🦷 Is All-on-4 Right for You? What I Recommend You Consider Before Deciding

You’ve probably seen the commercials and social media videos where patients are in tears when their new teeth are delivered. What you don’t see are the same patients crying again—this time out of frustration—when their All-on-4 prosthesis fails or complications arise years later.

While All-on-4 is a great option for some patients, I believe it’s very important to look beyond the advertising and understand whether it’s truly the right fit for your unique situation. As a cosmetic and implant dentist in Encino, CA, who has helped many patients restore their smiles, I want to share my perspective, so you can make an informed choice that you’ll be happy with for years to come.

⭐ What Is All-on-4 Implant Treatment?

All-on-4 is a treatment concept where four implants are placed strategically in your jaw to support a full arch of replacement teeth. The procedure was designed to help patients who have lost significant bone in the back of their jaws avoid bone grafting.

It can be a faster, sometimes more affordable way to get a fixed set of teeth compared to using six or more implants. And from the practice side, this approach is often promoted because it is faster and more profitable to deliver in volume.

✅ The Benefits of All-on-4

There’s a reason All-on-4 has become so popular. Here are a few advantages:

• Fewer Implants Required: Only four implants per arch instead of six or more.
• Shorter Treatment Time: In many cases, teeth can be attached sooner.
• Avoiding Bone Grafting: The angled implant placement helps work around areas of bone loss.
• Lower Initial Cost: Fewer implants and fewer procedures can reduce upfront expense.

I recommend All-on-4 for patients when these benefits truly align with their goals and anatomy.

⚠️ What I Think You Should Consider Carefully

Despite the benefits, All-on-4 is not always the best solution for everyone. Here are some important considerations I discuss with my patients:

🧼 Hygiene Challenges

Because the bridge is fixed in place, it can be more difficult to clean underneath. I see too much plaque accumulated under the prosthesis every time I remove them for cleaning, and I also see how inflamed the gums become because patients have a hard time getting under the bridge. Over time, this will ultimately lead to peri-implantitis and failure of the implants, and it can also contribute to persistent bad breath.

Another important detail many patients don’t hear upfront is that these restorations need professional cleaning two to three times a year. This isn’t a regular hygienist appointment—your dentist must remove the prosthesis, clean underneath, and sometimes replace the small screws holding it in place, which can’t be re-used indefinitely. These maintenance visits can be more costly and time-consuming over the years.

My prosthesis design is different from many others—I design bridges that allow far better hygiene accessibility and, in most cases, more natural esthetics. This extra planning helps my patients maintain healthier gums and implants long term.

🛡️ Limited Safety Net

If one implant fails later, it can compromise the stability of the entire prosthesis. I see many patients who come to my office after getting All-on-4 in other centers with failed implants. It’s very difficult to tell them that they have to start all over again—and that they often have to pay again for new implants and a new prosthesis. This is very painful for patients to hear—emotionally, financially, and because they have to go through surgery again.

That’s why I often prefer to place five or six implants instead of just four—to provide added security, greater longevity, and peace of mind. This extra support means that even if one implant develops a problem years later, your entire restoration doesn’t have to be redone.

🦷 Bite Force Distribution

With only four implants, forces are concentrated in fewer areas. This creates more stress on the implants and bone over time, which is another reason implants can fail after bad hygiene—too much force.

⏳ Rushed Treatment and Compromised Gum Health

One of the big selling points of All-on-4 is that everything can be done in a single visit. However, doing everything in one day often means the gums are not healthy before the implants are placed. I’ve seen that this can set the stage for chronic inflammation and bone loss right from the start.

There are also other treatment plans—such as All-on-6, segmented bridges, or removable implant-supported overdentures—that may be a better fit for certain patients, depending on their bone health and goals.

🛠️ How My Approach Is Different

My philosophy is that no two patients are the same. Even when I do All-on-4 cases, I approach them differently than many offices:

• I preserve as much bone as possible to support long-term success and future options.
• I often stage treatment rather than rushing everything in one day. This allows time to heal infected or inflamed gums and improve hygiene before final teeth are attached.
• I customize both the number and placement of implants—often recommending five or six instead of four—to provide better force distribution and long-term security.
• I design prostheses that make cleaning much easier and look more natural.
• In many cases, I build or enhance the existing bone to help preserve your jaw long term and support a healthier foundation

This extra care can make all the difference in your long-term health and satisfaction.

❓ Questions I Encourage You to Ask Before Deciding on All-on-4

• What happens if one implant fails in the future?
• Do I have enough bone for this approach, or will I need grafting?
• Will I be able to clean effectively underneath?
• Are there other options, and why is this one recommended for me?
• Are there any other treatment options that might be better for me?
• What materials will be used for my bridge?
• How long does it last? This is very important to know because after spending thousands of dollars, you should be aware that All-on-4 restorations may only last 7–15 years. Ask yourself: Do you accept that?
• I’ve heard that you cut bone away and it makes my jaw smaller. Is that true?

I believe you deserve clear, honest answers to all of these.

🤝 Let’s Find the Best Solution Together

Choosing to restore your smile is a big decision. My goal is to help you understand all your options, so you can make the best choice for your health, your lifestyle, and your budget.

Over the years, I’ve been honored to treat patients not only from Encino and Los Angeles, but also from as far as New York, Florida, and Nevada who come here seeking personalized, high-quality implant care.

If you’d like to learn more or get a second opinion about All-on-4 or other full-mouth solutions, I’m here to help. You’re always welcome to schedule a consultation with me in my Encino office.

🎥 Watch My Video

If you’d prefer to hear me explain this topic, you can watch my video discussing the pros and cons of All-on-4.

📄 Explore More

If you’d like even more details, see my next blog post where I talk specifically about the most common problems with All-on-4 treatment and how to avoid them.