Dr David Dunn is a leading dental surgeon with over 20 years of experience in aesthetic and implant dentistry.
If you’re facing the possibility of losing your teeth, or already struggling with loose dentures, you’re probably wondering what your real options are. The All-on-4 procedure offers a way to replace a full set of teeth with just four implants, creating a fixed smile designed for stability, comfort, and confidence.
This guide walks you through the entire process, including how the procedure works, what makes the newer Next Gen approach different, what recovery is like, and what it may cost, so you can understand exactly what to expect before taking the next step.
Enjoy getting your teeth into this topic when it suits you.
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What are All on 4 dental implants?
All-on-4 dental implants are a full-arch teeth replacement solution for people who have lost (or are about to lose) most or all of their teeth. The All-on-4 procedure uses four titanium implants in the upper or lower jaw to hold a fixed, non-removable dental bridge. The rear implants are usually angled to maximise contact with available bone, which can help improve stability and may reduce the need for bone grafting in suitable patients.
Before All-on-4 was developed, full mouth implant treatments often required more implants, longer healing times, and invasive bone grafting, with patients having to wear removable dentures for several months before permanent teeth could be placed.
With All-on-4, temporary teeth can be fitted soon after surgery, which may reduce overall treatment time for suitable patients.
And while standard All-on-4 is still effective, modern technology has led to an upgrade: All-on-4 Next Gen, designed for a more seamless, lifelike look and feel.
Illustration of an all-on-four implant placement in the bottom jaw.
What is All on 4 Next Gen
All-on-4 Next Gen takes everything that works in standard All-on-4 and improves it.
Instead of replacing both teeth and gums, Next Gen replaces only the teeth, preserving your natural gum line wherever possible. Preserving the natural gum line not only enhances aesthetics but also supports better oral function and tissue health. This creates a smile that looks and feels more natural, while blending seamlessly with your face.
Advanced CAD/CAM technology is used to manufacture teeth that closely replicate natural teeth, ensuring a precise fit and lifelike appearance.
How standard All-on-4 compares to All-on-4 Next Gen
In a standard all-on-4 pink “false gum” material is used to replace the missing gum but with Next Gen the teeth emerge naturally from the gumline.
Feature / Benefit
Standard All-on-4
All-on-4 Next Gen
Preserves natural gums
❌ Typically removes gum tissue to create space
✅ Preserves your own gumline wherever anatomy allows
Preserves bone
❌ Often requires removal of healthy bone
✅ Aims to avoid bone removal for better long-term outcomes
Gumline design
❌ Pink “false gum” material is used to replace missing gum
✅ Not required, as teeth emerge from your natural gumline
Transition line visibility
❌ Can be visible
✅ No clear transition line
Bridge design
❌ Thicker, bulkier design
✅ Ultra-slim and lifelike; zirconia bridges are available for maximum durability and aesthetics
Feel in the mouth
❌ Can feel foreign or full
✅ Feels closer to natural teeth
Food trapping & cleaning
❌ More prone due to transition line
✅ Minimal food trapping & easier to clean
Ideal for…
Moderate to severe bone loss, limited anatomy
Most patients seeking the most natural appearance and feel
The All-on-4 technique is suitable for both upper and lower teeth, with special consideration given to the lower teeth to maximize bone support and avoid nerve interference for optimal, long-lasting results.
Click the video above to learn all about All-on-4 Next Gen.
All-on-4 Procedure Step By Step
Step 1: Complimentary consultation
The success of your All-on-4 treatment (whether standard or Next Gen) starts with a thorough consultation and detailed planning.
During your consult, Dr Dunn and our team will:
Review your medical history and oral health, including any relevant medical conditions to ensure you are eligible and safe for the procedure
Take a 3D CBCT scan (needle-free and painless), plus digital scans and photographs; these x-rays and scans help evaluate your bone structure and bone density to determine suitability for All-on-4 implants
Assess your jawbone health and available bone density to see if additional bone grafting is needed, though the All-on-4 technique often avoids this step
Discuss various treatment options (Next Gen, standard All-on-4, or alternatives) based on your needs and bone structure
Provide a transparent cost breakdown and treatment timeline
Show and compare tooth bridge materials
Preview your new smile using digital smile design
Step 2: Treatment planning & smile design
If you decide to proceed, we take detailed records like, intraoral scans, photos, facial videos and bite analysis. We use these to plan where the implants go and design a smile that fits your face and features.
