Dr David Dunn is a leading dental surgeon with over 20 years of experience in aesthetic and implant dentistry. An internationally recognised expert 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.
While All on 4 dental implants problems are uncommon, they can include implant failure, infection, bite misalignment, nerve or sinus complications, and gum recession. Most issues can be avoided with the right planning, specialist care, and ongoing oral hygiene.
If you’re considering All on 4 dental implants Sydney, this guide will walk you through the most common All on 4 complications, what signs to look for, and how you can reduce your risk and enjoy the long-term benefits of your new smile.
Enjoy getting your teeth into this topic when it suits you.
Oops! Something went wrong while submitting the form.
What are the problems with All-on-4 dental implants?
The most common All on 4 implants problems include implant failure, infection (peri-implantitis), bite misalignment, gum recession, nerve damage, and sinus complications. While these risks exist, they are rare with proper planning and care.
All-on-4 is a proven treatment with a high success rate (95%+). But as with any surgical procedure, there are risks. Understanding potential All on 4 complications can help you make an informed decision and take steps to prevent them.
The average success rate for All on 4 dental implants is 96% when performed by an experienced All on 4 dentist.
All-on-4 implant failure: signs and causes
All on 4 implant failure is rare, but it can occur if the implant doesn’t fuse with the jawbone. Signs include pain, mobility, swelling, or loosening of the bridge.
Dental implant failure can result from:
Inadequate bone density
Poor blood flow to the gums
Smoking or medical conditions (e.g. diabetes)
Poor oral hygiene
Excessive bite force or misalignment
Your dentist may recommend bone grafting or adjusting your bite to reduce the risk of implant failure.
The good news? The average success rate for All on 4 dental implants is 96% when performed by an experienced All on 4 dentist. In the rare case that an implant fails, a new implant can be placed with a high chance that it will integrate into the bone the second time.
Infection and peri-implantitis
Infection is one of the most common All on 4 dental implant risksand can progress to peri-implantitis if untreated.
Infections typically occur at the implant site due to bacteria. Risk factors include gum disease, smoking, and poor hygiene. Peri-implantitis causes bone loss around the implant and can lead to failure if untreated. Signs of infection include:
There are some great products you can use to help keep your implants clean, like a Waterpik or special implant floss. Your dentist should talk to you about these and may even provide them as part of your All on 4 procedure.
Bite misalignment and jaw discomfort
If your bite isn’t properly aligned after surgery, you may experience jaw pain, uneven wear, or difficulty chewing.
Even small misalignments can put excess pressure on implants, leading to long-term issues. Modern digital planning and bite analysis at specialist clinics help minimise this risk.
Here at Macquarie Street Dental, we’ve invested in X-Guide — a groundbreaking technology that ensures every implant is placed with absolute precision. This guarantees a secure fit and natural feel, while reducing the risk of bite misalignment.
Nerve damage or sinus complications
Nerve or sinus issues are rare but can occur if implants are placed too close to a nerve or the nasal cavity.
Possible symptoms include tingling, numbness, pain or sinus discomfort. Advanced imaging (3D scans) and the latest technology (like X-guide, mentioned above) assists your implant dentist to avoid these complications by precisely planning implant placement.
At Macquarie Street Dental, we’ve invested in X-Guide — a groundbreaking technology that ensures every implant is placed with absolute precision.
Gum recession and bone loss
Gum recession around implants exposes the titanium base and increases the risk of infection or failure. Causes include incorrect implant placement, thin gum tissue, smoking, poor oral health, or untreated gum disease. Bone loss may occur if peri-implantitis develops.
In most cases gum recession and bone loss are addressed before All on 4 implant surgery. Your dentist may recommend bone grafting, gum disease treatment, or quitting smoking. Good oral hygiene and regular dental checks-ups are essential too.
Medical & lifestyle factors to consider
There are very few patients who contact us for All on 4 dental implants in Sydney that we cannot treat. However, there are a few medical conditions that may carry a slightly higher risk of failure, these are:
Osteoporosis or diabetes
If you have had radiation therapy
If you have a compromised immune system
If any of these describe you, it does not exclude you from treatment but we recommend that you book a free All on 4 consultation to assess your suitability and explore all your options.
Certain lifestyle factors can also increase the risk of implant failure. These include:
Smoking
Poor oral hygiene
Teeth grinding
Excessive alcohol consumption
These things don’t prevent you from having the procedure but can affect its success both in the short term and over the life of your treatment. Deciding to get All on 4 treatment is a big investment, so you want to ensure the highest chance of success.
