All on 4 Cost: The Honest Guide

The cost of an All-On-4 dental implant treatment varies significantly from $17,000 to over $30,000 which is cause for confusion among many patients who visit us for a consultation.

Financials are important. As a patient, it’s perfectly understandable to expect that All on four pricing should be the same wherever you go—the treatment is the same, after all: four dental implants to hold a full set of fixed teeth, or tooth bridge.

So why the huge differences in price? And, given the disparity in advertised cost, how do you go about making a fair All on Four price comparison?

The first thing we explain to patients is that the treatment has two parts. First, there’s the dental implant placement, where four implants are placed in the jaw - this is where the treatment gets its name.

The second and equally important part is the tooth bridge placed on the implants. As a patient, arguably the most important part as this is what gives you your smile back and restores function. It is this second part that most impacts the price of all on 4.

There are several methods to make the teeth that are attached to your dental implants. There are also many different materials.

The lower price point - $20K or under typically includes a provisional tooth bridge that’ll need replacing to a more robust option within a year, maximum two. This is what we refer to as the initial teeth, the ones you get in the few days following implant placement.

On the other hand, the more expensive options - $25K+ or more includes the cost of your definitive tooth bridge as well. This bridge is built to last longer, be more aesthetic and perfectly customised to you.

It pays to clarify this point with your dental practitioner to ensure that there are no surprises down the track.

But there are other factors that will determine how a clinic prices their all on 4 treatment and it’s important for you to ask the right questions to ascertain the level of treatment you’ll receive.

Lower All on 4 pricing may mean compromising on the quality of the clinic, dentist and materials—not to mention the end result.

Opting for a lower all on four cost could mean:

• Cheap dental implants from less reputable manufacturers
• Exposure to risk caused by inexperience
• A new smile that is not as natural or aesthetically pleasing
• Extra charges for items that should really be included as part of your treatment plan

The true cost of full mouth dental implants in Australia is determined by a range of factors, which I’ll go over in this guide.

Remember—an All on Four isn’t a cookie-cutter procedure, but a customised and complex dental treatment. Any complex dental treatment should always be performed by a highly trained, skilled and experienced dental surgeon. Your All on 4 treatment isn’t just a procedure, it’s an investment: in your health, wellbeing, and future.

All on Four cost: Variables at a Glance

So that you can truly assess whether you’re comparing apples with apples, I’ll dig deeper into each All on four cost variable in the next section including:

• 1. All on 4 cost variable #1
  Type and quality of your tooth bridge
• 2. All on four cost variable #2
  Training and expertise of your dentist
• 3. All on four cost variable #3
  Skill and experience in aesthetic smile design
• 4. All on 4 cost variable #4
  Type and quality of your dental implants
• 5. All on four cost variable #5
  Inclusions in your treatment plan

All on 4 treatment stages, explained"]It’s important to know that the All on 4 treatment concept has four treatment phases.  Please note this a high-level guide, your specific treatment needs may mean a slightly different course of action for best results.

Every aspect of All on Four treatment requires a high level of skill and training, and your dentist should invest a significant amount of their time into the planning and execution of each phase:

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1. Consultation, diagnosis and treatment planning

Your All on 4 dentist meets with you for a comprehensive check of your teeth, bite, medical history and assess your All on Four suitability. After reviewing the clinical notes and the 3D scan of your jaw, your personal treatment plan is presented.

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2. Dental Implant placement

This is the surgical part of your treatment, where your dentist will place the titanium tooth rods that will support your new tooth bridge. Timewise, this takes approx. 2.5hrs per jaw, plus 2-3 hours recovery. Typically just four dental implants are placed but if you have soft bone you may need six. At this stage, we also do a try-in of the proposed teeth with a 3D printed model to check your bite, tooth position before finalising them.

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3. Tooth bridge placement

On the 3rd or 4th day after your implants are placed your new teeth are ready to be connected to your implants. This tooth bridge is made from high-performance acrylic. It can take 3-6 months for your jaw bone to fuse around the dental implants and your soft gum tissue to heal. If you had grafting (bone added to your jaw) this process may extend to 12 months. While this first tooth bridge may well last beyond 12 months we always highly recommend upgrading as soon as possible to a stronger, more biocompatible definitive bridge. Typically one with a custom milled titanium frame with either Zirconia or acrylic teeth. Chapter 2 of this article covers these options in greater detail.

