What is All on 4 or Teeth in a Day?

Teeth is a day, or All on 4 (and there are other names, they mostly refer to the same treatment), are treatments were all teeth can be removed, dental implants are placed, and temporary teeth are placed, all in one day.

For a lot of people who have very bad teeth, this is a very good treatment option. BUT, there are a number of things that you should be aware of before you start down this journey.

We will discuss these in this short article

Firstly, lets start with its deceptive name. Teeth in a day.

It is never all done in a day, the implants still need time to heal, and this takes months.

It is true that all the surgical treatment is carried out in one day, and this is often the least comfortable part of the whole thing.

Typically you will get a good looking set of temporary teeth on the day of removing your bad teeth, so there is an improvement on day1, however this may not be the perfect look, so after 4-6 months, we will go through a detailed process that will let you fully customise your smile.

The photos below are with a full set of temporary teeth placed, on the day of treatment. In a few months, we will make a longer lasting, final set of teeth.

Last Resort Treatment

This kind of treatment is sometimes referred to as a last resort treatment, this means that if something in this treatment was to fail, then you don't really have many more options. There may be some options, and we will discuss these a little later on.

Removing teeth that can be saved is rarely a good idea.

I feel that a big problem with this treatment is that dentists are too eager to provide the treatment - even when other solutions exist.

From a patients perspective, it can sometimes sound like a good idea to have all of your teeth removed, and dental implants placed - and everything is new again.

This is especially true if you are in such a negative place with the health and appearance of your smile.

How long will All on 4 last?

There on no one answer, it depends on your personal health, how well the teeth and implants are maintained.

We expect the dental implants to last decades, but the teeth on the implants may not last that long, they can suffer from a lot more wear and tear, and if needed, they can be replaced.

If you are in your 40s, and this treatment lasts 20 years, then what happens next?

Really, from badly placed dental implants, and cheap components, problems with this treatment can start as soon as 6 years down the line.

Sometimes there is really no other option other than dentures.

We have done this treatment for patients in their early 40s, as they had no teeth at that stage, but we do need to think about the long term, even if our patient may not be.

Experience Counts For a Lot

This treatment is some of the most complex dental implant treatment that you can have, and there are not lots of dentists who have a lot of experience in it.

Over the last 10 years, we have improved our process for this treatment, from choosing the best types of dental implants, to completely planning the case on computer CAD systems, so we can use specialist guides to be extra precise with out dental implant placement.

On the day of writing this blog, I have carried out an upper only all on 4, and because everything was computer guided, the whole treatment took 4 hours from start to finish.

This is about an hour less than it took us a year ago, because of the efficiencies of computer guided dental implant placement.

But sometimes the guides don't fit, and they can break, so your dentist has to be able to do the treatment free hand.

It takes time to develop skills to be able to do this, and most dentists who place simple dental implants are simply not experienced in carrying out full arch dental treatment, which is a completely different ball game.

What are the options when All on 4 comes to the end of its life?

When dental implants are lost, its often because of gum disease around the dental implants.

On an x ray, this looks like a black halo around the dental implant. The black area means that there is no bone there.

So the big difficulty is finding enough bone for the new dental implants to go in.

There are options called extra maxillary dental implants.

These are implants which are placed in other areas of bone, like near the nose, the cheekbone, and implants further back in the jaw.

Again, these are very specialist dental implants, and there are only a handful of clinicians in the UK (less than 15) who regularly place dental implants like this.

I know this article is sounding a bit negative, but the reality is that this is a treatment that we carry out very often (1-2 times a month), and it is truly life changing for so many people.

It is often not the only option that you may have, and its often a good idea to see a dentist who is comfortable providing several options to you, and you can choose the best way forward from there.

The good news is that this treatment requires very little maintenance in the future, you will often only see the dentist once a year to remove the teeth, inspect the implants, take an x ray and make sure everything is okay.