Proper planning, x-rays, try-ins of your final teeth and implant planning software can prevent most all on 4 dental implants risks.
How can I avoid All on 4 problems?
The experience of the surgeon performing the All on 4 procedure is probably the most important factor determining the success of your treatment. This treatment is very advanced and it is not something that is taught at dental school.
You will want to ensure that your All on 4 dentist has had adequate and proper training and has performed this surgery many times. More importantly, you’ll want to know that they have long-term success with All on 4 patients that they can show you. This treatment has been around for over 20 years so patient case studies and All-on-4 reviews can be helpful.
Poorly placed implants are one of the problems that can occur with an inexperienced surgeon. This could affect your speech and may result in delayed healing, a poor cosmetic outcome or your teeth not feeling right in your mouth.
With today's technology, there is absolutely no excuse for poorly placed implants. Proper planning, x-rays, try-ins of your final teeth and implant planning software can prevent this entirely.
Another All on four problem that can occur with an inexperienced surgeon is teeth breaking off your All on 4 bridge. Sometimes this is inevitable but again, with proper planning and provision of a nightguard, this can be greatly minimised.
Practical steps to avoid All on 4 complications include:
Choosing a specialist team that uses high-quality implants
Quitting smoking
Managing medical conditions like diabetes
Maintaining excellent oral hygiene
Scheduling regular professional cleans
Following your dentist’s aftercare instructions carefully
What’s the long term success rate of All on 4?
The great news is that All on 4 has an incredibly high success rate, with implants often lasting 20 years or more.
While natural teeth can still suffer decay, implants resist cavities. The main risk is gum or bone disease, which is manageable with regular dental check-ups.
Ready to find out if All on 4 is right for you
At Macquarie Street Dental, we’ve been performing the All on 4 treatment at our Sydney clinic for more than 20 years. We use advanced planning, precision surgery, the latest technology, and long-term aftercare to ensure your smile not only looks natural but also lasts.
Studies show that All-on-4 implants have a 95–98% success rate over 10+ years, meaning failure is uncommon. Most patients enjoy long-term function without complications, particularly when treated by experienced implant dentists.
What is one common complication that can arise with dental implants?
One of the most common risks with dental implants is peri-implantitis, a type of gum infection that can cause bone loss around the implant.
Infection develops when bacteria build up around the implant site, often due to poor oral hygiene, smoking, or pre-existing gum disease. Symptoms may include bleeding gums, swelling, or tenderness near the implant. If left untreated, it can compromise the implant’s stability. Regular professional cleans and good home care are the best ways to prevent infection.
How will I know if my dental implant has failed?
Signs of implant failure include persistent pain, swelling, loose implants, bleeding gums, or difficulty chewing. If you notice these symptoms, contact your dentist immediately. Early treatment can often save the implant.
Why does smoking affect dental implants?
Smoking reduces blood flow to the gums, which slows healing and increases the risk of infection, gum recession, and implant failure.
Nicotine restricts blood vessels, meaning less oxygen and nutrients reach the tissues around implants. This delays healing, weakens your body’s defences, and raises the risk of gum disease or peri-implantitis. Over time, it can also cause bone loss and expose the implant. Quitting smoking before and after treatment greatly improves implant success.
Do All on 4 dental implant problems increase the cost of treatment?
Yes, if complications occur they can increase the overall cost of All-on-4 treatment through additional procedures, repairs, or maintenance.
While All on 4 implants problems are uncommon, issues like implant failure, gum disease, or bone loss may require extra appointments, bone grafting, or corrective surgery. This can add to your original treatment fee. To minimise this risk, choose an experienced implant dentist and following your dentist’s care instructions.
Why is post-operative care important for All-on-4 implant success?
The success of All-on-4 dental implant surgery is influenced by both the surgeon’s experience and the quality of post-operative care provided to the patient.
Following post-operative care instructions closely helps ensure successful treatment, supports proper healing and reduces the risk of problems such as infection or implant rejection. Regular 6-month check-ups are also essential for the maintenance of All-on-4 implants.
Are the benefits of All-on-4 worth the risks?
For most patients, the benefits of All-on-4 — fixed teeth, restored function, and improved confidence — far outweigh the small risk of complications.
While it’s important to understand potential All on 4 dental implants complications, the treatment’s high success rate and life-changing results make it one of the most reliable solutions for missing teeth. Patients enjoy a natural-looking smile, long-term stability, and the ability to eat and speak with ease.
