Reviewed by Dr. Nicole M. Berger, DDS — South Florida Smile Spa, Pompano Beach, FL
Quick Answer
All-on-4® replaces a full upper or lower arch of teeth with a fixed bridge supported by four dental implants, two of them angled to make the most of the bone you have. At South Florida Smile Spa in Pompano Beach, treatment is staged over multiple appointments, Dr. Nicole M. Berger plans your case and designs your new teeth, and IV sedation is available in our office for surgery.
Full-Arch Dentistry
What All-on-4 dental implants are
All-on-4® is a full-arch treatment that uses four dental implants to anchor a fixed, non-removable set of teeth to your upper or lower jaw. The two back implants are placed at an angle, which lets them use more of the available bone and can reduce the need for bone grafting compared with placing an implant for every missing tooth.
It is designed for people who have lost most or all of their teeth, or whose remaining teeth can no longer be saved. Instead of a denture that comes out at night, you get teeth that stay in place and that you brush and care for much like natural teeth. If you are missing only one or a few teeth, a single tooth implant or another option from our dental implant services may be a better fit.
All-on-4® vs. Dentures
Traditional dentures rest on your gums and rely on suction or adhesive to stay in place. All-on-4® teeth are fixed to implants, which changes daily life in a few ways:
- They stay in. No adhesives, no taking them out at night, and no slipping when you talk or laugh.
- A stronger bite. Implant-supported teeth let you chew with more force than a denture allows, so more of the foods you enjoy are back on the menu.
- Less bulk. An upper All-on-4® bridge does not cover the roof of your mouth the way an upper denture does.
- Simple daily care. You brush them every day and clean underneath the bridge with a water flosser, plus regular professional cleanings.
Why Your Jawbone Matters
When teeth are missing, the jawbone no longer receives stimulation from chewing, and the body gradually reabsorbs it. This process is called resorption, and over time it can make the face look sunken or older. Dentures do not stop it. Dental implants transmit chewing forces into the jaw, which helps preserve the bone you still have and support the shape of your face.
Sedation Options for All-on-4® Surgery
All-on-4® surgery typically takes about two and a half hours per arch, and many patients would rather not be fully aware for it. Because we offer sedation dentistry in-house, you can choose the level of comfort that suits you:
- IV sedation: medication delivered through a small IV keeps you deeply relaxed throughout surgery, and many patients remember little of the procedure afterward. Learn about IV sedation.
- Oral conscious sedation: a prescribed pill taken before your appointment to ease moderate anxiety. Learn about oral sedation.
- Nitrous oxide: mild, fast-acting relaxation that wears off quickly. Learn about nitrous oxide.
- Local anesthesia: numbs the treatment area and is used with every option above.
We review your health history and medications to recommend the safest option for you. With IV or oral sedation, you will need a responsible adult to drive you home. If dental visits make you anxious, our dental anxiety resources explain how we help.
Who Is a Good Candidate for All-on-4®?
You may be a good candidate if you:
- Are missing most or all of your teeth in the upper or lower jaw
- Have teeth that cannot be saved because of advanced decay, gum disease, or fractures
- Wear a denture that slips, rubs, or keeps you from eating what you like
- Have been told you do not have enough bone for traditional implants. The angled back implants often work around bone loss, although some patients still need grafting.
Your overall health also matters. Smoking, uncontrolled diabetes, and some medications, including certain osteoporosis drugs, can affect how well implants heal. These do not always rule you out, and we will review them with you at your consultation.
The All-on-4® Process at South Florida Smile Spa
All-on-4® treatment is staged over multiple appointments so each step fits your healing and your comfort:
- Consultation and exam. We review your dental and medical history, your current teeth or denture, and your goals.
- 3D imaging. A cone beam CT scan shows your bone, sinuses, and nerves in three dimensions.
- Digital planning. We plan the position of each implant and the design of your new teeth before surgery.
- Implant surgery. Any remaining teeth that cannot be saved are removed and the four implants are placed, with the sedation option you chose. You will wear a temporary set of teeth while you heal.
- Healing. Over the next several months, the implants fuse with your jawbone. We see you for follow-up visits along the way.
- Final bridge. Once healing is complete, Dr. Berger fits your final, custom-designed bridge.
Recovery and Diet After All-on-4®
Everyone heals a little differently, and we give you written instructions for your specific case. Here is what most patients can expect:
The First Few Days
Swelling, some bruising, and soreness are normal and usually peak around the second or third day. Rest with your head elevated, use cold packs on and off, and take medications as prescribed. Stick to cool liquids and very soft foods such as smoothies, yogurt, applesauce, and lukewarm broth. If you had teeth removed, skip straws for the first several days.
The First Two Weeks
Move to soft foods you can cut with a fork: scrambled eggs, mashed potatoes, oatmeal, soft pasta, flaky fish, and cooked vegetables. Many patients return to desk work within a few days to a week.
