All About “All-­On‐Four” Dental Implants: Learn about the Procedure, Recovery, Costs and Possible Complications

Jan 3, 2024

An All-On-Four dental implant is just one of many kinds of dental implants. In this article, we’ll talk about the All-On-Four implant in detail: what it is, information about the procedure to have them installed, recovery times, and possible complications with them.

And so to begin, note that Dental implants are specifically designed to provide a base for a fake tooth, in order to permanently replace missing teeth. A dental implant is a small screw, usually made of titanium, which is inserted into the jawbone in the spot that a tooth is missing. Once the implant is installed, the dentist can then attach the fake tooth.

An All-On-Four dental implant is designed to replace all teeth on the upper or lower jaw with only four implants, rather than an individual implant for each missing tooth. These four implants are placed in the jaw and then dentures are attached to those anchors so as to replace all the teeth. These implants can be used either only on the top jaw, only on the bottom law, or to replace all the teeth of both jaws.

All-On-Four Dental Implant Costs

One of the first things that people want to know about many dental procedures is the cost. The costs of All-On-Four dental implants vary depending on how many teeth you’re replacing and what material you choose to replace them with. Dental Insurance plan coverage (where applicable) can also vary, which will affect your final costs for All-On-Four dental implants.

Acrylic or Composite All-On-Four Dental Implants:

Acrylic dentures on a titanium framework are a standard All-On-Four option. This type of denture in the United States will typically cost from $20,000 to $30,000 (note that this is NOT the price in Ecuador), naturally depending on the specifics of your own dental circumstances, such as if you need to see more than one dentist for your procedure in the United States, then that will also of course further increase your costs.

Porcelain All-On-Four Dental Implants:

Porcelain dentures look better and tend to last longer than acrylic ones. These porcelain dentures cost up to $5,000 more per jaw (take your pick of top or bottom or both, and note again that these are NOT Ecuador prices), and so they can be up to $10,000 more than acrylic dentures if done in the US or Canada. For one single jaw, the total cost in the US or Canada will be between $25,000 and $35,000, plus these type dentures in the US or Canada cost about $15,000 to replace if they are damaged.

The All-On-4 Dental Implant Procedure

Dental implants can be scary for those who aren’t familiar with them, especially if you’ve never had a major dental procedure. A lot of that fear though comes from uncertainty about the process, so learning exactly how the dentist will carry out the whole procedure can help ease that uncertainty. To help you with that, here’s a general overview of the All-On-Four dental implantation procedure:

The procedure typically includes local anesthesia, cleaning and preparation, placing of the implants, and suturing.

First things first: you’ll be anesthetized for the procedure. If you have a fear of dental work, general anesthesia is always an option, and it’s generally used for surgical procedures like these, though local anesthesia is generally par for the course, as general anesthesia usually requires admission to a hospital (specifically in Ecuador that’s a must if you opt for general anesthesia versus local anesthesia how most patients select local anesthesia instead).

Your dentist or oral surgeon will prepare your mouth for your new implants. They will remove any teeth that need to be replaced, remove any infected or diseased tissue from your gums and jaw, and make sure that everything is clean.

Next, they will place the implants themselves. These specially designed titanium screws will be placed in your jawbone. Two of them will be near the front of your mouth and two will be toward the back. These screws will be the anchors that hold the dentures in place and bear the weight of them evenly.

Once all of the implants have been placed into your jaw, the surgical sites will be cleaned and sutured so that you can return home or wherever you’re staying locally (at least while on a Dental Vacation to Ecuador).

All-On-Four Dental Implants Recovery Time

Traditional dentures have a long recovery time, generally around three to eight months. Happily though, the recovery time after getting All-On-Four dental implants is generally quite a bit shorter, because the implants begin fusing to your jawbone as soon as they’re implanted. This promotes stability of your dentures and makes the healing process usually go fairly smoothly.