Dr David Dunn is a leading dental surgeon with over 20 years of experience in aesthetic and implant dentistry. An internationally recognised expert 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.
While All on 4 dental implants problems are uncommon, they can include implant failure, infection, bite misalignment, nerve or sinus complications, and gum recession. Most issues can be avoided with the right planning, specialist care, and ongoing oral hygiene.
If you’re considering All on 4 dental implants Sydney, this guide will walk you through the most common All on 4 complications, what signs to look for, and how you can reduce your risk and enjoy the long-term benefits of your new smile.
Enjoy getting your teeth into this topic when it suits you.
Oops! Something went wrong while submitting the form.
What are the problems with All-on-4 dental implants?
The most common All on 4 implants problems include implant failure, infection (peri-implantitis), bite misalignment, gum recession, nerve damage, and sinus complications. While these risks exist, they are rare with proper planning and care.
All-on-4 is a proven treatment with a high success rate (95%+). But as with any surgical procedure, there are risks. Understanding potential All on 4 complications can help you make an informed decision and take steps to prevent them.
The average success rate for All on 4 dental implants is 96% when performed by an experienced All on 4 dentist.
All-on-4 implant failure: signs and causes
All on 4 implant failure is rare, but it can occur if the implant doesn’t fuse with the jawbone. Signs include pain, mobility, swelling, or loosening of the bridge.
Dental implant failure can result from:
Inadequate bone density
Poor blood flow to the gums
Smoking or medical conditions (e.g. diabetes)
Poor oral hygiene
Excessive bite force or misalignment
Your dentist may recommend bone grafting or adjusting your bite to reduce the risk of implant failure.
The good news? The average success rate for All on 4 dental implants is 96% when performed by an experienced All on 4 dentist. In the rare case that an implant fails, a new implant can be placed with a high chance that it will integrate into the bone the second time.
Infection and peri-implantitis
Infection is one of the most common All on 4 dental implant risksand can progress to peri-implantitis if untreated.
Infections typically occur at the implant site due to bacteria. Risk factors include gum disease, smoking, and poor hygiene. Peri-implantitis causes bone loss around the implant and can lead to failure if untreated. Signs of infection include:
There are some great products you can use to help keep your implants clean, like a Waterpik or special implant floss. Your dentist should talk to you about these and may even provide them as part of your All on 4 procedure.
Bite misalignment and jaw discomfort
If your bite isn’t properly aligned after surgery, you may experience jaw pain, uneven wear, or difficulty chewing.
Even small misalignments can put excess pressure on implants, leading to long-term issues. Modern digital planning and bite analysis at specialist clinics help minimise this risk.
Here at Macquarie Street Dental, we’ve invested in X-Guide — a groundbreaking technology that ensures every implant is placed with absolute precision. This guarantees a secure fit and natural feel, while reducing the risk of bite misalignment.
Nerve damage or sinus complications
Nerve or sinus issues are rare but can occur if implants are placed too close to a nerve or the nasal cavity.
Possible symptoms include tingling, numbness, pain or sinus discomfort. Advanced imaging (3D scans) and the latest technology (like X-guide, mentioned above) assists your implant dentist to avoid these complications by precisely planning implant placement.
At Macquarie Street Dental, we’ve invested in X-Guide — a groundbreaking technology that ensures every implant is placed with absolute precision.
Gum recession and bone loss
Gum recession around implants exposes the titanium base and increases the risk of infection or failure. Causes include incorrect implant placement, thin gum tissue, smoking, poor oral health, or untreated gum disease. Bone loss may occur if peri-implantitis develops.
In most cases gum recession and bone loss are addressed before All on 4 implant surgery. Your dentist may recommend bone grafting, gum disease treatment, or quitting smoking. Good oral hygiene and regular dental checks-ups are essential too.
Medical & lifestyle factors to consider
There are very few patients who contact us for All on 4 dental implants in Sydney that we cannot treat. However, there are a few medical conditions that may carry a slightly higher risk of failure, these are:
Osteoporosis or diabetes
If you have had radiation therapy
If you have a compromised immune system
If any of these describe you, it does not exclude you from treatment but we recommend that you book a free All on 4 consultation to assess your suitability and explore all your options.
Certain lifestyle factors can also increase the risk of implant failure. These include:
Smoking
Poor oral hygiene
Teeth grinding
Excessive alcohol consumption
These things don’t prevent you from having the procedure but can affect its success both in the short term and over the life of your treatment. Deciding to get All on 4 treatment is a big investment, so you want to ensure the highest chance of success.