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4. Final Tooth bridge placement

Once you have reached your optimal healing period it is time to take new impressions and photos in order to craft your final tooth bridge. Most patients can expect this step to occur at around the 6-month mark after implant placement. But of course, each patient's needs are individually assessed.

Type and Quality of Tooth Bridge

A tooth bridge is a single piece that joins up to 12 teeth for strength and stability. Metal holes in the tooth bridge enable attachment to the titanium tooth rods with special screws. Typically higher all on 4 price points correlate to the type of final teeth you choose.

All on 4 dental implant tooth bridges can be made from different materials and the cost of the teeth is determined by the choice of material.

The two most important factors to consider are durability and aesthetics. The costlier tooth bridges are more complex to make but are made from more durable materials and have higher levels of aesthetic customisation.

The Four Most Common Types of All on Four Tooth Bridge

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1. Acrylic tooth bridges

There are different types of acrylic bridges and many ways to make them so this can get confusing. Different implant dentists have different methods they use so it’s important to ask which option your dentist prefers.

Often a denture is modified (or existing one used if you have one) to be attached to the implants. Only recommended for a short period of time as it is not strong enough to when you end your soft food diet and the teeth will break and fracture. This bridge can also feel quite bulky in the mouth and be harder to clean as it is not as customised and streamlined as it should be.

At Macquarie Street Centre, our acrylic option is the Starter tooth bridge. Recent technological advancements in 3D scanning and milling means we can use a single piece of high-performance acrylic milled to your ideal tooth shape. It's aesthetic and less bulky than a modified denture and a significant advancement in dental technology.

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2. Milled titanium foundation with Acrylic teeth

A metal foundation underneath the acrylic teeth provides strength and durability but also makes for a lean tooth bridge, as less acrylic is required. High-quality acrylic materials can look very natural, however, acrylic teeth will wear and tear over time—even when made to the most exacting standards.

At Macquarie Street Centre, our metal-reinforced acrylic option is the Classic tooth bridge.

Acrylic teeth and gums with a metal foundation. It’s difficult to achieve a life-like result with acrylic, but Dr Dunn’s experience and skill meant this patient walked away with exceptionally natural results.

3. Milled titanium foundation with Zirconia teeth

The strongest and most aesthetic materials currently available in dentistry for tooth replacement. Zirconia is a naturally-occurring white material with a similar strength to metal. We can customise the front surface of the zirconia by layering porcelain to mimic the translucency of natural teeth.

Unlike acrylic teeth that will likely need replacing every 5 years or so Zirconia teeth will not wear, tear or stain so while a bigger investment upfront it will pay for itself in the long run. Patients with a history of bruxism (tooth grinding) are recommended this option due to its strength.

At Macquarie Street Centre, our zirconia and titanium option is the Signature tooth bridge.

4. Titanium and zirconia tooth bridge with individual porcelain teeth

Macquarie Street Centre is one of the few clinics in Australia to offer this tooth bridge option— our Statement tooth bridge. Giving you the strength of titanium and zirconia, and the highest standard of Smile Design, each tooth is individually handcrafted and layered in porcelain for unbeatable lifelike results.

The very best way to decide which tooth bridge solution is right for you is to hold, feel and compare the bridges in person.

We invite you to book a complimentary consultation with our Patient Coordinator who can take you through every option, and answer your questions in a relaxed and caring environment.

How long does a tooth bridge last?

The lifespan of your tooth bridge depends on a range of factors.

Some your dentist can control—for example, using only the best materials and a highly skilled prosthetist, bite management, and providing you with a custom All on Four protective nightguard.

Other factors are harder to control.

For example, you may have a strong bite and exert more force while chewing. You may have a natural predisposition to grinding (bruxism) which means you’ll exert more wear and tear on your tooth bridge. For patients with signs of bruxism, we recommend our Signature tooth bridge for added strength, and may also recommend regular muscle relaxant injections to control the strong jaw muscles.

The best way to combat all factors is to choose a well-trained dentist who will individually assess your needs and predicted outcomes before your All on Four treatment even begins.

