What are all-on-four teeth?

Before receiving all-on-four teeth you have to remove all broken and infected teeth (before treatment).

All-on-four teeth is a complete set of prosthetic teeth which is supported by just four dental implants. With all-on-four teeth you get teeth which are fixed and remain in place like your own natural teeth. So if you’re missing all of your teeth already or need to have them all removed and are looking for a fixed replacement option, then all-on-4 teeth could be your solution. Getting all-on-four teeth is the most economical way to replace all your missing teeth with a fixed, non-removable prosthesis. Otherwise, your only other option is to wear dentures which are removable teeth.

fter all-on-four teeth, you get all of your missing teeth back (after treatment).

Why go for all-on-four teeth?

All-on-four teeth are fixed which makes them much more comfortable than dentures. Most patients find that wearing dentures is difficult and cumbersome. Denture wearers face lots of problems with their false teeth, for example:

  • Dentures offer poor chewing function
  • They require constant maintenance
  • Most dentures require a redo every couple of years
  • Dentures become loose over time which leads to sore lesions inside the mouth
  • As compared to natural teeth, dentures typically offer poor aesthetics
  • The psychological impact of not having teeth is profound on most people

With all-on-4 teeth you get teeth which resemble your own natural teeth. All-on-4 teeth offer you excellent chewing capability, beautiful aesthetics and the feeling of having natural teeth back. You can chew steak, talk without slurring and eat as if you had your original teeth back. These are the reasons why people invest into replacing their missing teeth with all-on-4 dental implants.

What are the steps involved in all-on-four procedure?

It is nearly impossible to tell all-on-four teeth apart from your own natural teeth.

The all-on-four process has simplified replacing all of your teeth by minimizing the steps involved. The process starts by placing just four dental implants followed by a full set of teeth which attaches to the implants. Treatment is quick, affordable and much less complicated than full mouth dental implants. Plus, the all-on-four process bypasses extensive surgical procedures and simplifies the restorative process. Treatment is typically completed in weeks or months, instead of years as is the case with full mouth dental implants.

This is the same patient above. With the lips retracted, you can now see how the lower four implants hold the porcelain teeth in place.

The all-on-four process involves a few steps, which are:

(1) Implant Surgery & Tooth Extraction

(2) Temporary Teeth

(3) Permanent Teeth

Implant Surgery & Tooth Extraction

This is what you will look like after surgery. Don’t worry, your dentist will place a temporary to cover your gums during the healing process.

To begin your all-on-four journey, you first need to remove all bad teeth and place four dental implants in each arch. If you’re without teeth, then you only need to receive the four dental implants. However, if there are any remaining teeth, they need to be removed at this time. Because all-on-four teeth replaces all of your teeth in the arch, this means that any healthy teeth remaining also needs to be removed and sacrificed.

Typically, all teeth extraction and dental implant placements are performed at the same time. Not only does this spare you, the patient, an additional surgery but it allows your dentist to take advantage of your existing bone structure to better position the dental implants. Keep in mind, this is a technique sensitive treatment which requires a skilled and experienced oral surgeon, periodontist or implant dentist.

Your all-on-four surgery typically takes about 2 to 4 hours to complete. If you’re worried about having a surgery, consider going under sedation. Almost all dentists who perform all-on-4 procedure offer some type of sedation option to help you get through your appointment. Once sedated, you can relax and fall sleep while your dentist removes your bad teeth and places the dental implants.

Temporary Teeth

Example of a removable denture temporary teeth (top) and porcelain all-on-four teeth (bottom).

You may or may not have to wear temporary teeth after your all-on-four surgery. If you have lots of existing teeth that need to be removed, you definitely will need temporary teeth. Wearing temporary teeth allows time for your extractions to heal, dental implants to integrate and your gums to settle into their final position. However, if you’re without teeth, then you may be able to skip this step and go straight to the final permanent teeth. There are several different options when it comes to all-on-four temporary teeth, which are:

Removable Temporary Teeth

Removable temporary teeth are basically dentures which you wear while your gums and bone heal after surgery. If you already have an existing denture, your dentist may be able to modify the denture so you can continue wearing it afterwards. Otherwise, you will require a new temporary denture. Either way, your dentist will prepare your temporary teeth in advance of your surgery. This way, you leave with your temporary teeth after surgery so you’re not walking around without teeth.

Permanent Temporary Teeth

Wearing fixed temporary teeth is another option after your surgery. These temporary teeth stay in your mouth during the 3 to 4 months healing process and can not be removed. Keep in mind, most dentist typically charge an extra fee to make fixed temporary teeth. This is because fixed temporary teeth are both difficult to fit and expensive to make. Regardless of whether you go for removable or fixed permanent teeth, your final results will be the same.

All-on-Four Permanent Teeth

Lower all-on-four porcelain teeth model mounted on a cast.

Once you have healed from your surgery, it’s now time to make your permanent teeth. There are two basic types of permanent all-on-four teeth, both which are great options, which are:

Porcelain Teeth with a Metal Bar

Porcelain teeth look very natural and beautiful and closely resemble your natural teeth. However, since porcelain is not strong enough to support your bite pressure, an internal metal bar is incorporated into the design. Don’t get worried, the metal bar is completely invisible and does not affect your smile whatsoever!

Zirconia Teeth

Another excellent option for all-on-4 teeth is zirconia. Since zirconia is stronger than porcelain, there’s no need to add a metal bar inside. In terms of looks and function, both zirconia and porcelain teeth offer amazing and durable results. In fact, they are almost indistinguishable from one another. The decision between the two typically comes down to your dentist’s preference and technique. Either way, you can’t go wrong with zirconia or porcelain.

Interior view of all-on-four teeth clearly shows the four access holes used to install and secure the prosthesis on top of 4 implants. Don’t worry, the access holes will be sealed after delivery!

Note that we did not mention acrylic as an option for all-on-four teeth. This is because you can not use acrylic for all-on-four permanent teeth. Acrylic is not strong enough to support your bite pressure and breaks after several months. Plus, acrylic irritates your gums and causes swelling and infection over time.


As you can see, getting all-on-four teeth is a life-changing commitment. Not every dentist offers all-on-4 teeth. This is why it’s important to do your research to find a reliable, skilled dentist before committing to treatment. Ideally, make sure you have future access to the dentist in case there are complications with your all-on-4 teeth. If you live in Orange County and are interested in all-on-four teeth, be sure to give us a call. Schedule your complimentary consultation with us by calling (949)481-2540 or book online today.

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