All-on-4 Dental Implants: The Full Treatment Process Step by Step

The All on 4 dental implants procedure involves several stages, from your initial consultation and 3D scans through to implant placement, healing and fitting your permanent teeth.

Most patients tell us the same thing: the procedure itself was far less intimidating than the uncertainty beforehand. The best way to reduce that uncertainty is to understand every stage before it happens.

This guide walks you through the complete All-on-4 treatment process at Atria Dental Gordon, step by step. What happens at each appointment, how long each phase takes, what you’ll feel, what to eat, and when you’ll finally have your permanent new smile.

 

How the All on 4 Dental Implants Procedure Works

All-on-4 replaces a full arch of teeth using just four titanium implants per jaw. Two implants are placed vertically at the front of the jaw, and two are placed at an angle at the back. This angled placement grips the densest available bone, which is why All-on-4 often works for patients who’ve been told they don’t have enough bone for traditional implants.

A complete set of fixed replacement teeth is then secured to the implants. Unlike dentures, these teeth don’t come out. They’re brushed, flossed and cared for just like natural teeth.

On surgery day, a temporary set of teeth is usually attached immediately — so you don’t leave the clinic without a smile. After several months of healing, the temporary bridge is replaced with a permanent prosthesis made from zirconia or high-grade acrylic.

For a broader overview of dental implant types, see our dental implants page.

 

Who Is a Good Candidate for All-on-4?

All-on-4 is designed for people who have lost most or all of their teeth in one or both jaws, or whose remaining teeth are too damaged to save.

You may be a good candidate if:

• You’re missing most or all teeth in your upper jaw, lower jaw, or both
• Your remaining teeth are failing due to decay, gum disease or fractures
• You currently wear dentures and want a fixed, permanent alternative
• You’ve been told you don’t have enough bone for conventional implants
• You’re in generally good health and can undergo a minor surgical procedure

Factors like uncontrolled diabetes, active gum disease, heavy smoking, or certain medications may affect your suitability. These are assessed during the consultation — they don’t automatically rule you out, but they do need to be managed. 

Step 1: Initial Consultation and Assessment

When: Your first visit to Atria Dental Gordon.

Duration: 45–60 minutes.

 

This is where everything starts. During your consultation, Dr Juzer Naseem and the team will:

• Review your medical history, current medications and overall health
• Conduct a full oral examination of your teeth, gums and bite
• Take 3D CBCT scans and x-rays to assess bone density, bone volume and the position of nerves and sinuses
• Discuss your goals, concerns and what you want from treatment
• Explain whether All-on-4 is suitable for your situation — or recommend an alternative if it’s not

The 3D imaging is important. It gives your dentist a detailed, three-dimensional view of your jaw that a standard x-ray cannot provide. This is what allows the implant positions to be planned with precision before any surgery takes place.

For additional information about dental implant treatment and oral health in Australia, the Australian Dental Association provides further patient information.

At Atria Dental Gordon, we offer complimentary dental implant consultations. There’s no obligation — the consultation is about giving you the information you need to make a confident decision.

 

Step 2: Treatment Planning and Preparation

When: 1–3 weeks after consultation.

 

Based on your scans and examination, the team develops a customised treatment plan. This includes:

• The exact position and angle for each of the four implants
• Whether any teeth need extracting (and how many)
• Whether bone grafting or a sinus lift is needed before or during surgery
• The type of temporary prosthesis you’ll receive on surgery day
• The material for your permanent bridge (zirconia or acrylic)
• An itemised cost breakdown and payment plan options

If bone grafting is required, it may be done as a separate procedure a few months before implant placement, or in some cases it can be done on the same day as surgery. Your dentist will explain which approach is right for your situation.

You’ll also receive pre-surgery instructions: what medications to stop or start, dietary preparation, and practical arrangements for the day (someone to drive you home, time off work, etc.).

 

Step 3: Surgery Day — Extractions, Implant Placement and Same-Day Teeth

When: The scheduled surgery date.

Duration: Approximately 2–4 hours per arch.

 

Surgery day is the biggest milestone in the All on 4 dental implants procedure. This is when the extractions, implant placement and temporary teeth are completed. Here’s what happens:

Anaesthesia and sedation

The procedure is carried out under local anaesthesia — your jaw is fully numbed so you won’t feel pain during surgery. If you’re anxious or having both arches done in one session, sedation dentistry options are available. These range from oral sedation (a tablet that makes you drowsy) to IV sedation (you’re conscious but deeply relaxed and unlikely to remember the procedure). For nervous patients, sedation can make a significant difference.

Tooth extractions

If you still have teeth that need to come out, they’re removed at the start of the surgery. This is done carefully to preserve as much bone as possible for the implants. You can learn more about our approach on our tooth extractions page.

Implant placement

Four titanium implants are placed into your jawbone: two vertically in the front section and two at a 30–45 degree angle in the back. The angled back implants anchor into the densest part of the bone, which is what gives All-on-4 its stability even in patients with reduced bone volume.