As a rule of thumb if the bridge is made with acrylic material teeth (Our Classic bridge) you can expect it to last 3-5 years, however, many patients have worn theirs longer. Regular hygiene appointments will keep your bridge in tip-top shape and reduce natural staining from foods and drinks in addition to committing to wearing your night guard supplied at the end of treatment while you sleep.

The Signature bridge will yield the highest lifespan and exceptional value for money. Both the titanium and zirconia material are incredibly strong and barring an extreme accident are extremely difficult to break. As the material is not porous it will also not stain.

Tooth bridge material types at a glance

Acrylic

Used in dentistry for removable dentures and All on 4 fixed teeth. Acrylic is a strong plastic available in various tooth and gum shades.  At Macquarie Street Centre our acrylic option is our Starter tooth bridge.

Titanium

Widely used in dentistry to make dental implants and reinforce tooth bridges. Titanium is an exceptionally strong corrosion and mechanical resistant metal, which makes it long-lasting and durable. It is highly biocompatible, with very high success rates. At Macquarie Street Centre, we use a titanium foundation in our Classic, Signature and Statement tooth bridges.

Zirconia

A strong ceramic used in dentistry to make tooth crowns and tooth bridges. Porcelain may be applied over zirconia to create a more natural tooth-like appearance. Considered to be highly aesthetic and strong. At Macquarie Street Centre, our zirconia option is the Signature tooth bridge.

Porcelain

Porcelain is used in dentistry to make crowns, veneers and tooth bridges. Porcelain is layered over a foundation (either metal or Zirconia) to closely mimic the look and feel of real tooth enamel. At Macquarie Street Centre, our porcelain option is the Statement tooth bridge.

Summary: Tooth materials costs can vary greatly. Further cost variations occur based on the time and quality of materials used to make your new teeth. Only highly customised All on 4 tooth bridge methods result in teeth that are strong, long-lasting and easy to clean.

Training and Expertise of your Dentist

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There’s an enormous amount of skill involved in dental implants to achieve natural-looking results that can also stand the test of time.

When it comes to choosing your All on 4 dentist, a proven track record in delivering service matters. Ask to see theirs.

Studies suggest that the number of years experience in performing full implant tooth replacement procedures is a key factor in the success rate of implants.

Done well, All on Four implants can have a success rate of up to 98%, making it one of the most successful dental treatments, but these studies are based on treatments performed by the most experienced dentists.

It’s simple: great dentists produce great results.

Your overall All on four cost is reflective of not only parts or materials, but your dentist’s experience and ability to manage all sorts of treatments, from the straightforward through to the most complex, with absolute confidence.

Remember—you’re effectively replacing the hardest working part of the mouth; it needs to withstand biting and chewing. Replacing an entire set of teeth requires a strong knowledge base to recreate the ‘bite’: how the teeth fit together against the opposing teeth.

A common complication of implants occurs when the ‘bite’ isn’t correctly adjusted, leading to pressure on the implants holding the teeth, sore jaws, headaches and even teeth popping off due to uncontrolled biting pressure. Make no mistake, a perfect bite takes years to master and is one of the most challenging aspects of providing fixed teeth on implants.

A quick word on dental tourism

‍If the thought of a cut-price All on 4 in Thailand sounds enticing, read up on the major implications of having this procedure done off-shore before you make your choice.

Additionally, your All on four dentist should be dedicated to keeping up with advancements in dental implants, especially procedures to replace all missing teeth with fixed dental implants: the most complex and clinically challenging procedure of all.

Summary:

Senior professionals who have spent years perfecting their craft are likely to command higher All on 4 pricing.

Seven Questions for your All on 4 Provider

Choosing the right dentist is a critical decision in your journey. Asking the right questions will give you the information and confidence needed to help you make a fair assessment of your prospective dentist’s All on 4 pricing.

Q1.How many All on 4 procedures has the dentist performed?

‍All on 4 is a treatment that falls under the category of ‘all fixed teeth on implants’. While All on Four has been around for just 15 years, fixed teeth on implants have been around for over 50 years. It’s important to work with a dentist skilled in fixed teeth on implants procedures—someone who performs them regularly, with years of experience—to get you the best results for your money.

Q2.What training has the dentist completed?

‍Most patients are surprised to learn that there is no official qualification for dental implants. The level of dental implant training varies from a weekend course to a *literal* investment of years. Before deciding a dentist’s All on 4 cost is too high, consider how your investment translates to their experience and expertise in the field.