Step 3: Implant placement
We perform your procedure under IV sedation (twilight sedation) with an accredited anaesthetist, so you feel relaxed and comfortable. Using advanced guided technology such as X-Guide, we place implants with exceptional accuracy, and remove any remaining damaged or decayed teeth, if needed. For upper jaw implants, the position is carefully planned to avoid the sinus cavities.
Next Gen patients typically receive same-day temporary teeth, made and adjusted with FastMap photogrammetry while they’re still in the chair.
Standard All-on-4 patients may receive their temporary teeth within a few days, depending on their case and treatment plan.
After surgery, you’ll spend around 30-45 minutes in recovery, and you’ll need someone to take you home.
Step 4: Temporary bridge design, try-in & fitting
For a standard All-on-4, once your temporary bridge is ready, you’ll come in to try a 3D-printed version. This lets us check the fit, comfort, bite and aesthetics. Temporary bridges are often made from acrylic teeth, which are softer and may need to be replaced after a few years. After any final adjustments, we secure your temporary bridge to your implants. You’ll also get clear aftercare instructions for healing.
A temporary implant bridge is worn during healing, then replaced with the final bridge once your implants are fully integrated.
Step 5: Healing & final teeth
Over the next 4–6 months, your implants integrate with the bone as your mouth heals.
Next Gen patients: your same-day teeth are refined over the first 12 weeks to support healing and help shape the gumline. Your final ceramic bridge is usually fitted around six months.
Standard All-on-4 patients: your temporary bridge is worn during healing, then replaced with the final bridge once your implants are fully integrated.
Before and after of a real patient who went through with the all on 4 dental implants procedure with Dr Dunn.
How Long Does All-on-4 Procedure Take?
Implant placement for a standard All-on-4 typically takes around 3-4 hours per jaw. The Next Gen procedure usually takes less time. If any remaining teeth need to be removed, this is usually done during the same procedure.
Temporary teeth may be fitted on the same day or shortly after surgery for suitable patients.The healing and integration period usually takes 4–6 months, after which the final bridge is attached.
Many patients resume normal daily activities within 10–14 days, although mild swelling or discomfort can occur during the first few days.
How Much Does The All-on-4 Procedure Cost
All-on-4 cost can vary from around $20,000 to more than $40,000. The cost of All-on-4 (whether standard or Next Gen) varies for each patient because everyone’s jaw, treatment plan, and goals are different.
Factors that affect the price include:
Complexity of your case
Experience of your dentist
Technology used during treatment
Type of bridge and materials used
After your free consultation and 3D assessment, we give you a clear, personalised treatment plan and a detailed cost breakdown. You’ll know exactly what’s involved before you start.
For a closer look at typical costs, what’s included, and payment options, you can download our free All-on-4 Price Guide.
Like any dental treatment, All-on-4 implants have advantages and considerations.
Pros Of The All-On-4 Dental Implants
Full arch rehabilitation for a natural smile
Improved chewing and speech
Enhanced facial support/preserves jaw bone
Long-term solution—with success rates over 93%
Almost-immediate temporary teeth
No bone grafting needed in most cases
Quick recovery
Cons Of The All-on-4 Dental Implants
Requires surgical treatment and recovery time
Not all patients are suitable without assessment
Healing period required before final bridge placement
As with any surgery, risks such as infection or implant failure can occur
Upfront cost is typically higher than removable dentures
Suitability and outcomes depend on individual health, anatomy, and oral hygiene practice.
What to expect during the All on 4 recovery period?
Recovery after All-on-4 dental implant surgery is often quicker than expected, with most patients resuming normal activities within 10 to 14 days.
It's normal to experience some discomfort, bruising and mild swelling for a few days after All on four surgery, but this can be easily managed with over-the-counter pain medication.
During your recovery, it's crucial that you follow the clear aftercare and All on 4 cleaning instructions provided by your dentist.
