If you are missing most of your teeth, wear a denture that slips, or have been told your remaining teeth cannot be saved, All-on-4 can give you a full arch of fixed teeth that you do not take out. At Brightly Dental Midtown, Dr. Ziva Yonaiev and our other doctors plan and place All-on-4 implants in our office at 425 Madison Ave, Suite 500, steps from Grand Central. Start with a free implant consultation.
Book your free implant consultation Call (212) 758-1000
What is All-on-4?
All-on-4 is a way to replace a full arch of teeth, upper or lower, with a fixed bridge supported by four dental implants. The two front implants go in straight. The two back implants are placed at an angle, which lets them use the denser bone toward the front of the jaw and gives the bridge a wider base of support.
The result is a complete row of teeth that is screwed onto the implants. You brush and clean it every day, but you do not take it out at night, and there is no adhesive and no plastic covering the roof of your mouth.
All-on-4 is one of several full-arch options. Some patients need more support and do better with All-on-6. Others prefer implant-supported dentures that snap in and out. Your doctor will explain which fits your mouth, health and goals.
Who is a good candidate?
All-on-4 is usually considered for adults who:
- Are missing all or most of their teeth in the upper or lower jaw
- Have failing teeth because of advanced gum disease, decay or old dental work
- Wear a full or partial denture and are tired of it moving, rubbing or affecting how they eat
- Want fixed teeth rather than a removable appliance
Some factors need extra planning: heavy smoking, uncontrolled diabetes, certain medications that affect bone, and active gum infection. These do not always rule you out, but they change the plan and the healing. If you have gum disease, our periodontal team may treat it first (periodontics and LANAP laser gum therapy).
How All-on-4 works at Brightly Dental Midtown
1. Free implant consultation
You meet with one of our implant doctors, talk through what bothers you about your teeth now, and review your medical history. We examine your mouth and explain your options, including whether All-on-4 makes sense. The free consultation does not include 3D imaging or treatment.
2. 3D scan and treatment plan
If you move forward, we take a cone beam CT scan in the office. It shows your bone, nerves and sinuses in 3D, so your doctor can plan where each implant goes before surgery. You get a written plan with the steps, the timeline and the cost of your treatment.
3. Surgery day
Any remaining teeth that cannot be saved are removed, the four implants are placed, and the gums are closed. We use local anesthesia, and you can choose nitrous oxide or IV sedation if you would rather be more relaxed. If you choose IV sedation, bring someone to drive you home.
4. Temporary teeth
When the implants are stable enough at surgery, a temporary fixed arch is attached the same day or shortly after. This is what people call Teeth in 1 Day; see our Teeth in 1 Day page. Same-day temporary arches are made at a nearby partner lab for same-day delivery.
5. Healing
Over the next several months, the implants fuse with the jawbone. You eat a soft diet at first and come in for check-ups so we can watch healing.
6. Your final teeth
Once healing is complete, we take new records and make your final arch, designed for your bite, face and the look you want. Then we attach it and show you how to clean around it.
All-on-4 compared with other options
| Option | Fixed or removable | What to know |
|---|---|---|
| Traditional denture | Removable | Rests on the gums and can move; covers the palate on the upper jaw |
| Implant-supported denture (snap-on) | Removable | Clips onto implants for stability; you take it out to clean |
| All-on-4 | Fixed | Four implants hold a full arch; only your dentist removes it |
| All-on-6 | Fixed | Six implants for more support when bone or bite calls for it |
| Individual implants | Fixed | One implant per tooth or small bridges; needs more implants and bone |
For one or a few missing teeth, single implants or an implant bridge are usually a better fit; see dental implants in Manhattan and crowns and bridges.
Bone grafting and All-on-4
The angled back implants often make it possible to avoid bone grafting, which is one reason All-on-4 is popular for people who have worn dentures for years. It is not guaranteed. If your scan shows that grafting is needed, we can do it in the office as part of your plan, and your doctor will explain how it affects the timeline.
