Are All-on-4 Implants Really My Only Option?

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Last month, I had a consultation with a dentist about stabilizing my dentures. They don’t have to be perfectly stable, but I do not want them sliding around anymore. The dentist recommends all on 4 implants. When he told me the cost, I told him that is way out of my budget, and I will have to explore my options. He quickly said that there are no other options because I’ve worn dentures too long. He said that his rate is among the best I will find. Is it possible that all on 4 could be the only way a patient could qualify for implant dentures? If so, I will forget about getting implants and accept my dentures as they are. Thank you. – Brett from TN

Brett,

Thank you for contacting our office.

You mentioned that you had a consultation with this dentist. Based on your description, it seems that you did not have an exam, CT scan, or any x-ray for the dentist to decide that All-on-4 implants are your only option. And that is puzzling. Be careful with this dentist.

If you have worn dentures for many years, you have some jawbone shrinkage. But an implant dentist can build up the bone with grafting to ensure the implants have plenty of support.

What Type of Implant Dentures Can You Receive?

The American Academy of Implant Dentistry clearly explains the types of dental implants available. But a dentist can define your treatment options only after these steps:

  • Reviewing your medical and dental histories
  • Examining your teeth and gums
  • Reviewing a CT scan

Affordable Implant Dentures

Diagram of snap-on dentures. Dental implants are in the lower jawbone, and a denture with attachments in the base is hovering above the gumline.

A snap-on denture is an affordable alternative to All-on-4

A snap-on denture or a denture retained with mini-implants is more affordable than the All-on-4 technique. Those affordable options use as few as two dental implants. Although more implants will improve a denture’s stability, your treatment costs will increase.

And not every patient qualifies for All-on-4. We recommend that you look for an implant dentist with extensive post-graduate training and schedule an appointment for an exam. The dentist will explain your treatment options. A conscientious dentist will discuss the pros and cons of each option but will not insist that you receive a specific type of treatment—or any treatment at all.

 

Steven Brooksher, DDS, is a  Baton Rouge cosmetic  dentist and Fellow of International Congress of Oral Implantologists. Read about his credentials and visit his smile gallery. It will help you determine what to look for in a dentist in your area.

Is It Too Late for Dental Implants?

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After wearing dentures for 18 years, is it too late for dental implants? My dentures won’t stay in, and my entire experience with wearing them has been disappointing and frustrating. It’s almost time for new dentures, and if I can minimize my misery, I would love it. Thanks. Vera from Biloxi, MS

 

Vera,

No, it’s not too late for dental implants. There isn’t a limit on how many years you can wear dentures before you’re not a candidate for implants, but you’ll need to be patient with the process. We’ll explain.

Dentures and Jawbone Resorption

The longer you wear complete removable dentures, the more your jawbone will shrink. Jawbone shrinkage occurs in areas where teeth are missing. And when all your teeth are missing, the entire surface of your jawbone shrinks. Your body takes the minerals from the bone and uses them elsewhere. As your jawbone shrinks, it’s more difficult for your denture to stay in place.

Dental Implants and Bone Volume

An implant dentist or oral surgeon places implants in your jawbone with the goal of the bone and implant fusing to anchor a denture or arch of teeth. If you have significant bone loss, your jawbone won’t support implants.

If You Don’t Have Enough Bone for Dental Implants

If you don’t have enough jawbone to support dental implants, implant dentists offer two treatment options—bone grafting and All-on-4 dental implants.

Bone grafting for dental implants

Bone grafting for dental implants is a procedure that takes bone from one part of your body, like your hip, to use it for building up your jawbone. As an alternative, a dentist might use sterilized or artificial bone. Depending on the type of bone used and the extent of bone loss, the Academy of Osseointegration says it can take four to twelve months for grafts to heal. After healing, you can receive dental implants. Your implant dentist will explain your options for grafting.

All-on-4 dental implants

Denture above dental implants ready to be screwed on

Dental implants secure dentures

All-on-4 dental implants are a system that angles implants in the front of your mouth. The bone in the front of your mouth is often thicker than other areas. And angling the implants increases contact with the bone and resistance to movement. Implant dentists use 3-D cone beam computed tomography (CBCT) scans to see your bone structure and identify a precise location for All-on-4 or All-on-6 dental implants. This process prevents the need for bone grafting. But your implant dentist will determine if you’re a candidate for this treatment.

For predictable results, look for an implant dentist who is a Fellow of the International Congress of Oral Implantologists. Dentists with fellowship have advanced dental implant training and experience and have completed rigorous testing and examination of their patient cases by a review board.

You can receive implant-supported dentures and have a comfortable, confident smile at last.

 

Steven Brooksher, DDS, a Baton Rouge dentist, sponsors this post. Dr. Brooksher is an accredited cosmetic dentist and a Fellow of the International Congress of Oral Implantology. He completes implant surgery and restores implants with dental crowns or dentures.