We recommend taking things easy by doing the following:
Resting and avoiding heavy lifting
Drinking plenty of fluids (avoid hot drinks)
Eating soft, nourishing foods and avoiding hard or sticky foods
Follow the cleaning instructions provided and maintain good oral hygiene
Schedule regular dental check-ups
Follow-Up Care
After your All-on-4 dental implants are placed, ongoing follow-up appointments are essential to ensure your new teeth remain healthy and functional. Typically, your dentist will schedule check-ups at 4–6 weeks and again at 3–6 months after implant surgery. During these visits, the dentist will assess the healing of your implants, make any necessary adjustments to your bite, and provide guidance on maintaining excellent oral hygiene.
Proper care is key to the long-term success of your All-on-4 implants. Patients should brush and floss their new teeth daily, just as they would with natural teeth, and attend regular dental check-ups to monitor oral health. These follow-up appointments allow your dentist to catch any potential issues early and help you maintain a natural smile and optimal oral health for years to come. With the right care and regular follow-up, All-on-4 dental implants can provide a permanent solution for missing teeth, restoring both function and confidence.
The Dr Dunn difference
Dr Dunn has a special interest in dental implant treatment and cosmetic dentistry and has spent over 25 years transforming thousands of smiles with All-on-4. To see some of the incredible transformations Dr Dunn has achieved, check out our All-on-4 before and after gallery.
Before and after of a real patient who went through with the all on 4 dental implants procedure with Dr Dunn.
FAQs
What’s the difference between standard All-on-4 and All-on-4 Next Gen?
Standard All-on-4 replaces both teeth and gums using a fixed bridge. All-on-4 Next Gen aims to replace only the teeth, preserving more natural gum and bone tissue. This can allow for a slimmer bridge design and a more lifelike appearance. Suitability depends on individual anatomy and is assessed during consultation.
What materials are used for All-on-4 Next Gen?
For our Next Gen bridge restorations, we use the ICE zirconia ceramic system by Zirkonzahn. This high-strength, all-ceramic material allows for a thinner yet durable bridge without a titanium framework. Each bridge is custom-contoured to match your gumline and anatomy, offering a more natural feel and appearance compared with bulkier alternatives.
Is All-on-4 All on 4 worth it?
For people needing to replace a full arch of teeth, All-on-4 is widely considered a worthwhile long-term solution. Studies report high satisfaction rates, with around 95% of patients satisfied and 98% willing to recommend the treatment. As with any medical procedure, suitability and outcomes depend on individual factors and should be discussed during a consultation.
How long does the All on 4 surgery take?
Implant placement for a standard All-on-4 typically takes around 3-4 hours per jaw. The Next Gen procedure usually takes less time. If any remaining teeth need to be removed, this is usually done during the same procedure.
Is the surgery painful?
You'll receive local anaesthetic and twilight (IV) sedation to keep you relaxed and comfortable – with little or no memory of the procedure.
Are there any risks?
As with any surgical procedure, there are risks. Potential complications may include implant failure, infection, nerve injury from improper placement, bridge damage, or issues related to existing health conditions. Choosing an experienced clinician and following aftercare instructions significantly reduces these risks.
How long do All-on-4 dental implants last?
All-on-4 dental implants are built for durability, often lasting 20 to 25 years or more – and with proper care, they may last a lifetime. The implants are intended to be permanent, while the dental bridge (including Next Gen ceramic designs) may require replacement over time due to normal wear.
How do you care for All on 4 implants?
Caring for All-on-4 implants is similar to caring for natural teeth. This includes brushing twice daily, cleaning around the bridge, and attending regular professional check-ups. Once healing is complete and your final bridge is fitted, most patients can eat and chew normally.
Not sure if All-on-4 is right for you?
Get a personalised assessment and treatment estimate.
Dr David Dunn is an internationally recognised expert with over 20 years of experience in the All-on-4 procedure. He holds a BDS (Hons) from the University of Sydney and is a Fellow of the Royal Australasian College of Dental Surgeons (FRACDS) and the Pierre Fauchard Academy. He is also a faculty member of the prestigious gIDE/UCLA Master Clinician Program, the founder and past chair of the Osseointegration Society of NSW, and a published author in the International Journal of Prosthodontics.
Dr David Dunn is one of Sydney’s most experienced and renowned implant and cosmetic dentists. At Macquarie Street Dental, you’ll feel 100% confident that your new smile will be beautifully natural and as unique as you.
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