Now, here’s an overview of what to expect during your recovery, starting from when you first wake up in the recovery room:

First Day Recovery

For the first hour of your recovery, or until the bleeding stops, you’ll have gauze packed over the areas where the implants were placed. You’ll be instructed to gently bite down on them in order to hold them in place. The gauze will be removed after that first hour or once you’ve stopped bleeding. If you’re bleeding excessively for any reason, your dentist will change your gauze and instruct you to change it every half hour or so until the bleeding stops.

Once you get home after your oral surgery, you’ll have some basic care instructions to follow. Be sure to take heed of all of your dentist’s instructions. First of all, be sure to not rinse or touch the surgical areas. You may be able to very gently brush them with a soft toothbrush. Smoking after oral surgery can drastically impede healing and should be avoided.

While you need to be extra-gentle with the area, it’s very important to keep your mouth clean. It’s likely that your doctor will prescribe you a medicated rinse that will help gently clean your mouth, reduce bacteria, and promote fast healing.

Twenty-four hours after the surgery, if you’re no longer bleeding, you can use a saltwater rinse to help keep the surgical sites clean. Mix one tablespoon of salt into a cup (eight ounces) of water, and gently rinse out your mouth two to three times a day.

The Days Following Surgery

In the days after your procedure, you’ll need to spend most of your time resting and reclining. You should avoid any strenuous activity, which could lead to further swelling or bleeding. Avoid bending over and lifting heavy objects.

When you change positions, especially when you’re moving from lying down to standing up, do so slowly and gradually to avoid getting dizzy or lightheaded. Skip your normal exercise routine for at least three or four days after your surgery so that your body can focus its energy on healing. During your recovery, focus on resting, managing any pain based on your dentist’s instructions, and eating soft foods that won’t irritate your mouth.

What To Eat After All-On-Four Dental Implantation

The main consideration with food is to avoid anything that can irritate your mouth. Avoid any hard foods, candy, and very hot beverages/foods. Avoid chewing if you can’t feel your tongue. Ideally you should only eat semi-pureed foods and liquids for the first few days following the surgery.

Despite the restrictions, it’s critical to make sure you’re getting some good nutrition during your recovery. It can be hard to want to eat when your mouth hurts, but eating is crucial to help you heal well, even if it’s inconvenient at first.

Common Post-Surgery Issues With All-On-Four Dental Implants

While the recovery for All-On-Four dental implants generally goes smoothly, there’s always the chance for complications. Here are some of the issues that can arise after your surgery and how to deal with them. As always, contact your dentist promptly if there’s anything you’re unsure about:

Persistent Bleeding

One of the common complications that arise is bleeding. If you continue to experience bleeding that isn’t stopping, it’s often because the gauze packs aren’t positioned over the surgical sites correctly. Try repositioning the gauze and see if the bleeding stops after a little while.

If adjusting your gauze packs doesn’t help and the bleeding continues, sit up instead of lying down, use ice packs, and avoid activity as much as possible. You can also try gently biting down on a moist black tea bag for about half an hour or so.

If nothing seems to help stop the bleeding, give your dentist a call.


Swelling is normal after surgery, and it’s normal for it to increase in the few days following the procedure, so don’t worry if you’re more swollen two or three days after the surgery. You can use an ice pack intermittently (20 minutes at a time) during the twenty-four hours after the procedure. If there is so much swelling that it interferes with eating or is causing any other problem, be sure to contact your dentist.


Pain is an unavoidable part of any surgery. You’ll get a prescription from your dentist for pain medication, so take it as directed and it will help. Call your dentist if you can’t manage your pain with the prescribed medication.


Sipping a carbonated drink can help with mild nausea, which you may experience as a side effect of medications or from any blood you might have swallowed during your surgery. If your nausea persists or is severe, call your dentist. They may prescribe an anti-nausea medication or have other recommendations.


You may notice some discoloration from bruising (this will be black and blue or yellow) near the surgical sites about 2-3 days after surgery. This is normal, and you can apply moist heat to your cheek 36 hours after the procedure to help ease bruising.

