All on 4 Dental Implants
If you’ve arrived on this page, you’re probably looking into alternatives to dentures. Whether you currently wear dentures or are about to lose your natural teeth, All on 4 dental implants is a common alternative to removable false teeth. The procedure involves placing four implants in the jaw and attaching a set of replacement teeth onto the implants. This is typically completed in three days, avoiding the need for other time-consuming procedures. All on 4 has become a popular option given the speed patients can have natural looking fixed teeth, combined with its cost-effectiveness. Learn about All on 4 treatment performed at Macquarie Street Centre by Dr David Dunn.
All on 4 dental implants at Macquarie Street Centre
Dr David Dunn, our experienced implant dentist, has been providing dental implant treatment for over 30 years at Macquarie Street Centre, Sydney.
As one of the first Australian dentists invited to learn about dental implants from their Swedish inventor, Dr Dunn was also one of the first Australian clinicians to adopt the All on 4 implant method, treating his first patient in 2003. Having helped thousands of patients regain their confidence and return to life without struggling with loose dentures or bad teeth, Dr Dunn can help you, too.
Our promise to you
- We don’t ‘cut corners’ or compromise to save time or money using inferior materials. Our goal is to provide excellent treatment at a fair cost.
- A successful outcome for you is our priority. We have perfected and refined our techniques, each step of your treatment is meticulously planned and executed.
- Natural looking, beautiful teeth. Dr Dunn is skilled in creating attractive smiles in harmony with your face. He has lectured and taught extensively on cosmetic dentistry, so your new smile is in great hands.
The first step in your journey is a FREE, no obligation, suitability telephone call. After your first evaluation if you feel that All on 4 is right for you we then proceed to book a full consultation with Dr Dunn.
Dr Dunn was part of a small group of Australian clinicians invited to attend training in Sweden from Prof. Branemark, the inventor of dental implants in 1988.
In 1989 Dr Dunn submitted his first ten patient cases to be reviewed and evaluated by colleagues at the Branemark Centre in Perth. This training was a mandatory requirement to purchase the products from the manufacturer.
Longevity of treatment is our measure of success. We have long-term follow-up of implant treatment spanning over 20 years performed by Dr Dunn.
All on 4 procedure
How does All on 4 work?
At MSC, Dr Dunn has refined our method over decades of providing patients fixed teeth with dental implants.
Before surgery, we use software to “virtually” plan and ensure accurate positioning of the dental implant, reducing the risk of poorly placed implants and problems that may arise. A template may also be produced at this stage to be used during your surgery to guide implant placement. Four dental implants are typically placed in each jaw. Sometimes, depending on your needs such as if you have soft bone, we’ll place up to 6 implants if required.
Specially designed dental implants are used for this procedure, allowing us to immediately ‘load’ (place teeth on) the implants. We don’t use ‘generic’ or ‘copy’ dental implants, only top-tier dental implants from tried and proven manufacturers. In most cases, we can put teeth on your implants on the second or third day following surgery.
After implant placement, a set of teeth is made based on our try-in, or an example set approved by you. Your custom-made teeth are laboratory fabricated, ensuring they are durable, stable and easy to clean.
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Most patients choose sedation for their procedure, and with oral pain relief medication, they also cope well with the discomfort after surgery. Fitting your teeth on the implants is usually painless, but if required, we may apply local anaesthetic for added comfort.
We’ll fit your teeth on the second or third day after surgery and organise a follow-up for check-ups two, four and six weeks after treatment.
Who is a candidate for All on 4?
Only rarely have we not been able to offer dental implant solutions for our patients, even those with advanced bone loss. If you feel embarrassed to take the first step fearing you’ve "let it go too far", rest assured that our clinic is a safe, judgement-free place. No matter your reasons for tooth loss we are here to serve you. It’s never too late to prioritise your quality of life.
We can help you if you have:
- Ill-fitting, loose dentures – some cope well with dentures, others struggle with loose dentures, speech difficulties and sore spots even if they have a good set of dentures. Most often bone shrinkage after tooth loss is to blame, especially in the bottom jaw.
- Many decayed, broken, missing or damaged teeth – gum disease, medication, illness, accidents or other reasons may result in poor teeth. If you already have many missing teeth, broken, loose or decayed teeth, it's not always viable to repair them and the cost-benefit of a remedy doesn't make financial sense. Sometimes, the best option is to remove these teeth and progress to All on 4 dental implants.
- Bone loss – tooth loss and gum disease can cause bone loss in the jaw. Previously, implant treatment after bone loss was complicated requiring procedures to add (graft) bone to the jaw to place dental implants. Today, we graft less and instead use the All on 4 method as it can be successful with less jawbone.