Each implant is inserted through a small incision in the gum tissue. Using the pre-planned surgical guide, the dentist positions each implant at the exact depth, angle and location mapped out during the planning phase.

Temporary teeth attached

Once the implants are placed and secure, a temporary acrylic bridge is attached. This bridge gives you a full set of functioning teeth before you leave the clinic.

The temporary teeth aren’t your final smile — they’re designed to protect the implants while they heal and let you eat and speak normally during the recovery period. They’re functional and natural-looking, but the permanent prosthesis (fitted months later) will be stronger, more precise and more polished.

 

Step 4: The First Two Weeks After Surgery

When: Days 1–14 post-surgery.

 

The first two weeks are the most important recovery period. Here’s what to expect:

Days 1–3: Swelling, bruising and rest

• Swelling peaks around days 2–3, then gradually subsides. Applying ice packs (15 minutes on, 15 minutes off) helps.
• Bruising around the jaw and sometimes the neck is normal and fades within a week.
• Some oozing or light bleeding from the surgical sites is expected on day 1.
• Take the prescribed or recommended pain medication before the anaesthesia wears off. Most patients manage comfortably with standard over-the-counter pain relief.

Days 1–7: Soft food only

Stick to a soft food diet for at least the first week. Good options include:

• Smoothies and protein shakes
• Scrambled eggs
• Mashed potato, pumpkin or sweet potato
• Yoghurt and soft cheese
• Soups (lukewarm, not hot)
• Avocado

Avoid anything hard, crunchy, chewy or very hot. No biting into foods with your front teeth during this period.

Days 7–14: Gradual return to routine

• Most patients feel comfortable enough to return to desk work after 3–5 days. Physical jobs may require a full week off.
• Swelling continues to reduce. By day 10–14, your face should look and feel close to normal.
• You’ll have a follow-up appointment at the clinic to check healing, remove any sutures, and make adjustments to the temporary bridge if needed.

 

Step 5: The Healing Period — Osseointegration (Months 1–6)

When: Month 1 through month 3–6.

 

This is the phase most people don’t hear much about, but it’s the most critical for long-term success.

During this period, your jawbone is growing around and bonding with the titanium implants — a biological process called osseointegration. This is what creates the permanent, stable foundation for your final teeth.

You’ll be wearing your temporary bridge throughout this period. It’s fully functional — you can eat, smile and speak normally — but you do need to treat it with care:

• Continue eating softer foods for the first 4–6 weeks, then gradually reintroduce firmer foods as directed
• Avoid biting into very hard foods (raw carrots, nuts, crusty bread) with the temporary bridge
• Maintain excellent oral hygiene — brush gently twice daily, use a soft-bristle brush, and rinse with the prescribed mouthwash
• Attend all scheduled check-up appointments so the team can monitor healing

The lower jaw typically integrates faster (around 3 months). The upper jaw, which has less dense bone, usually takes 4–6 months. Your dentist will assess integration with imaging before proceeding to the next step.

 

Step 6: Fitting Your Permanent Teeth

When: 3–6 months after surgery, once osseointegration is confirmed.

Duration: 2–3 appointments over 2–4 weeks.

 

This is one of the final stages of the All on 4 dental implants procedure and the stage patients look forward to most. The temporary bridge comes off and your permanent prosthesis goes on.

The process involves:

• Detailed impressions or digital scans of your implants and gums
• A try-in appointment where the shape, colour and fit of the permanent bridge are checked against your face, smile line and bite
• Final adjustments and lab work
• The permanent bridge is secured to the implants using precision abutment screws

The permanent prosthesis is manufactured by a specialist dental laboratory. Zirconia bridges are the strongest and most natural-looking option — they’re highly stain-resistant and can last 15–20+ years. Acrylic bridges are lighter and less expensive but have a shorter lifespan (typically 5–10 years).

Once fitted, your permanent teeth will look, feel and function like natural teeth. You can eat, laugh, speak and smile with full confidence.

 

Step 7: Ongoing Care and Maintenance

All-on-4 implants aren’t maintenance-free. Like natural teeth, they need daily care and regular professional check-ups.

Daily care at home

• Brush twice a day with a soft-bristle toothbrush
• Use a water flosser or interdental brushes to clean underneath and around the bridge
• Avoid abrasive toothpastes that can scratch the prosthesis surface

Professional maintenance

• Visit your dentist every 6 months for a professional clean and implant check
• The bridge may be temporarily removed during these visits so the implants and gum tissue underneath can be thoroughly cleaned and inspected
• Your dentist will check for signs of peri-implantitis (inflammation around the implants) and address it early if detected

With proper care, the titanium implants themselves can last a lifetime. The prosthesis will eventually need replacement — typically after 10–15 years for acrylic or 15–20+ years for zirconia. Book your regular dental check-ups to keep everything on track.

