When to consider an All-on-4 for patients

All-on-4TM full arch dental implant therapy often provides the ultimate solution for sufferers of severe tooth loss or damage.
Whether tooth loss is due to gum disease, improper dental hygiene or facial trauma, The All-on-4 TM procedure can restore a patient’s smile in just one day.
But as a dentist, when should you recommend All-on-4 TM for your patients as opposed to alternate restorative solutions?
Here are a few simple guidelines to help determine when it’s time to refer patients to an oral surgeon for an All-on-4 TM consultation.
Insufficient healthy teeth for a lower partial
Patients who do not have enough quality teeth left to do a satisfactory bridge or partial denture on the lower arch are generally seen as good candidates for a full arch implant therapy. Patients generally require both canines and ideally a molar or two to have a stable non-shifting partial on the lower arch.
While a full lower denture is certainly a possibility, it is widely known that such prostheses are very unstable and prone to wobbling (1 in 3 patients report that they almost never wear their lower denture.)
Continued loosening of teeth
Patients with loosening teeth may feel that a bridge or partial is unsatisfactorily “temporary”. A patient disposed to losing additional teeth in the future will need to have their prosthesis adjusted or replaced repeatedly. In addition, anchoring a prosthesis to teeth prone to loosening will likely exacerbate the condition.
A patient who is likely to eventually lose most or all of their teeth may be better off undergoing extraction and a full arch implant treatment sooner rather than later, while they still have a sufficient amount of bone. They typically save thousands of dollars in the long run as well.
Trouble adjusting to dentures
Whether it’s due to dental fear or financial considerations, some patients opt to try dentures first prior to committing to All-on-4 TM. While some people adjust quickly to wearing and eating with dentures, many don’t.
Patients who are unhappy with dentures for any of the following reasons should be informed about All-on-4 TM as a long-term solution:
- Continuous pain from wearing dentures
- Unable to learn to use the tongue, lips and oral muscles to hold dentures in place
- Insufficient biting power to chew and eat the foods they enjoy
Unhappy with the cosmetic look and feel of dentures