We assess your overall health before starting any treatment. There are few contraindications to getting dental implants. If you have an ongoing illness which you are getting treatment for, we’ll work with your medical GP and Specialist before starting to ensure safe treatment.
We can provide you with an indication of your initial suitability over the phone and confirm this after seeing you for a consultation.
What to expect before, during and after your All on 4 treatment
Before your All on 4 treatment
Like an architect or engineer carefully plans a new structure or house we plan your new smile to ensure stable, long-lasting outcomes. All aspects of your treatment are examined from the right place to insert your implants to the more artistic side of designing the ideal smile for you.
At your first consultation with Dr Dunn, we:
- Get to know you, what you wish to achieve from your treatment and what is most important to your quality of life going forward
- Take a medical history to understand your overall health, including any medications and pre-existing medical conditions (ongoing medical conditions are mostly not a contraindication to implant treatment, it just means we work hand-in-hand with your specialist or GP, so they are aware of your dental treatment plans)
- Take a special 3D x-ray (called a CBCT) that allows us to see your jawbone and take accurate measurements
- Take photographs and videos of you smiling, at rest and speaking so we can intricately plan your ideal tooth shape, length and width, leaving nothing to chance
- Take moulds of your mouth which become our study models to design your new teeth
We’ll also explain the different treatment options and the advantages and disadvantages of each. We believe that All-on-4 offers significant benefits over other therapies, but we also believe that it is our responsibility to provide you with all your options so you can make an informed choice.
After your consultation, you’ll get a comprehensive written treatment plan outlining the steps, timeline and cost. We advise you to always obtain a written treatment plan before accepting treatment from any clinician.
All on 4 procedure: day 1-3
When you arrive our patient care team will be there to assist you and get you ready, you will also meet and speak with our Anaesthetist. Our rooms are specially set up to perform implant placement in sterile conditions for your safety. Your implants are placed in your jaw based on Dr Dunn’s prepared plan.
It takes 3-4 hours to place the implants for each jaw, most patients under sedation will have little to no recollection of the treatment. You’ll spend an hour or two recovering as the anaesthetic wears off, after which you're ready to return to the comfort of your own home. We ask you to have a friend, spouse or family member escort you home as you won’t be able to drive.
You’ll attend our clinic to ‘try-in’ your new teeth. During this ‘try-in’ Dr Dunn checks how the teeth fit together and feel in your mouth, making sure your bite is perfect, and teeth are in the correct position before making the finishing touches.
We connect your new teeth to your dental implants. Dr Dunn performs a final check of your bite, and then you're ready to see the result!
Your teeth are securely attached to your implants so throw away your messy denture glue. This is the closest thing to real teeth.
Before you leave, you’ll get clear verbal and written instructions on the ‘dos’ and ‘don'ts’ during your recovery period. It's important to remember that although your new teeth feel firmly anchored in your jaw, the bone around the implants is still recovering. It takes 3-6 months for the bone to grow around the implants completely, so we recommend care and a soft diet during this period.
After All on 4 procedure
Most patients are surprised by the speed of recovery, often they’re able to return to their daily routine within a few days. Nevertheless, we still encourage our patients to take it easy in the days and weeks after treatment avoiding heavy lifting or exercise, opt instead for light walks. Eating nourishing soft foods and drinking plenty of fluids is also important to allow your body the rest it needs to heal.
You can expect some bruising and swelling around the face, the extent of this varies. Some experience visible bruising and swelling while it’s more subtle for others. It’s difficult to predict, but most find their bruising and swelling starts to subside after 3-4 days and is barely visible within a week.
Does All on 4 hurt?
“How much pain will I experience?” is the most common question we’re asked. Discomfort is mostly due to swelling and bruising which is normal after any surgery, and with some pain relief medication, most patients cope well.
If you’re afraid of dental treatment, we can work out strategies to help you including relaxation techniques, having a great support person nearby or even some counselling sessions before treatment to significantly reduce your anxiety. We’ve worked with many patients to help them overcome their fears.
Dental tools and treatments have come a long way, today we can provide most treatments with less discomfort and pain than what was available previously.
All on 4 reviews
The first dental implant treatment occurred over 50 years ago, so this is not “new” treatment. Dental implants, well planned by an experienced clinician is one of the most successful dental procedures.
There are many studies on dental implants in scientific journals supporting a success rate of 95-97%.