 

All-on-4 Treatment Timeline at a Glance

 

Stage	What happens	Approximate timing
Consultation	Exam, 3D scans, treatment plan discussion	Day 1
Planning	Customised surgical plan, pre-op preparation	1–3 weeks after consult
Surgery day	Extractions, 4 implants placed, temporary teeth attached	Single appointment (2–4 hours per arch)
First 2 weeks	Soft diet, rest, manage swelling, first follow-up	Days 1–14
Healing (osseointegration)	Bone fuses with implants; wear temporary bridge	Months 1–6
Permanent teeth	Impressions, try-in, final bridge fitted	3–6 months after surgery
Ongoing care	6-monthly professional cleans, daily brushing and flossing	For life

 

Timelines are indicative. Your actual treatment schedule may vary depending on healing speed, bone quality and individual clinical factors.

 

How to Prepare for All-on-4 Surgery

Preparation makes a real difference to how smoothly surgery day goes and how quickly you recover. Here’s a practical checklist:

In the weeks before

• Attend all pre-surgery appointments and follow your dentist’s instructions
• If you smoke, stop as early as possible — smoking significantly impairs healing and increases implant failure risk
• Stock your kitchen with soft foods: soups, yoghurt, eggs, protein shakes, mashed vegetables
• Arrange time off work (3–7 days for desk jobs, up to 2 weeks for physical work)
• Organise someone to drive you home after surgery — you should not drive yourself, especially if sedation is used

The night before and morning of

• Eat a light meal the night before and follow any fasting instructions if sedation is planned
• Wear comfortable, loose-fitting clothing
• Bring your medications list and any prescribed pre-surgery tablets
• Arrive on time — the team needs to prep you before the procedure begins
• Leave jewellery and valuables at home

What to tell your dentist before surgery

Make sure your dentist knows about:

• All medications you’re taking, including blood thinners, supplements and herbal remedies
• Any history of heart conditions, diabetes or autoimmune conditions
• Whether you’ve taken bisphosphonate medications (for osteoporosis) — these can affect jaw healing
• Any allergies to anaesthetics, antibiotics or latex

Honest disclosure helps the team plan for your specific needs and avoid complications.

 

Frequently Asked Questions

How long does the All-on-4 procedure take on surgery day?

Approximately 2–4 hours per arch. If both upper and lower arches are done in one session, the total time is around 4–7 hours including breaks. You’ll leave the clinic with temporary teeth attached.

Will I be awake during surgery?

Under local anaesthesia alone, yes — but you won’t feel pain. With IV sedation, you’ll be in a deeply relaxed, semi-conscious state and are unlikely to remember the procedure. At Atria Dental Gordon, we offer sleep dentistry to help you through it comfortably.

How long until I can eat normally?

Soft foods only for the first 4–6 weeks. You can gradually reintroduce firmer foods after that, as directed by your dentist. Once the permanent bridge is fitted (3–6 months after surgery), you can eat virtually anything.

How much time off work will I need?

Most patients return to desk work within 3–5 days. Physically demanding jobs may need 7–14 days. Plan for swelling and mild discomfort during the first week.

Does All-on-4 hurt?

The surgery itself is painless due to anaesthesia. Afterwards, most patients describe the discomfort as moderate and manageable with standard over-the-counter pain medication. Swelling and bruising are the most common complaints, not sharp pain.

What if I don’t have enough bone?

All-on-4 was specifically designed to work with reduced bone by angling the back implants. However, some patients still need a bone graft or sinus lift. This is assessed during the consultation using 3D CBCT imaging.

Can both jaws be done at the same time?

Yes. Many patients have upper and lower arches treated in a single surgical session. The procedure takes longer, and sedation is more strongly recommended, but it means one recovery period instead of two.

How long do the temporary teeth last?

The temporary acrylic bridge is designed to be worn for 3–6 months while your implants heal. It’s functional and natural-looking but is not as strong or polished as the permanent prosthesis. Avoid biting very hard foods with it.

When do I get my final permanent teeth?

Typically 3–6 months after surgery, once your dentist has confirmed osseointegration is complete. The fitting involves 2–3 appointments over 2–4 weeks for impressions, a try-in and final placement.

What happens if an implant doesn’t fuse with the bone?

This is uncommon — success rates for All-on-4 exceed 95%. If an implant fails to integrate, it can be removed and replaced. In many cases, the remaining three implants continue supporting the bridge while the replacement heals.

How long will my All-on-4 implants last?

The titanium implants can last a lifetime with proper care. The prosthesis typically needs replacing after 10–15 years (acrylic) or 15–20+ years (zirconia). Regular dental check-ups are essential for long-term success.

Can I get All-on-4 if I currently wear dentures?

Absolutely. Many All-on-4 patients are people who have been wearing dentures and want a permanent, fixed alternative. The implant placement process is similar — your dentures are removed, the implants are placed, and a fixed bridge is attached.