My teeth are in such bad shape, I am overwhelmed just thinking about what to do next!

This patient's teeth are almost entirely built with filling material and are very weak. This also makes his gums very unhealthy. All-on-Four treatment would make his mouth much healthier.

This patient’s teeth are almost entirely built with filling material and are very weak. This also makes his gums very unhealthy. All-on-Four treatment would make his mouth much healthier.

We often meet patients who have been burdened by bad dental health and/or lack of good dental care.  Sometimes this happens because the patient has been fearful of dental treatment, or limited by finances, or has had accidental injury.  Whatever the reason, by the time an appointment is scheduled the teeth are in such poor condition that they cannot be saved.  This can be an extremely frightening situation, especially because in many of these cases the patient is unaware that the dental condition is so severe.  How does this happen?  As a general rule of thumb, cavities and gum disease are not painful!  Also, bleeding gums are (wrongly) thought of as normal because the condition is common, so the bleeding gums may be ignored. So, when a patient presents to our office with either tooth pain in many areas, already with some teeth (or many teeth) missing, and/or several loose teeth, it can be difficult for us to do anything to save the teeth.  Unfortunately, in cases like these the remaining teeth in one jaw, or even both jaws, need to be removed.

What is a good option for treatment in a situation like this?

All-On-Four dental implants are a great treatment for patients missing all of the teeth in one or both jaws

All-On-Four dental implants are a great treatment for patients missing all of the teeth in one or both jaws

Especially when most of the teeth are still present, a terrific option for the right patient could be “Teeth in a Day”, also known in the dental community as “All-On-Four”.  This is a term coined by a dental implant company, Nobel Biocare, which describes the placement of four dental implants in the upper or lower jaw, followed immediately that day with full teeth replacement attached to those implants.  This procedure can be finished on the same day teeth are removed, if necessary, and all while the patient has intra-venous sedation (IV sedation) in the oral surgeon’s office. This treatment is being accomplished fairly frequently here in Ottawa, Ontario, and with very good success and patient satisfaction.

How does this work?

An illustration of the All-on-Four treatment on top and bottom jaws

An illustration of the All-on-Four treatment on top and bottom jaws

All of the proper measurements and molds are made prior to the day of surgery. Photographs of the existing teeth and models are sent to the dental laboratory, along with a description of the desired final look of the teeth (the dentist does this with the patient’s input). On the day of surgery, the patient is given a light injectible sedation along with dental freezing, any teeth remaining in the jaw to be treated are removed, and the surgeon places four dental implants in a very specific way to be able to have teeth attached to them the same day.  Meanwhile, the restorative dentist and the dental laboratory technician work to make the piece that will act as teeth and look like teeth for the patient to wear during a healing phase of approximately six months.  In the large majority of cases, this “temporary” looks even nicer than the patient’s original teeth!

Once the gums have fully healed, the patient will return to the restorative dentist’s office for new molds and photographs, and the permanent tooth replacments will be made.  This second set of visits is completely painless and typically requires no dental freezing at all.

This type of tretament must be expensive!

Yes, it is.  In fact, the patient having the All-on-Four procedure can expect to pay the cost of a luxury car to treat both top and bottom jaws in this way!  However, there is something to keep in mind…the dramatic benefits of having a healthy mouth with a stable ability to chew and a great smile as well.  Also, there are companies that will help a patient finance treatment such as this, one of these companies is DentalCard.

Is everyone a cadidate for this treatment?

The patient should be in good health. Heavy smokers, uncontrolled diabetics, and those who are immunocompromised may have a less predictable treatment outcome, so a consultation with an oral surgeon and the restorative dentist would be important.  However, if a person is in fairly good health, except for the health of the mouth, treatment works very consistently.

If you would like more information about this subject, please don’t hesitate to contact Dr. Andrea Stevens Dentistry.  We can help get you started, and make sure you know the treatment option that’s best for you. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario.  If you have dental questions, you can call her at 613-271-7091. Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!