There is something so alluring about catchy marketing phrases such as ‘All on 4″, “Teeth in one day”, and “full mouth implants“. Essentially, they all mean the same thing – replacing all your teeth with dental implants. You have been thinking about new teeth for years, and now that you have saved up, voila! It needs to happen now; you are ready! People are surprised when I suddenly hit the brakes. ‘It’s a process,’ I tell them. Good things come to those who wait.
I decided to dedicate this article to those who are wondering what “All on 4” and “teeth in one day” really mean and the steps involved in your full mouth implant journey. Honour these steps, and there is a good chance of success or disrespect biology, and you are in for a nasty surprise. Without too many unnecessary words, I will get right into the steps.
Initial Consultation
Starting the process for “all teeth on 4 implants” begins with a consultation. During this appointment, we will talk about your aspirations and any worries you might have as far as your dental health is concerned. I will thoroughly check your oral health, go over your medical history, and see if you’re a suitable candidate for “All teeth on 4 implants”. Conditions such as uncontrolled diabetes, and smoking are of particular importance as these may affect success rate with “All teeth on 4 implants”. Also, be sure to share the medications you take as blood thinners and medications prescribed for osteoporosis such as bisphosphonates can affect the way we approach your procedure. We might take photographs, X-rays, mouth impressions (moulds), and a 3-D oral scan to collate all the necessary information. I will explain the procedure and what to expect, giving you the information you need to make an informed decision. Make sure to ask any questions you have during this appointment. Since implant treatment can take some time, your first consultation is also a chance to see how comfortable you feel with the dentist. It is important to not only think about the cost but also make sure you feel at ease with the dentist you choose
3-D Scan (CBCT)
3-D images provide a detailed view of your bone structure, nerves, and surrounding soft tissues, allowing for precise measurements of bone density, height, width, and gum thickness. With this information, the appropriate size and type of dental implant can be selected, and the best position for implant placement is identified. A CBCT (a dental Cone Beam CT) scan can also reveal any potential issues, such as anatomical deviations or bone problems. As useful as it is, this scan is just one tool and needs to be combined with a physical examination of your teeth and gums. Additionally, factors like how wide you can open your mouth for surgery and your overall health are crucial. Therefore, a treatment plan can’t rely solely on the scan.
Treatment Planning
After gathering initial information, a treatment plan will be created. This step includes a recommendation on how many implants you need, the type of restoration (fixed bridge, or removable implant-supported denture), costs, and the overall timeline. You might have a choice of how many implants you opt for. Four implants (All teeth on 4 implants) in each jaw is the minimum and the most cost-effective choice but if possible and your finances allow, five or 6 implants (all teeth on 5 or 6 implants) will provide better stability and possibly longevity.
Your input is crucial – we need to understand your goals to achieve the best results. If you prefer to have the option to easily clean you teeth, a removable implant-supported denture could be the way to go, or if you can’t stand the thought of removable teeth, then opting for fixed bridges would work better for you. If you grind your teeth at night, a stronger zirconia bridge might be recommended, but if you do not, and you are mindful of finances, the most common titanium-reinforced acrylic bridge will suffice. We will try to balance your expectations with what is realistically possible. A clear understanding of the plan by both yourself and the dentist leads to long-term success and satisfaction.
Measuring and preparing for the surgery
Now is the time to measure and do further, more specific planning. Impressions of your mouth, photos and intraoral 3-D scan will be used by the dentist and the dental laboratory to pre-make your new temporary teeth so that you don’t have to go without teeth for long after the surgery. With digital technology we can manufacture a custom device called a surgical guide, which can guide your implants into a precise, pre-planned position, ensuring precision during surgery. At this stage, we plan and make these surgical guides if necessary.
Implant Placement Surgery
The key part of this process is placing implants into your jawbone. This procedure is done either in a day hospital or at a dental practice under local or general anaesthesia to keep you comfortable. Using surgical guides, titanium implants are placed into your jaws. Depending on the complexity, the surgery can last from two to six hours, and you will take some time to wake up. Make sure someone trusted can pick you up from the practice and look after you for the first 24 hours.
