Full arch implant treatment
A fixed set of teeth supported by as few as four implants, for people who have lost most or all of their teeth in an arch, or who are tired of a denture that moves.
The concept
Instead of replacing every missing tooth with its own implant, four implants are placed at angles that make use of the strongest available bone. A single bridge of teeth is then fixed onto those implants. It does not come out, and it is not held in by suction or adhesive.
The bridge is secured to the implants. You clean around it rather than taking it out at night.
Tilting the back implants makes it possible to use bone that is already there, which often avoids grafting.
Four per arch in most cases, sometimes five or six where the bite or bone calls for it.
Some people need only the upper, some only the lower, some both. That is decided at your assessment.
Comparison
There is no single right answer. The honest comparison matters more than the sales pitch, so here it is.
| All-on-4 full arch | Full denture | Individual implants | |
|---|---|---|---|
| Stays in place | Fixed to implants, not removed by you | Rests on the gum, can move | Fixed, one tooth at a time |
| Implants needed | Usually four per arch | None | Often eight or more per arch |
| Bone grafting | Often avoided by angling the implants | Not applicable | More often required |
| Palate covered | No, on the upper arch | Yes, which affects taste and feel | No |
| Eating | Closest to natural teeth | Softer foods, takes practice | Closest to natural teeth |
| Surgery | One surgical visit in most cases | None | Staged, sometimes multiple surgeries |
| Cleaning | Around and under the bridge daily, plus regular professional cleans | Removed and cleaned | Brush and floss as for natural teeth |
| Relative cost | Higher than a denture, usually lower than a full set of individual implants | Lowest | Highest |
| Best suited to | Most or all teeth missing or failing in an arch | Anyone, including where surgery is not suitable | A small number of missing teeth |
Suitability
You have lost most or all of the teeth in an arch, or the remaining ones are failing. You wear a denture and want something that does not move. You have been told there is not enough bone for conventional implants. You are medically well enough for a surgical procedure and you are committed to cleaning it properly.
Heavy smoking, uncontrolled diabetes, some bone conditions and certain medications all affect how implants heal, and some make treatment unwise. Untreated gum disease is dealt with first. Severe grinding may change the design. None of these is automatically a no, but each changes the plan, and we will tell you plainly if we think something else would serve you better.
Suitability can only be assessed in person, with a scan. Any indication given over the phone or online is general information, not a diagnosis.
The process
A full examination, a 3D scan of your jaw, photographs and a discussion of what you want from treatment. We look at bone volume, your bite, gum health and your general health.
You receive a plan in writing with the number of implants, the stages, the timeline and the full cost before anything is booked. Nothing proceeds until you have had time to read it.
Any gum treatment, extractions planned into the surgery, and medical clearance if needed. We also plan the implant positions digitally from your scan.
Remaining teeth in the arch are removed if required and the implants are placed. This is done under local anaesthetic, with sedation available if you would prefer it.
A temporary set of teeth is fitted so you are not without teeth while the implants integrate with the bone. Timing depends on your case and is confirmed in your plan.
Several months while bone bonds to the implants. You are reviewed through this period, your temporary bridge is adjusted as things settle, and you follow a modified diet at first.
Once healing is complete, the definitive bridge is made and fitted. From there you move onto a maintenance schedule of regular reviews and professional cleaning.
Your clinician
Dentist, implant surgery
Dr Callum North handles our full arch implant cases. He has a particular focus on implant surgery and on restoring function for patients who have lost most or all of their teeth.
He plans each case from a 3D scan before any surgery is booked, and he is straightforward about what treatment can and cannot achieve. If a simpler or less costly option would serve you better, he will say so.
Your consultation is with Dr North, so the person planning your treatment is the person carrying it out.
Cost
Full arch treatment is a significant investment, and any single figure quoted online would be misleading. What it costs for you depends on three things.
Treating the upper only, the lower only, or both. Two arches is not simply double, but it is substantially more than one.
Extractions, gum treatment, or bone work where it cannot be avoided. Some cases need none of this, others need all of it.
Bridge materials differ in strength, appearance and longevity. We will explain the options and what each is suited to.
You get a written quote after your consultation and scan, itemised and fixed, before any treatment is booked. Health funds with major dental cover often contribute, though full arch treatment typically exceeds annual limits, so the contribution is usually partial.
On finance: our standard interest free payment plans are capped well below the cost of full arch treatment, so they will not cover the whole amount. There are finance options that do, and we will talk you through them at your consultation rather than pretending the standard plan fits.
Being straight with you
This is surgery. It works well for most people who are suitable, but it carries real risks and real commitments, and you should hear them before you decide, not after.
Swelling, bruising and discomfort for several days to a couple of weeks. A soft diet at first, and time off work for most people.
Implants can fail to integrate or can fail later, particularly with smoking, poorly controlled diabetes or inadequate cleaning. Failure may mean further surgery.
Infection is uncommon but possible. Altered sensation in the lip, chin or tongue can occur and is usually temporary, rarely permanent.
It takes time to adjust. Speech and eating usually normalise within weeks, but the bridge will not feel identical to your own teeth.
Daily cleaning under and around the bridge, plus regular professional reviews and cleans. Neglect is the most common cause of late problems.
Implants can last many years, but nobody can promise a number. Components wear and a bridge may need repair or replacement over time.
Results vary from person to person. Any surgical or invasive procedure carries risks. Before proceeding, seek a second opinion from an appropriately qualified health practitioner.
Questions
The aim is that you are not. A temporary bridge is planned as part of treatment so you leave with teeth. The exact timing depends on your case and is set out in your written plan.
The surgery itself is done under local anaesthetic, so you should not feel pain during it. Afterwards expect swelling and soreness for several days, managed with pain relief and, where appropriate, antibiotics. Sedation is available if the procedure itself is what worries you.
From consultation to the final bridge is usually several months, because bone needs time to bond to the implants. The surgical part is typically a single visit.
No. You start on a soft diet and build up as healing allows. Once the final bridge is fitted, most people eat a normal diet, though very hard foods are still best treated with some care.
That is one of the reasons the technique exists. Angling the back implants makes use of bone that is already present, which often avoids grafting. Whether it works in your case depends on your scan.
Yes, and this part is not optional. Regular reviews and professional cleaning are what keep implants healthy long term.
Funds with major dental cover generally contribute, but full arch treatment usually exceeds annual limits, so expect a partial contribution rather than full cover. Your fund can confirm your entitlement against the item numbers in your quote.
No. An implant retained overdenture still comes out for cleaning. A fixed full arch bridge stays in. Both are valid, they suit different people, and we will go through the difference with you.
A consultation with Dr Callum North includes a full examination, a 3D scan and a written plan with costs before anything is booked.
All-on-4 is a registered trademark of Nobel Biocare. Meadowgate Dental uses the term to describe the full arch treatment approach.