While the Implants Heal
For the next few months, avoid hard, crunchy, and sticky foods such as nuts, chips, crusty bread, raw carrots, tough meats, and caramel, and chew gently. This protects the implants while they fuse with the bone.
After Your Final Bridge
Once your final teeth are in place, most patients return to a wide, varied diet, including many foods that are hard to manage with dentures.
Call us at (954) 785-1100 right away if you have bleeding that will not stop, a fever, or pain that gets worse instead of better.
Comparing Full-Arch Tooth Replacement Options
All-on-4® is one of several ways to replace a full arch of teeth. During your consultation, we will explain which approach fits your bone, your bite, and your goals.
| Option | Fixed or removable | Implants per arch | Often a good fit for |
|---|---|---|---|
| Traditional denture | Removable | None | Patients who are not candidates for implant surgery |
| Implant-supported (snap-in) denture | Removable for cleaning | Typically 2 to 4 | Denture wearers who want more stability |
| All-on-4® | Fixed | 4 | Patients who want fixed teeth, including many with some bone loss |
| Fixed bridge on 5 to 6 implants | Fixed | 5 to 6 | Patients with more available bone |
| Individual implants | Fixed | One per tooth (or per bridge) | Patients with good bone who want each tooth replaced separately |
Weighing whether to save a tooth or replace it? Our guide to root canal vs. dental implant walks through that decision.
Life After Treatment
How Long Do All-on-4® Implants Last?
Long-term research on the All-on-4® concept has followed patients for 10 to 18 years and reports high implant survival rates (Maló et al., Clinical Implant Dentistry and Related Research, 2019). How long yours last depends on your bone, your overall health, not smoking, and consistent care. The bridge teeth wear with everyday use and may need repair or replacement over the years, which is normal.
To protect your investment:
- Brush twice a day and clean under the bridge daily with a water flosser or implant floss
- Keep regular checkups and professional cleanings, every six months or as we recommend
- Wear a night guard if you clench or grind your teeth
- Avoid smoking and vaping, which raise the risk of implant problems
Financing Your All-on-4® Treatment
All-on-4® is a significant investment in your health, and we want it to be something you can plan for with confidence. Our team will walk you through your treatment plan, check what your dental insurance may contribute, and explain financing options with monthly payments. Visit our new patient page for insurance information, or call (954) 785-1100 to talk through your options.
Care in Pompano Beach
Why patients choose South Florida Smile Spa
Full-arch treatment works best when the surgery and the new teeth are planned together. At our Pompano Beach office, Dr. Nicole M. Berger plans each case from a 3D cone beam CT scan, and implant surgery is performed right here in our office by our implant surgeon. Dr. Berger then designs and fits the bridge that attaches to your implants. You work with one team from your first consultation through your final teeth.
Our team takes the time to walk you through every option, including whether All-on-4® is the right choice for you at all, and answers your questions before anything is scheduled.
Ready to talk about All-on-4®?
Meet with Dr. Nicole M. Berger to find out whether All-on-4® is right for you, which sedation option fits, and how financing works. Treatment is staged over multiple appointments, and every plan starts with a conversation.
South Florida Smile Spa · Dr. Nicole M. Berger, DDS · 572 E McNab Rd, Suite 102, Pompano Beach, FL 33060 · (954) 785-1100
Frequently Asked Questions
Who should get All-on-4®?
All-on-4® is designed for people missing most or all of their teeth in an arch, people whose remaining teeth cannot be saved, and denture wearers who want fixed teeth. Many patients who have been told they lack the bone for traditional implants are still candidates because of the angled back implants.
What is the success rate of All-on-4®?
Long-term studies of the All-on-4® concept, including research following patients for 10 to 18 years, report high implant survival rates (Maló et al., 2019). Your own outcome depends on your bone, overall health, not smoking, and consistent home care and checkups, and we will talk through your specific situation at your consultation.
Is All-on-4® surgery painful?
Your treatment area is numbed with local anesthesia, and we offer IV sedation, oral conscious sedation, and nitrous oxide in our office, so you can be relaxed or deeply sedated during surgery. Soreness and swelling afterward are normal and usually improve after the first few days.
How long does the All-on-4® process take?
Treatment is staged over multiple appointments. Surgery typically takes about two and a half hours per arch, followed by several months of healing with temporary teeth before your final bridge is placed.
What can I eat after All-on-4®?
Start with cool liquids and very soft foods for the first few days, move to fork-tender soft foods for about two weeks, and avoid hard, crunchy, or sticky foods while the implants heal. After your final bridge is placed, most patients return to a varied diet.
Can I get All-on-4® if I have bone loss?
Often, yes. The two back implants are angled to use the strongest available bone, which can reduce or avoid the need for grafting. A 3D cone beam CT scan shows us exactly how much bone you have, and some patients still need grafting first.
Do you offer financing for All-on-4®?
Yes. We offer financing options with monthly payments, and our team will check what your dental insurance may contribute. Call (954) 785-1100 to talk through your options.