Q3.What’s the dentist’s longest patient follow-up?

‍This question is actually more important than how many implants they’ve placed! Ask to see a proven track record and long-lasting results. All on 4 problems may not show up until years later. A good rule of thumb is to ask to see examples of work completed 5-10 years ago.

Q4.Can I see your before and after All on 4 photos?

‍Most dentists will be more than happy to show you what to expect after an all on Four treatment and the results they’ve been able to provide patients. The most experienced dentists will be able to show you examples that are similar and relevant to your case.

Q5.Who is the prosthetist?

‍Prosthetists are the professionals who work with making denture teeth, but not all of them have experience with dental implants. Their level of skill and experience makes a big difference to the quality, aesthetics and durability of your final teeth.

Q6.Has the dentist’s work been assessed by their colleagues?‍

When implants first became available, the only way to learn the procedure was to visit the inventor's training centre in Sweden. After initial training, the dentist was required to treat at least 10 patients, and submit their work to be peer-reviewed, before the manufacturer would even sell them the dental implants! Today things have changed significantly. Technically, there’s nothing stopping any dentist, with or without further training, from purchasing and placing implants. That's why it's crucial to quiz your prospective implant dentist’s experience and track record.

Q7.Does the dentist lecture or teach official courses and conferences?

‍Any dentist can set up a teaching facility or ‘Institute’ and say that they “teach” dental implants, but few are selected by independent committees to speak on these topics at official conferences based on the outcomes of their work. Teacher credentials speak volumes about the quality of your All on Four dentist’s work.

All on 4: Dr Dunn's Credentials

• Dr Dunn trained with the inventor of dental implants prof. Per Ingvar Branemark in Sweden in the 80s. After this initial training, he continued under the auspices of the local branch of the Branemark Centre in Perth with world-renowned Prosthodontist and dental implant researcher Dr Patrick Henry. As a part of his training, Dr Dunn treated 10 patients with full mouth dental implants, which were submitted for peer review assessment.
• Dr Dunn has attended hundreds of implant-related training programs. He was part of the first group of Australian practitioners to be trained in the All on Four treatment concept in 2005
• Today, Dr Dunn gives back to his profession by mentoring other clinicians in dental implant treatment and cosmetic dentistry through his mentor program. He’s a long-serving teacher with the gIDE dental implant program. He’s lectured internationally on dental implants and All on 4 and cosmetic smile makeovers, and serves as a trusted advisor to manufacturers of dental materials.
• At your consultation, we’ll take you through a range of Dr Dunn’s All on 4 treatments comparable to your situation—many with 10+ years of follow-up.

Work Examples: All on 4 by Dr Dunn

A dentist’s lack of experience in All on Four can lead to upsetting results for patients, including breakages, aesthetic and functional failure, and an overall compromise in quality.

Below is a selection of remedial work on patients who have received disappointing All on 4 results. I include these images not to scare prospective All on Four patients, but to highlight the potential complications that can occur in the hands of an inexperienced dentist.

All on 4 Remedial Work: Case Study 1

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Image 1: BEFORE - Patient was referred to Macquarie Street Centre due to a failing All on Four tooth bridge that was breaking, difficult to keep clean, and aesthetically unappealing with an incorrect bite.

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Image 2: BEFORE - Misplaced dental implants caused excessive load in the tooth bridge. The left side of the tooth bridge cracked in the front, completely breaking the back three teeth.

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Image 3: BEFORE - Here, you can clearly see that the original dental implants weren’t evenly distributed, causing excessive pressure on one side of the jaw. Luckily, we were able to place an additional implant to support a new tooth bridge and prevent further breakages.

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Image 4: AFTER - The new tooth bridge, placed after the additional All on 4 dental implant fused to the bone. The patient's new smile is aesthetically pleasing, with a strong metal foundation and correct bite.

All on 4 Remedial Work: Case Study 2

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Image 6: BEFORE - Patient was referred to Macquarie Street Centre for an All on Four acrylic tooth bridge replacement. Her teeth were stained with visible wear and tear. Remedial treatment gave us the opportunity to enhance her tooth shape and smile for a more natural appearance.