Proper planning, x-rays, try-ins of your final teeth and implant planning software can prevent most all on 4 dental implants risks.
How can I avoid All on 4 problems?
The experience of the surgeon performing the All on 4 procedure is probably the most important factor determining the success of your treatment. This treatment is very advanced and it is not something that is taught at dental school.
You will want to ensure that your All on 4 dentist has had adequate and proper training and has performed this surgery many times. More importantly, you’ll want to know that they have long-term success with All on 4 patients that they can show you. This treatment has been around for over 20 years so patient case studies and All-on-4 reviews can be helpful.
Poorly placed implants are one of the problems that can occur with an inexperienced surgeon. This could affect your speech and may result in delayed healing, a poor cosmetic outcome or your teeth not feeling right in your mouth.
With today's technology, there is absolutely no excuse for poorly placed implants. Proper planning, x-rays, try-ins of your final teeth and implant planning software can prevent this entirely.
Another All on four problem that can occur with an inexperienced surgeon is teeth breaking off your All on 4 bridge. Sometimes this is inevitable but again, with proper planning and provision of a nightguard, this can be greatly minimised.
Practical steps to avoid All on 4 complications include:
Choosing a specialist team that uses high-quality implants
Quitting smoking
Managing medical conditions like diabetes
Maintaining excellent oral hygiene
Scheduling regular professional cleans
Following your dentist’s aftercare instructions carefully
What’s the long term success rate of All on 4?
The great news is that All on 4 has an incredibly high success rate, with implants often lasting 20 years or more.
While natural teeth can still suffer decay, implants resist cavities. The main risk is gum or bone disease, which is manageable with regular dental check-ups.
Ready to find out if All on 4 is right for you
At Macquarie Street Dental, we’ve been performing the All on 4 treatment at our Sydney clinic for more than 20 years. We use advanced planning, precision surgery, the latest technology, and long-term aftercare to ensure your smile not only looks natural but also lasts.
Studies show that All-on-4 implants have a 95–98% success rate over 10+ years, meaning failure is uncommon. Most patients enjoy long-term function without complications, particularly when treated by experienced implant dentists.
What is one common complication that can arise with dental implants?
One of the most common risks with dental implants is peri-implantitis, a type of gum infection that can cause bone loss around the implant.
Infection develops when bacteria build up around the implant site, often due to poor oral hygiene, smoking, or pre-existing gum disease. Symptoms may include bleeding gums, swelling, or tenderness near the implant. If left untreated, it can compromise the implant’s stability. Regular professional cleans and good home care are the best ways to prevent infection.
How will I know if my dental implant has failed?
Signs of implant failure include persistent pain, swelling, loose implants, bleeding gums, or difficulty chewing. If you notice these symptoms, contact your dentist immediately. Early treatment can often save the implant.
Why does smoking affect dental implants?
Smoking reduces blood flow to the gums, which slows healing and increases the risk of infection, gum recession, and implant failure.
Nicotine restricts blood vessels, meaning less oxygen and nutrients reach the tissues around implants. This delays healing, weakens your body’s defences, and raises the risk of gum disease or peri-implantitis. Over time, it can also cause bone loss and expose the implant. Quitting smoking before and after treatment greatly improves implant success.
Do All on 4 dental implant problems increase the cost of treatment?
Yes, if complications occur they can increase the overall cost of All-on-4 treatment through additional procedures, repairs, or maintenance.
While All on 4 implants problems are uncommon, issues like implant failure, gum disease, or bone loss may require extra appointments, bone grafting, or corrective surgery. This can add to your original treatment fee. To minimise this risk, choose an experienced implant dentist and following your dentist’s care instructions.
Why is post-operative care important for All-on-4 implant success?
The success of All-on-4 dental implant surgery is influenced by both the surgeon’s experience and the quality of post-operative care provided to the patient.
Following post-operative care instructions closely helps ensure successful treatment, supports proper healing and reduces the risk of problems such as infection or implant rejection. Regular 6-month check-ups are also essential for the maintenance of All-on-4 implants.
Are the benefits of All-on-4 worth the risks?
For most patients, the benefits of All-on-4 — fixed teeth, restored function, and improved confidence — far outweigh the small risk of complications.
While it’s important to understand potential All on 4 dental implants complications, the treatment’s high success rate and life-changing results make it one of the most reliable solutions for missing teeth. Patients enjoy a natural-looking smile, long-term stability, and the ability to eat and speak with ease.
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.
.webp)
