What is an All on 4?

There are commercials and information or should I say, misinformation, all over the place now about All on 4’s or Hybrid dentures.  I have so many patients asking questions about it.  The commercials from the big corporations make it seem like a perfect fairy tale, so I figured I would go over the facts.  

Let’s start with the basics.  You know, Who, What, When, Where, Why, and How.  

Who needs it?  Very few people “need” a hybrid denture.  There are certain cases where people cannot tolerate dentures, either due to anatomy or a bad gag reflex.  However, in general, hybrid dentures just improve quality of life.  They allow a patient who is either already suffering with dentures, or whose teeth are hopeless, to go back to the feeling of having a full set of teeth.  The chief complaint of patient’s with dentures is they can’t eat, talk, and function the way they used to.  Typically, salads and hard to chew foods like steak are off limits.  Hybrid dentures allow the patients to return to a normal quality of life and eat any food just like having regular teeth.   

What is it?  An all on 4 or a hybrid denture, is a dental prosthesis that is made from a combination of acrylic and porcelain.  It is screwed into the 4-6 implants to hold it in place…so that it is permanent in the sense that only the dentist can take it out.  

When: Hybrid dentures can be completed either after you have had all your teeth removed and already have dentures, or they can be done at the same time as the tooth removal.  

Where:  This is tricky.  Obviously I am extremely biased to our office.  We have a board certified Periodontist whom I have personally worked with for the last 15 years.  Without this kind of personal knowledge, there are a few things that I find imperative to look for.  First of all, ask questions.  Be certain that your provider has done several hybrid dentures.  Every mouth is different, and you want to be sure that if a situation arises, your provider knows how to handle anything that comes their way.  I would recommend an experienced surgeon.  It’s one thing to be able to perform the procedure, but it’s quite another to deal with any complications or unusual complexities that may arise.

Why:  This is the fun one!  Quality of life.  Never having to worry about your denture moving around while you are speaking, or singing, or socializing.  Being able to eat any food again.  Being able to taste food properly again without the roof of your mouth being covered.  Not having a big chunk of plastic moving around in your mouth.  The better question is, why not?

How does it work?  This depends how your mouth is to begin with.  People who already have dentures have a completely different experience than people who still have their teeth.  In both cases, the road to a hybrid denture is not a short one.  Many of the big companies that advertise tell you that it can be done in a day.  While this is true, it is not optimal or even advised.  Imagine planting a tree and then tying something to it that moved it around and around.  What would happen to the root system?  Would it be allowed to grow and become stable?  This is similar to what happens to implants when hybrid dentures are restored in the same day.  An implant is a screw that is screwed into the jawbone.  Over 2-6 months, the bone actually grows around it and stabilizes it in the jawbone becoming a part of the body.  This occurs when the implant is left alone and no force is applied to it.  When the implant is not left alone to heal and/or exposed to forces from a restoration like a hybrid denture, it does not allow the bone to properly heal around it and become part of the jawbone.  The healing process is as essential to the procedure as the placement of the implants.  


I hope this clears up some of your questions about hybrid dentures.  I think they are, by far, the most exciting procedure in dentistry today.  In the not too distant past, people who lost their teeth had no options.  Then when implants first entered the scene, if you wanted something that was permanent in your mouth, it was literally hundreds of thousands of dollars.  Now, we can offer something that will literally change the rest of your life, and with financing, most people can afford it.  Please reach out with any questions.  I would love to tell you more about this amazing addition to the world of dentistry.  

Dr. Ariana Clayton
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