Studies on patient satisfaction find that 95% of patients are satisfied with their new teeth and 98% of patients would recommend All on 4 treatment to a friendi.
Dental implants rarely need replacing. Once your bone has grown around the implant, it should last a lifetime. Consistent at-home oral hygiene routines and regular check-ups at 6-month intervals are critical. Like natural teeth it’s important to brush away bacteria build-up in the mouth. At your two-week check-up, we’ll teach you how to clean around your new implants and teeth and how to use the water flosser included in the treatment package.
The teeth may need replacing every five years if you have opted for the acrylic denture teeth as these materials are more prone to wear and tear. Alternatively, the more robust zirconia teeth option can last 15-20 years (or more) with proper care. Like real teeth, they’re strong but not indestructible, so care is required. Don’t use your teeth as tools (e.g. to open bottles) and be cautious when biting into hard foods like olive pips or nutshells that can chip or damage teeth.
Your initial set of teeth come with a one year warranty, and the implant treatment has five years warranty subject to regular maintenance, attendance and lifestyle factors (for example smoking cessation). A nightguard is included with treatment and needs to be worn to protect your teeth. With regular maintenance and consistent wearing of a nightguard, you’ll find your initial set of teeth will serve you for many years.
At our clinic, we carefully monitor our dental implant patients, and we have follow-up spanning 15 years of patients with All on 4 performed by Dr Dunn.
Choosing an All on 4 dentist
All on 4 can be life-changing for patients but it’s also an advanced and irreversible procedure, so experience counts.
As you compare All on 4 providers, which we highly recommend you do, here are some points you will want to check:
- How many All-on-4 procedures has the clinician performed?
- How long have they been doing dental implant treatment?
- What training have they undertaken in this procedure?
- What’s the longest patient follow-up they have? (This is even more important than the quantity of cases performed as you want to assess the long-term outcomes)
- What implants will the surgeon be using? (Some implants have decades of research, others have very little)
- Can they show you quality (close-up) images of the patients they have treated?
- Who is the Prosthetist (denture expert) that will assist and do they have expertise working with dental implants? Or will this portion of the work be outsourced to offshore laboratories?
- What materials are used to make the teeth?
- Has the clinician explained all your treatment options to you including possible complications and ongoing maintenance?
- Has the surgeon provided a comprehensive, itemised treatment plan describing their assessment?
Unfortunately, there is no ‘official’ qualification required to perform this treatment so the degree of expertise can vary significantly between surgeons from someone who’s completed a three-day course to someone who’s invested countless hours and years to learn this treatment, so ask questions and assess carefully.
Take the time you need to make a decision, speak to friends, family and even past patients. You should never feel rushed to proceed with treatment.
How much does All on 4 cost
Pricing for All on 4 treatment can range from $20,000 -$35,000 across various clinics but as there is no ‘standard’ way to quote for All on 4 treatment, it makes ‘apples with apples’ comparisons almost impossible. The major factors influencing the final price include:
- The type of final teeth you choose as these range from simple denture teeth to custom designed porcelain teeth (not to be confused with porcelain denture teeth that are not custom made)
- Experience & training of the clinician; like in all professional field years of proven experience delivering results equates with higher fees
- Quality of the first set of teeth provided following your surgery; depending on how the first set of teeth are made they will need replacing as soon as 6 months after implant placement, this is particularly the case if there is no ‘try-in’ of your first teeth or if they are not reinforced with strong, welded structure underneath the teeth
- Type of dental implants used by the surgeon, top tier products made by the longest serving dental implant manufacturers are more expensive
- Time allocated for your treatment, some clinics may offer appointments to do ‘try-in’ of your first teeth to check your bite, more time in the planning phase and more post-operative checkups to ensure your proper healing
- Expertise of Prosthetist or laboratory technician – not all prosthetists are trained in dental implants
- Hidden costs – sometimes only the cost for the surgery is quoted and then the teeth are quoted separately, obscuring the total cost
- Extra inclusions: for example, has a nightguard been included to protect your new teeth and are repairs covered during the first year.
With all of the variables that affect the costs for All on 4 treatment, it’s not surprising cost is a common point of confusion for patients considering treatment. To help, we’ve compiled a handy guide to help you understand costs, health insurance rebates and financing options. Access our All on 4 costs guide here.
Want to know more about All on 4 dental implants?
i Babbush CA, Kanawati A, Kotsakis GA, Hinrichs JE. Patient-Related and Financial Outcomes Analysis of Conventional Full-Arch Rehabilitation Versus the All-on-4 Concept: A Cohort Study. Implant Dent 2014;23(2):218–24