Sharp Sensations In Your Mouth

A sharp feeling in your mouth is likely the bone that supported teeth that are now missing. After a few days, you may feel these small pieces of bone protruding. If this is uncomfortable and you’re concerned, contact your dentist to see if there’s anything you or they can do, but you may have to just wait for your gums to heal.

Dry Lips

Dry and chapped lips are normal, since you may be holding your mouth open because of the gauze and swelling. Use Chapstick or another ointment to keep your lips hydrated and prevent cracking.

Sore Throat

Another consequence of holding your mouth slightly open with the gauze is a sore throat. If swallowing is painful, be sure to drink plenty of liquids and take it easy. This symptom will pass after a few days.

Stiff Muscles

Finally, you may experience some stiffness in your jaw muscles from holding your mouth slightly open. Take some time to occasionally stretch those muscles by gently moving your jaw, and take a break from biting down on gauze when you can.

Most importantly, if you’re uncomfortable and experiencing any of these symptoms, contact your dentist. They may have advice that can ease your discomfort, or just reassure you that everything is fine, but they would rather hear from you than have you let a real issue go untreated.

Common Problems With All-On-4 Dental Implants

The above list includes common post-surgical side effects that are usually not serious and will ease up in the days after your procedure. However, you may experience some actual problems or complications with All-On-Four implants. And so, here are the most common complications:

Surgical Complications

There are always risks with any surgery. The complications from an All-On-Four dental implant procedure can include profuse bleeding, poor healing, and infection. Your dentist will take every precaution to avoid these complications, but they still can happen occasionally, so it’s good to be prepared.

Keep an eye out for these possible complications, and as always, contact your dentist right away if there’s anything you’re concerned about or elsewise that seems abnormal in your healing process.

Dental Implants That Don’t Integrate Into Your Jawbone

Occasionally, the dental implants won’t integrate themselves well into the bone, and in such case that can cause instability. Smoking, low bone density, poor nutrition, and other factors can prevent effective integration of any type of implants. Your dentist may have to remove them in such in an event, let you heal, and then try again with new implants.

Failed Implants

It is rare for dental implants to fail completely. The All-On-Four dental implants have a very high rate of success. If one or more of them do fail for any reason, your dentist will be able to replace them.

Gum disease is the most common reason that an implant fails. This can be avoided by taking good care of your oral hygiene and visiting your dentist regularly for checkups.

Patient Reviews Of All-On-4 Dental Implants

Patients who have All-On-Four dental implants are generally very satisfied with their new teeth. If your dentist is skilled and reliable, your experience is likely to be positive as well.

Most patients report that they are very happy with their implants, saying that they feel quite similar to their natural teeth, that the recovery was easy, and that the whole process doesn’t take very long and isn’t particularly uncomfortable. They like that their teeth and gums look natural as a direct result of having opted for the procedure. Overall, patients with All-On-Four dental implants affixed in one or both jaws are highly pleased with their final results.

Adam Elliot Altholtz ("Find Health in Ecuador Dental Clinic")

Adam Elliot Altholtz serves as the Administrator & Patient Coordinator of the “Find Health in Ecuador Dental Clinic”, along with his fellow Expats' beloved 'Dr. No Pain', right here in Cuenca, Ecuador, and for purposes of discussing all your Dental needs and questions, is available virtually 24/7 on all 365 days of the year, including holidays. Adam proudly responds to ALL Expat patients from at least 7:00am to 9:00pm Ecuador time, again every single day of the year (and once more even on holidays), when you write to him by email at and also by inquiry submitted on the Dental Clinic's fully detailed website of for you to visit any time, by day or night. Plus, you can reach Adam directly by WhatsApp at +593 98 392 9606 or by his US phone number of 1‐(941)‐227‐0114, and the Dental Clinic’s Ecuador phone number for local Expats residing in Cuenca is 07‐410‐8745. ALWAYS, you will receive your full Dental Service in English (NEVER in Spanish), per you as an Expat either living in or desiring to visit Cuenca by your Dental Vacation, plus also to enjoy all of Ecuador's wonders that are just waiting for you to come arouse and delight your senses.

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