental implants?
A good candidate for All-on-4 implants or prosthesis is somebody who has good healthy sound bone, who has poor teeth existing in the mouth, but they have good oral hygiene and maintenance protocols. Things may have just gotten away from them throughout their life. They're wanting something that looks very nice and performs well, and their expectation is to have something in there that allows them to chew and smile like they once used to, or improve on what they once had if they had major dental issues even as a kid. That type of person tends to be the ideal person for this treatment. Acceptable is somebody who is missing all their teeth; it can be placed and restored that way.
When would someone not be a good candidate for All-on-4s?
The most common poor candidate that I see are people who come into my office who have other good options. Typically speaking, and this is just in general, if it's possible to fix things up without major compromises to its longevity, I'm going to recommend that route before we go towards taking everything out and replacing it. There are some nuances to that. If you come in, I will talk with you specifically about what's going on in your mouth and I'll talk about some of those nuances or limitations.
What steps are involved in an All-on-4 procedure?
All-on-4 procedures are typically done in four steps, but this can be extended depending on how the surgery goes, how things respond in healing, and whatnot. Typically, the first step is the planning phase. We plan out what we're doing, either planning a surgical guide or doing it without a surgical guide, and that's how we execute the work. Then there's the surgery day, where we have prepared a denture in the worst-case scenario, if you have to wear a denture for a little bit. We have prepared impression material and equipment to capture where the implants are, where the bone is, and where the soft tissue is. The next step is putting in a temporary bridge; as long as the implants have enough hold, we'll put a temporary bridge on over the top of them. That temporary bridge stays on there for a couple of months. The final stage is getting the final prosthesis or the final bridge on over top of the implants.
What anesthesia options will be available to me during an All-on-4 procedure?
Anesthesia is sometimes a concern. There are two options fundamentally for dental anesthesia in something like this. The first option, which is my go-to, is to get everything numb and comfortable so you're not feeling anything, and get the work done. That can be done comfortably in many cases and is the cheaper of the two options. The second option is bringing in a board-certified anesthesiologist. This isn't a nurse practitioner or me doing the anesthesia and surgery at the same time. It's a separate individual who comes in and sedates you. That sedation can be anything from a deep sedation, where you're kind of asleep and not aware of what's going on, to being fully asleep, where you won't wake up until everything's done.
How long does it take to heal from getting All-on-4 dental implants?
The healing time really depends on what other procedures are needed in placing those implants. Typically, the implant itself heals in and around the bone in about 6 months. It can take as little as 3 months and as many as 8 months, depending on what else was done in and around the implant. But the average is about 6 months.
How long do All-on-4s last?
The longevity of All-on-4 really depends on two caveats. The average is about 20 years for these prostheses, but it can be about 15 years depending on how much force is on them. As long as you're not smoking or diabetic, that's typically what I see as a good long lifespan. This assumes, too, that you have the soft tissue grafting procedures needed in and around the implants to give the best result, not just a basic result.
What is the cost to receive All-on-4 dental implants?
The cost of All-on-4 dental implants varies depending on the materials used, but I typically see it range from 25,000 to 30,000 per arch. When someone is doing both the top and bottoms, it's going to be somewhere between 50,000 and 60,000 to accomplish that.
Will insurance help with the cost of All-on-4s?
Insurance typically doesn't contribute in a meaningful manner. Sometimes they might take a few thousand off, but it really depends on your individual insurance. When it comes to planning for All-on-4, which is the Ferrari of the dental world, insurance often doesn't want to pay for it. They're happy collecting your premium but not actually paying out. I find they really don't contribute more than about 10% at best.
How can I schedule an appointment to discuss getting All-on-4 dental implants?
You can schedule an appointment by giving us a call. Call our office at (573) 637-4404. We'll get you scheduled in. Our first visit will involve taking records, seeing where the bone is at, taking a look in your mouth, and having a conversation with us. We'll see what you need, what you want, and how we can deliver it for you.
Hopefully, this information has been helpful for you in deciding if you want All-on-4 and what you need or want to do with the situation in your mouth. If you're interested in our help, give us a call at Farmington Family Dental at (573) 637-4404. We'll get you scheduled in and taken care of. Thanks!