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All on Four Implant Dentures

A message from Dr. Ted Reese: It has happened too many times now to disregard and overlook so I find myself compelled to write and address the issue of ‘All on Four’ implant dentures.

This technique and procedure is a marketing endeavor of an implant manufacturing company that has it’s place and provides a wonderful service, but….. like many otherwise good things has been over prescribed and abused in inappropriate situations. The ‘All on Four’ was originally utilized to secure loose and troublesome lower dentures by which four implants were placed into the ‘chin’ area of the lower jaw (as this is often where the only substantial amount of bone is available) and then either a bridge, denture, or ‘hybrid’ implant denture is fabricated to support and retain the lower teeth. When provided to chew against an upper conventional denture this can be a very satisfactory and effective means to restore proper and comfortable chewing.

My discouragement has come from seeing too many patients who’ve been recommended this treatment as a panacea for their dental or denture problems. It is often used as a ‘cookie cutter’ solution and then recommended to remove teeth unnecessarily, remove jaw bone unnecessarily, and promise results and longevity that isn’t being delivered. Much of this care is coming from ‘clinics’ set up to mass produce this type of ‘solution’ and it becomes inappropriate treatment or oversimplification of what is really needed to meet the patient's ‘expected’ outcome.

For instance, four implants in the upper arch to provide the chewing support for an entire ‘arch’ of teeth is often insufficient to withstand the rigorous chewing forces that lower natural teeth or a lower implant denture provides. In relatively minimal time I’ve seen this ‘solution’ result in loosening of implants or fracture of the implant bridge/denture. Not a problem many patients want to experience from expensive implant therapy that is intended to be more maintenance and trouble free.

The bottom line: Ask lots of questions, do your research, seek out options, and understand the limitations and reasonable expectations of what is being recommended before you agree to have teeth removed and implants placed. Implant therapy is a wonderful solution when performed and diagnosed properly. If not, it can be an expensive regret.

Dr. Reese is board certified from the American Board of Oral Implantology and has been placing and restoring dental implants for over 30 yrs. He has thousands of successful cases through the years and understands the benefits and limitations of different conditions and implant offerings. Call him today for an implant consultation.