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All on 4: FAQs

There is a dental treatment gaining in popularity known as “all on 4”.  You may see it on dental practice advertisements or hear about it on the radio.  The name derives from the fact that this specific dental treatment replaces “all” of the teeth “on 4” dental implants.  In this week’s blog, we’ll answer the questions people frequently ask Google about All on 4.

What is “All on 4”?

Officially, all on 4 is an implant-supported prosthesis that replaces all of the missing teeth in a dental arch (upper or lower).  This treatment is unique in several ways.  Your dentist places at least 4 dental implants at prescribed angulations and immediately attaches the replacement teeth (“immediate loading”).  The prosthesis attaches to the dental implants via screws, which can only be “unscrewed” by your dentist.

After all of the pre-operative planning, the procedure itself is a “same-day” procedure.  Your dentist has the dental lab fabricate the prosthesis based on precise measurements and exact replicas of your mouth so that it is ready before your surgical visit.  On the day of surgery, your dentist removes any remaining teeth, places the dental implants according to the prescribed positions, and attaches the prosthesis.  You leave with a completely new smile!

Is All on 4 Covered by Insurance?

This question has a complicated answer.  Because all on 4 involves several separate dental procedures (extractions, dental implants, prosthetic restorations), it is possible to use some dental insurance benefits to cover this treatment.  Coverage varies widely by both carrier and specific plan, so it is important for you to understand what your specific dental plan covers.

Most insurance plans cover at least a portion of tooth extractions, and some will cover a portion of prosthetic restorations.  We have actually seen a few insurance plans catching up with the times and covering a portion of dental implants as well.  In order to know your specific coverage, our front office team can communicate with your insurance company before you complete the procedure.

Is All on 4 Painful?

In the long run?  No.

It is a surgical procedure, though, so you should expect some post-operative pain and/or discomfort.  Any time you have a tooth pulled or a dental implant placed, your body experiences “normal” post-op pain as part of the healing process.  Because an all on 4 procedure involves multiple extractions and multiple implants, we cannot claim that it will be pain free.

We can assure you that we have many years of experience in dental surgeries and know exactly how to help our patients manage surgical pain.

Is All on 4 Worth It?

All on 4 is a relatively expensive investment in your smile.  For one who has suffered decades of pain, infection, discomfort and embarrassment from his or her teeth, an all on 4 treatment is well worth the investment.  It provides a healthy oral situation by replacing any and all sources of dental pain and infection with an implant-supported prosthesis that functions well to properly chew food.  It builds confidence by providing a cosmetically appealing smile with “new” teeth.

Because these are benefits that will last a lifetime, they far outweigh the monetary costs.

Is All on 4 Removable?


When people call all on 4 “implant dentures”, they are incorrect.  Your dentist attaches the prosthesis to the implants with tiny screws that only the dentist can unscrew.  This makes it a “fixed” restoration, as opposed to a removable one.  Patients do not remove all on 4 prosthetics.  The dentist removes it about once a year for maintenance, evaluation and professional cleaning.

Is All on 4 Comfortable?


After the initial healing phase, there should be no discomfort with an all on 4 restoration.  There is an adjustment period, during which your lips, cheeks, and tongue must get used to the presence of the prosthesis.  You could suffer minor friction irritation or biting your cheeks, lips, or tongue in that adjustment phase.

Is All on 4 a Denture?


As we’ve already stated, all on 4 is not removable by the patient.  There is another important difference.  Where dentures require extensions into the area under the lips and cheeks, causing an unnatural bulky or full appearance to the face, all on 4 rests only on the jawbone of the dental arch.  Because the dental implants support the prosthesis, there is no need for excess material that presses outward into the cheeks and lips.

In fact, the only thing that all on 4 has in common with a traditional denture is that it also replaces all of the teeth in a dental arch.

All on 4 at Designer Smiles

At Designer Smiles, we provide excellent customized dental care for each individual patient.  That means that we do not follow a single protocol for “all on 4” on every person.  We have found that some people require more than create implants to create a predictable, long-lasting prosthesis.  While we still call it “all on 4” because that is the name many people recognize, we might actually do an “all on 6” if the logistics of a case require more support.

We use advanced technology in the form of three-dimensional x-ray imaging and intraoral scanning to plan the precise positioning of the dental implants and measurements of the prosthesis.  Dr. Ann performs the surgical procedure using strict adherence to sterile protocol, and we offer IV sedation for those who want to “sleep” through the surgery.

More Questions about All on 4?

Call Designer Smiles today to schedule a consultation with Dr. Ann and Dr. Lauren.  We can answer any questions you have about all on 4 and begin the planning process at your first visit.