All-on-4 Dental Implants vs Dentures
All-on-4 is a full arch of replacement teeth fixed on four dental implants, while dentures are removable teeth that rest on the gums. All-on-4 stays in your mouth, is cleaned by brushing with special aids under the bridge, involves surgery and costs more upfront. Dentures are taken out for cleaning, need no surgery and cost less upfront. The right option depends on your jawbone, health, budget and preference, confirmed at a clinical assessment.
If you have lost most or all of the teeth in a jaw, there are two main ways to replace them: removable dentures, or fixed teeth supported by implants such as All-on-4 dental implants. Here is how the two options compare, so you can weigh them up with your dentist at Pure Dentistry in Brisbane.
The main differences
Dentures
Also called traditional or conventional dentures, this is a gum-coloured base holding prosthetic teeth that you take in and out. There is no surgery and a lower upfront cost, and dentures can replace a full arch or fill gaps around teeth you still have.
- No surgery required
- Lower upfront cost
- Taken out for daily cleaning and left out overnight
- Can be relined or adjusted as your gums change
All-on-4 implants
A full arch of fixed replacement teeth supported by four titanium implants, designed as a long-term alternative to removable teeth. The bridge stays in your mouth and is made to look and feel natural while you eat and talk.
- Fixed in the mouth, not taken out daily
- Cleaned by brushing, with special aids under the bridge
- May help maintain jawbone volume
- Placed surgically, with a healing period
What are dentures?
Dentures are removable replacement teeth on a gum-coloured base, custom made to fit your mouth and taken out whenever needed. If tooth loss has followed gum disease or decay, your dentist will recommend full or partial dentures based on how many teeth are missing. Dentures are cleaned daily with a soft brush, left out overnight, and reviewed at regular check-ups, because the shape of your mouth changes over time.
Full dentures
Replaces a full arch of teeth on the upper or lower jaw, resting on the gum. A conventional full denture is made after any remaining teeth are removed and the gums have healed, which takes longer but allows a careful, close fit.
An immediate denture can be fitted straight after teeth are removed, so you are not without teeth while healing, and it usually needs adjusting as the gums settle. Over time, bone loss under a denture can change the fit and reduce support for the facial muscles.
Partial dentures
Fills the gaps when you still have some of your natural teeth. Partials clip onto your natural teeth with metal clasps or precision attachments, and precision attachments are less visible and generally cost more.
Bone under the gum can still reduce over time, and partials may need relining as the shape of your gums changes.
Between removable dentures and All-on-4 sits a middle option: implant-supported dentures, also called snap-in dentures, overdentures, implant dentures or denture implants. These clip onto a small number of implants for more stability than a standard removable denture and are still taken out for cleaning, while an All-on-4 bridge is fixed in place and only removed by your dentist.
What are All-on-4 dental implants?
All-on-4 uses four strategically placed implants to hold a fixed full arch of replacement teeth. It is a form of full mouth dental implants, one of several dental implant options in Brisbane, and can be done on the upper jaw, the lower jaw, or both.
The implant placement provides a stable foundation for the new teeth.
Angling them uses the bone you already have, which often avoids the need for bone grafting.
A full arch of teeth is fixed in place and cleaned in the mouth, not taken out at night.
After implant surgery there is a healing period, and recovery time varies from person to person. In one long-term study that followed 471 patients for 10 to 18 years, 98.8% of All-on-4 fixed bridges and 93% of the implants were still in place (Maló and colleagues, 2019). Individual results vary, and suitability depends on your bone volume and general health, confirmed at a clinical assessment.
Comparing All-on-4 and dentures
| Consideration | All-on-4 implants | Dentures |
|---|---|---|
| In the mouth | Fixed in place, not taken out daily | Taken in and out |
| Cleaning | Brushed in the mouth, with special aids such as interdental brushes or a water flosser to clean under the bridge | Taken out and cleaned separately each day |
| Gum health | Gums around implants need daily care and regular reviews to stay healthy | Gums under the denture need daily cleaning and regular check-ups |
| Stability | Stays in position when eating and speaking | May move; can need denture adhesive |
| Eating | Supports chewing across a wider range of foods | Some foods may need to be avoided |
| Jawbone over time | May help maintain bone by acting like a tooth root | Bone under the gum can reduce over time |
| Surgery | Surgical placement with a healing period | No surgery required |
| Upfront cost | Higher initial investment | Lower upfront cost |
Which is right for you?
