Eligibility Criteria for All-on-4 Dental Implants

All-on-Four dental implants are generally suitable for everyone, but certain criteria must be met.
These criteria include:

• General health requirements.
• Oral health requirements.
• Lifestyle factors.

General Health Requirements

People considering this treatment need reasonable health to be suitable for All-on-Four. Good general health is important because of the anesthesia required for treatment, especially if you would prefer to have sedation dentistry. Suitable candidates shouldn’t have any uncontrolled conditions that could affect healing, for example, diabetes. If you have diabetes that is well controlled, you are almost certainly suitable for implants.

Oral Health Requirements

Several factors must be considered when reviewing your oral health.

Oral Infections or Oral Disease Must Be Treated First

You mustn’t have any signs of active oral diseases. These include any infections in existing teeth or signs of active gum disease. If you do have existing oral health problems, we must treat these first to ensure they are eliminated or well-controlled before you can have implant surgery. If you previously had gum disease, you are most likely suitable for implant surgery, but be aware it could increase the risk of implant failure in the future without the proper after-care.

Bone Density

Good jawbone density is extremely important for successful dental implant treatment. However, it is less of an issue with All-on-Four because of how the implants are situated. The implants are inserted towards the front of your jaw, and your jawbone is naturally stronger and thicker. Therefore, it’s unlikely that you would need bone grafting, but your jawbone health will be assessed carefully to determine the quality and quantity of available bone.

Commitment to Ongoing Oral Care

Dental implants are easy to care for but require some commitment to keep them clean and free from infection. You must be prepared to look after them and to clean around them as shown by our hygienists. Regular dental checkups and hygiene appointments are equally important so we can check the condition of your implants and clean them professionally.

Not everyone is prepared to look after dental implants, but failure to do so can lead to the gum and jawbone around the implants becoming infected. Ultimately, this can increase the risk of implant failure. Anyone who is less likely or less able to look after their implants may be advised to consider another form of treatment that is easier to look after, such as a removable denture.

Lifestyle Factors

If you currently smoke, you may be wondering if you are suitable for implants. The short answer is yes, but it can impact the success of your treatment. Quitting smoking is extremely important for successful implant surgery and healing. If you smoke, you must be prepared to quit while preparing for implant surgery and during the healing process. Smoking affects osseointegration, making it harder for the implants to become firmly fused in the bone.

Ideally, we would prefer it if you could stop smoking completely. Smoking can increase the loss of bone around the implants, and although the amount of bone loss is minimal each year, it can add up over time. Smokers are also likely to have dry mouth, as the habit affects the salivary glands. The drier conditions can allow harmful bacteria to thrive more easily, increasing the risk of infection.

If you can’t quit or don’t want to stop smoking, ensure you commit to maintaining excellent oral hygiene after implant surgery to help protect your implants.

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Evaluating Your Suitability for All-on-Four Implants

A comprehensive evaluation at our dental office determines if you are suitable for this treatment. During this evaluation, we take diagnostic images, including a cone beam CT scan, and assess the quality and quantity of bone available for implant placement.

We also set aside plenty of time to discuss All-on-4 implant treatment. Our dentist will want to ensure you understand the treatment plan fully, know what is required during and after surgery, and that your treatment expectations are realistic. Our dentist will also discuss suitable alternatives, ensuring you understand every treatment option available and can make a fully informed choice.

Special Considerations for All-on-Four Implants

Certain people requiring implant treatment need special consideration because of their circumstances, including:

• Younger patients.
• People taking certain medications.
• People who have received radiation therapy.

Younger Patients

Younger patients who need implants may have to wait until their teeth and jaws have finished growing and developing. Generally, this is around age 18, but everyone is different. If you are younger and would like this treatment, our dentist will examine your jaws to determine if they are fully grown. In the meantime, we can provide other solutions for tooth loss until your facial growth is complete.

People Taking Certain Medications

The success of dental implants depends on good osseointegration when bone cells grow on and around the implants, firmly fusing in them in the jawbone. It is a process that can last anywhere between three and six months, but certain medications may interfere with osseointegration.

Medications that can interfere with this process include bisphosphonates given to people to increase bone density and reduce the risk of fractures. Commonly prescribed medications like those to treat heartburn, as well as antidepressants, can affect bone healing.

Other medications that may affect this process include those that are prescribed to treat hypothyroidism and diabetes, cardiovascular disease, neurological diseases, and anti-inflammatory drugs. Recreational drug use and using alcohol to excess may mean implant treatment is less successful.

When you visit our dental office, we ask for a complete list of all medications prescribed, including over-the-counter and prescription medicines. Our dentist can review your list with you and determine if implants are suitable or if there is a possible risk of failure. Sometimes, certain medications may need to be discontinued shortly before surgery, and if this is the case, we may need to liaise with your healthcare team to ensure treatment is safe.

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People Who Have Received Radiation Therapy

Your suitability for dental implants depends on where in the body the radiation therapy was focused. For example, highly focused radiation treatment that is aimed at the body and is well away from the head and neck area may not affect your suitability for implants.

Anyone who has received radiation therapy around the head and neck area may be less suitable for dental implants, especially if radiation therapy affects their jawbone. Radiation therapy increases the risk of osteonecrosis, a bone disease that is also associated with bisphosphonate therapy, a therapy that is often prescribed as part of cancer treatment.

The amount of radiation therapy received can affect the success of implant treatment, even if the therapy was received many years ago.

Please let us know if you have received radiation therapy in the past. We may liaise with your oncologist to determine your suitability for dental implants.

Visit Our Dental Office to Get a Professional Opinion On Your Suitability

If you have medical problems that may impact implant treatment, it’s still worth visiting our dental office to receive a professional opinion based on your unique situation. Sometimes, someone who has previously investigated traditional implant treatment will find they are suitable for All-on-4 as fewer implants are needed and they are situated in a specific way.

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