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Image 7: AFTER - After Thorough implant planning meant that the patient walked away with a natural-looking, comfortable new tooth bridge. Her new teeth are narrower and more feminine— better suited to her face. Significant time was spent getting the pink portion of the bridge to look like real gum tissue. The new tooth bridge is leaner, with a strong metal structure, for easy cleaning and enhanced comfort.

All on Four Remedial Work: Case Study 3

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Image 8 & 9: BEFORE: Patient attended Macquarie Street Dental Practice with concerns that her top and bottom All on 4 treatment was failing.  Poorly placed implants due to little to no planning and tooth bridges that had pink gum material falling off and unnatural looking and stained teeth meant that a complete redo was required.

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Image 10: AFTER: Patient attended Macquarie Street Dental Practice with concerns that her top and bottom All on 4 treatment was failing.  Poorly placed implants due to little to no planning and tooth bridges that had pink gum material falling off and unnatural looking and stained teeth meant that a complete redo was required.

Skill and Experience in Aesthetic Smile Design

How adept is your dentist at creating natural-looking teeth based on modern approaches including Aesthetic Smile Design?

Though technical, this is an important question because your tooth bridge will not only restore function—it will also change your appearance.

Sometimes a patient’s new smile ends up being quite similar to their original. Other times, minor tweaks may be all that’s required to enhance facial features. Some patients may require a complete rethink of their tooth shape and composition.

In short: you want your new set of teeth to look as lifelike and unique as possible. No one wants a cookie-cutter smile!

Aesthetic Smile Design by Macquarie Street Centre

Don’t worry if you’re unsure what you’d like your new smile to look like. My job is to hold your hand through the entire process and discuss all the available options with you until, together, we come up with the final cosmetic result.

As one of the first dentists in Australia to pioneer dental implants, training with the inventor, my practice was the first digital Smile Design centre in Australia. Today, my focus is on creating exceptional, lifelike results for my patients through blending artistry with the latest technologies.

Summary:

Your All on 4 dentist should be able to customise tooth shape and composition according to your unique needs, appearance and desired results. This is an extremely important part of All on 4 treatment and shouldn’t be skipped or rushed.

Aesthetic Smile Design: Dr Dunn’s Credentials

• Macquarie Street Centre has over 25 years experience in dental implant and cosmetic dentistry
• Selected to run the very first Digital Smile Design centre in Australia
• Regularly lectures his peers on the subject of cosmetic dentistry
• Strong expertise in creating custom smile makeovers
• Meticulous process of planning your new smile
• Try-in process and planning to empower you every step of the way.

Work Examples: Aesthetic Smile Design by Dr Dunn

Question: What do these before-and-after case studies have in common?

Answer: Not much: three different patients, three completely different smiles—and sets of issues. That’s why each patient received a customised, bespoke final result.

Aesthetic Smile Design: Female, late 60s

Problem: Failing top and bottom teeth due to aged restorations and advanced gum disease

Solution: All on 4 treatment to the top and bottom jaw: top teeth porcelain hand layered teeth with a custom metal platform underneath: the most aesthetically pleasing option to mimic natural tooth translucency.

(Image here of BEFORE and AFTER)

Aesthetic Smile Design: Male, mid 50s

Problem: Missing teeth, failing root canal treated teeth, worn teeth, gum disease

Solution: All on 4 treatment to top and lower jaw: acrylic teeth with metal structure underneath

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Aesthetic Smile Design: Female, mid 20s

Problem: Broken, missing teeth and cavities

Solution: All on 4 treatment to top and lower jaw: acrylic teeth with metal structure underneath

(Image here of BEFORE and AFTER)

Getting your ‘bite’ (occlusion) right: function just as important as aesthetics

Getting your bite right prevents a swathe of health issues down the track including headaches, sore jaws, teeth popping off, or feeling your teeth are uncomfortable are too ‘bulky.’

Perfecting your ideal bite works best when you’re no longer numb from the anaesthetic and may require a few separate appointments, which is why we rarely insert your tooth bridge on the same day that your dental implants are placed.

We’ve said it before and we’ll say it again: the time spent getting your bite right impacts the cost of All on 4 because it takes years to master and is one of the most challenging aspects of the treatment.

Type and Quality of your Implants

The quality of your dental implants is so important—they should be strong and long-lasting.