These are general pointers, not a diagnosis. Only a clinical assessment of your teeth, gums and jawbone can confirm what suits you.
All-on-4 may suit you if
- You have lost, or are losing, most or all teeth in a jaw
- You would prefer fixed teeth rather than something removable
- You want a natural look and improved chewing
- You are replacing a full arch rather than one or two individual implants
- You have found dentures loose or uncomfortable
- You have enough healthy jawbone, confirmed at assessment
- You are comfortable with a surgical procedure and healing time
Dentures may suit you if
- You would like a lower upfront cost
- You would prefer to avoid surgery
- You are comfortable with removable dentures that are taken out to clean
- You are still deciding and want a reversible starting point
- Your bone volume is not currently suited to implants
- You want to replace a few teeth around ones you still have
What about cost?
Dentures generally cost less upfront, while All-on-4 is a larger investment that fixes a full arch in place. Both options involve ongoing maintenance as part of long-term care, and if a denture breaks or you have sudden pain, an emergency dentist can help.
The exact figure depends on your clinical situation and can only be confirmed after an assessment. Payment plan options are available to help spread the cost.
Not sure which is right for you?
Book a suitability assessment and your dentist will examine your teeth, gums and jawbone, then talk you through the option that fits your situation and budget.
Common questions
Which is better, All-on-4 or dentures?
Neither option is better for everyone. All-on-4 tends to suit people who want fixed teeth and have enough healthy jawbone, while dentures tend to suit people who prefer to avoid surgery or want a lower upfront cost. The right choice depends on your teeth, gums, jawbone, general health and budget, which is why it is confirmed at a clinical assessment.
What are the downsides of All-on-4 compared to dentures?
All-on-4 involves surgery with a healing period, a higher upfront cost and, like any surgical procedure, risks that your dentist will explain, such as infection or implant failure. The gums around implants can also become inflamed, a condition called peri-implant disease, if plaque builds up, so daily cleaning and regular professional reviews are part of long-term care. Dentures avoid surgery but can move, may need adhesive, and the bone under them can reduce over time.
Can I start with dentures and switch to All-on-4 later?
Often, yes. Many people begin with dentures and consider fixed implants later. Whether All-on-4 is suitable when the time comes depends on your jawbone at that point, which your dentist can assess. Regular check-ups help keep your options open.
Is All-on-4 surgery painful?
The procedure is carried out under local anaesthetic, and sedation options are available for patients who feel anxious, including happy gas, IV sedation and sleep dentistry. Your dentist will discuss which approach is appropriate for you.
Do implants stop bone loss?
Implants sit in the jawbone and act like a replacement tooth root, which may help maintain bone in that area. Dentures rest on the gum and do not provide this stimulation, so bone underneath can reduce over time. Individual results vary.
How long does each option take?
Conventional dentures are usually made over several weeks once the gums have healed, while immediate dentures can be fitted sooner after extraction. All-on-4 involves surgical placement followed by a healing process, and recovery time before the final teeth are completed depends on your individual treatment plan.
Which option lasts longer?
Both dentures and implant-supported teeth need ongoing care and regular reviews. Dentures may need relining or remaking as your gums change, while an All-on-4 bridge is looked after with daily brushing, special aids to clean under the bridge, and check-ups. Long-term studies have followed All-on-4 patients for 10 to 18 years, and your dentist can discuss expected longevity for your circumstances.
Can All-on-4 replace every tooth including molars?
An All-on-4 bridge is a form of full-mouth restoration, sometimes called full mouth reconstruction, though it does not extend into the rearmost molar positions. For most people this still provides a comfortable, functional bite. Your dentist will explain what the fixed bridge will include for your case.
Sources
- Maló P, de Araújo Nobre M, Lopes A, et al. The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: a longitudinal study with 10 to 18 years of follow-up. Clinical Implant Dentistry and Related Research, 2019. Peer-reviewed long-term outcomes for All-on-4 fixed bridges and implants.
- European Federation of Periodontology. Peri-implant diseases: patient information. Guidance on keeping the gums around dental implants healthy.
- Australian Dental Association, Teeth.org.au. Dentures. Consumer guidance on denture types, cleaning and check-ups.
This page is published by Pure Dentistry, a private dental practice in Upper Mt Gravatt, Brisbane. It is general information and is not a substitute for advice from your dentist. Any surgical or invasive procedure carries risks. Before proceeding, seek a second opinion from an appropriately qualified health practitioner. Suitability for any treatment can only be determined after a clinical assessment, and results may vary between individuals.