Delivery of your new teeth
Finally! The most exciting part – your new teeth. After months of preparation, measurements and surgery, your new teeth are ready! They can be screwed into your implants within 1-2 days of the surgery, thus the common marketing term, “teeth in 1 day”. Although these will not be your final teeth, and changes might be required with the final set, they will make you smile and give you back your confidence. You will be able to go to work and carry on with your social activities while you recover from the surgery. In a small number of people, who have soft bone, implants don’t tighten enough on the day of the surgery. In such cases, removable dentures will have to be worn for the duration of the healing phase to give the implants adequate time to solidify and fuse with your jawbone.
Recovery
Now that you have your long-awaited teeth, you need to heal post-surgery. Prescribed medications and oral care practices are your allies in minimising swelling and discomfort. Adhering strictly to the prescribed regimen and attending regular follow-up appointments will ensure a smooth and complication-free recovery. If you experience a problem during the recovery phase such as intense pain, excessive bleeding, or opening of the wound be sure to notify your surgeon promptly. Many complications can be addressed if they are dealt with in a timely manner. Stitches in the mouth might be uncomfortable but when they are covered by the new teeth, they become less noticeable and manageable. Stitches can be removed in seven to ten days after the surgery.
Osseointegration: The Dance of Implant and Bone
Following implant placement, osseointegration takes place. This gradual fusion of the jawbone with the implanted titanium screws spans three to five months. The best thing you can do to maximise success is to follow your dentist’s advice. No chewing with your temporary teeth means that all the food you eat during this phase needs to be minced and mashed. Soups, mashed potatoes, and smoothes will get boring, but if you don’t adhere to this strict regime, success is compromised. Think of it as a broken leg. If you start walking on it before the fracture heals, the leg will keep breaking. Thus, plaster and crutches are first, and once the fracture heals, you can slowly start putting weight onto it. Similarly, if you put pressure on implants prematurely, before they fuse with jawbone, they can fail. Monthly review appointments during this phase allow for timely detection and resolution of any potential issues, ensuring uneventful healing.
Making of the final teeth:
With osseointegration completed in 5 months, now is the time to make your final, titanium-reinforced teeth. This is the time to finalise the type of restoration you want (fixed bridge in acrylic or zirconia or removable acrylic overdenture). It is the right time to discuss the changes you want to make to the overall look of the teeth. You might want them longer, shorter, bigger or smaller. You might decide that you want to recreate some natural gaps between your teeth or twist some of them just as you had it with your natural teeth or make them darker. Next, impressions or 3-D digital scans of the implants are taken, and a custom-made restoration is crafted. This process involves several trials, so you will have every opportunity to see how your final teeth will look and suggest any changes according to your wishes. We will guide you on what changes are realistic. Once your final teeth are made, they are set and are costly to change.
Maintenance and Checkups
Once the process is complete, you can enjoy your new smile and eat almost anything you want, applying some simple logic, of course. If you wouldn’t crack nuts or open beer bottles with your natural teeth, implants are likewise vulnerable to trauma. It pays to protect them by not biting their nails or eating foods that are too hard. Simple practices, such as flossing each implant for six seconds a day, play a crucial role in ensuring the longevity of your full-mouth dental implants. This will prevent a condition called peri-implantitis which can result in implant loss. If you grind your teeth, wearing a protective plate called “occlusal splint” at night in your sleep will minimise the risk of prosthetic teeth fracturing and your implants becoming overloaded. Regular check-ups, typically every 6-12 months, are not just recommended – they’re your proactive stance in ensuring the health and longevity of your implants.
In conclusion, no surgery is ever a walk in the park, so it’s good to be prepared and well-informed about the process and the outcomes. The initial plan could take several possible directions, so accommodations will need to be made for each possibility. You will have some choices to make about the number of implants you have, the type of final prosthesis (teeth), and the look you want to achieve. As overwhelming as it might seem, we are here to guide you, so rest assured we will hold your hand the whole way.
These days, “All teeth on 4 implants” is not a difficult process, and materials and techniques are improving each day. You will be asleep for the main part of the surgery, and people are surprised by how little pain they feel afterwards and how quickly they recover. However, don’t be fooled by catchy marketing slogans. As magical as it is to get new teeth in only a couple of days, the entire process is much more involved and takes five to six months. Despite the involved process, in all the years that I’ve been performing “All teeth on 4 implants” surgeries, I haven’t had a single patient tell me that they regret making the decision to do it. The results are dramatic and speak for themselves. People’s lives are turned around. They start smiling again, stop dreading social situations, and enjoy the most primal pleasure in life – food. Their faces perpetually glow every time I see them for check-ups.