Macquarie Street Center accepts dental implants only from reputable, well-established manufacturers—and you should, too.

Here’s why the type of implants matter:

• Established implant companies (some operating since the 1970s) have spent decades acquiring manufacturing expertise
• Over time, your implants may need parts (like new screws that hold the bridge). Established companies are far less likely to disappear, giving you peace of mind that you’ll always be able to access spare parts
• Your implants are recognised wherever you go. We’ve seen cases where patients have implants that are unavailable in Australia, which made it very difficult to identify the implant, not to mention access spare parts
• Long-serving brands have hundreds of research studies published on their products; other less established brands have just a few (if any)

Summary:

The potential problems related to lesser-known companies are simply not worth the short-term All on Four cost saving—especially if you average the savings over the number of years your implants will serve you.

Our Dental Implants of Choice

Macquarie Street Centre is committed to only using premium brand dental implants and components from reputable manufacturers.

• No generic ‘copy’ dental implants: we demand and only purchase the best for you from suppliers including Nobel Biocare, Straumann and Astra as they have proven track records and clinical studies supporting their efficacy
• All ancillary parts are genuine, not cheap copies
• We do not recycle dental implant components from patient to patient; we have a strict single-use policy for your safety and hygiene.

You can rest assured that this policy extends to all equipment and dental materials used as part of your treatment.

Inclusions in your Treatment Plan

It pays to watch out for treatment inclusions, as they can really impact your final All on 4 cost.

Some clinics provide advanced healing procedures with platelet-rich plasma all-inclusive in every All on Four treatment. Others will charge an additional fee, and some charge for the tooth extractions if you need them per tooth, which can quickly add up.

What’s Platelet-Rich Plasma (PRP)?

A relatively new advancement in the medical field, this technique extracts platelets from your own blood. The platelets are then prepared in a centrifuge to create tissue-like ‘steaks’.

The ‘steaks’ are then placed on your implant wounds to promote faster and improved healing by stimulating collagen production.

Macquarie Street Centre adopted this procedure for many years ago as part of our standard All on 4 treatment inclusions. In our experience, platelet-rich plasma greatly assists with healing and in the creation of new, healthy gum tissue.

Five Questions for your All on 4 Provider

1. Is tooth removal included?
2. Is platelet-rich plasma included standard or an extra?
3. Will the dentist charge more if I need more than four implants?
4. Are follow up appointments included, how many?
5. Is a custom night-guard included to protect my teeth while I sleep?
6. Do you include a Waterpik flosser to help keep my new tooth bridge in tip-top condition?

Remember: in addition to your in-home care routine, you’ll need to factor in twice-yearly checkups with your dentist to keep your All on 4 teeth in their very best shape.

Summary:

All on Four treatment inclusions have a huge impact on your bottom line, and vary from clinic to clinic. Be sure to quiz your dentist about what procedures and products are—and aren’t—included your overall All on 4 cost.

Included in your All on Four treatment cost at Macquarie Street Centre:

• Tooth removal: we carefully remove any remaining teeth to preserve as much bone as possible (some clinics may charge upwards of $200 for each tooth removal)
• Platelet-rich plasma: included as standard (some clinics charge $1500 or more for this procedure alone)
• Up to six implants: not all patients are suited to just four implants. For example, soft bone or a strong bite may require more than four implants. Because this is beyond your control, we don’t cap you at just four implants
• Three follow-up appointments after your teeth are placed: two weeks, four weeks and six weeks
• Custom night-guard: apart from regular six-monthly check-ups, the best way to protect your new teeth is to wear a custom guard when you sleep. This is especially important if you have a history of bruxism (tooth grinding). Some clinics may charge upwards of $500-600 for a night-guard, or not offer it at all
• Waterpik cordless water flosser

Conclusion

We hope you’ve found this helpful to understand all the factors that contribute to the final cost of an All on 4.

If you’re ready to take the next step in your journey we invite you to book a time to visit our practice and speak with our patient coordinator. During this visit, you’ll be able to hold and feel the different types of tooth bridge options, ask questions and see many more smile transformations. Request your appointment here (link to contact) or alternatively call us to book your visit.

Further Reading

It pays to be informed when making your decision to have an all on 4, some further articles you might like include:

All on 4 Payment Plans: Understanding your options
All on 4 Reviews Australia

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