Living with All-on-4
- Eating: soft foods while you heal, then most foods once your final arch is in. Your doctor will tell you what to avoid.
- Cleaning: brush twice a day and clean under the bridge with a water flosser or floss threaders. We will show you how.
- Check-ups: regular professional cleanings and checks. From time to time we may remove the bridge to clean around the implants.
- Night guard: if you clench or grind, we may recommend one to protect your teeth.
Implants need the same daily care as natural teeth. Good home care and regular visits are what keep them healthy for the long term.
Why patients choose Brightly Dental Midtown
- Implants placed in-house. Dr. Ziva Yonaiev and our other doctors place implants, including All-on-4, Teeth in 1 Day, implant dentures and bone grafting. Meet the team on our doctors page.
- Specialists under one roof. Our practice brings together implant dentists, periodontists, endodontists and orthodontists, so you are not sent across town for each step (our history).
- 3D planning and an on-site lab. Cone beam CT and digital X-rays let us plan each implant before surgery, and our on-site lab makes crowns, bridges and other restorations (your office experience).
- Sedation options. Nitrous oxide and IV sedation for anxious patients and longer procedures.
- Weekend surgery by request. We are open Monday to Friday, 9 to 5, and larger procedures can be scheduled on weekends by request.
- Easy to reach. 425 Madison Ave at 49th Street, a short walk from Grand Central (dentist near Grand Central).
Paying for All-on-4
The cost of All-on-4 depends on your case: one or both arches, extractions, grafting, sedation and the material of your final teeth. We give you a written estimate after your planning visit, before anything starts. Financing is available with CareCredit and Cherry, subject to credit approval, and we can check your dental insurance benefits for you.
Frequently asked questions
Is All-on-4 the same as Teeth in 1 Day?
Not exactly. All-on-4 describes the design: a full arch of fixed teeth held by four implants. Teeth in 1 Day describes the timing: a temporary fixed arch attached the same day the implants are placed. Many All-on-4 patients get both, but same-day teeth depend on how stable the implants are at surgery.
Am I a candidate for All-on-4?
Good candidates are missing most or all teeth in an arch, or have teeth that cannot be saved, and are healthy enough for minor oral surgery. We check bone with a 3D cone beam scan and review gum health, medical history, medications and smoking. If All-on-4 is not right for you, we will explain the alternatives, such as All-on-6 or implant-supported dentures.
Do I need bone grafting for All-on-4?
Often not. The back implants are angled to use the denser bone toward the front of the jaw, which in many cases avoids grafting. Some patients still need grafting, and your doctor will tell you after reviewing your 3D scan.
Does All-on-4 hurt?
The surgery is done under local anesthesia, and we offer nitrous oxide and IV sedation for patients who want to be more relaxed. Most patients have swelling and soreness for several days afterward, managed with medication and a soft diet. Your doctor will go over pain control before surgery.
How long does All-on-4 take from start to finish?
Planning usually takes one or two visits. Surgery and temporary teeth are typically one day. The implants then heal for several months before your final arch is made and attached. Your doctor will give you a timeline for your case at the consultation.
Can I remove All-on-4 teeth at home?
No. The arch is fixed to the implants and only your dentist removes it, usually during maintenance visits. That is the main difference from snap-on implant dentures, which you take out to clean.
How do I pay for All-on-4?
Start with a free implant consultation. If you choose treatment, we offer financing with CareCredit and Cherry, subject to credit approval, and we can check what your dental insurance may cover.
Can surgery be scheduled on a weekend?
Yes. The office is open Monday to Friday, 9 to 5, and larger procedures and surgeries can be scheduled on weekends by request. Ask about weekend dates when you book.
Book your free All-on-4 consultation
Find out whether All-on-4 is right for you. Your free implant consultation includes an exam and a conversation with one of our implant doctors about your options.
Book online Call (212) 758-1000
Brightly Dental Midtown · 425 Madison Ave, Suite 500, New York, NY 10017 · Mon–Fri 9–5; weekend surgery by request.
Free implant consultation does not include 3D imaging or treatment. Financing subject to credit approval.