All On 4

All on 4 enables a whole set of permanent teeth to be fixed in place by just four dental implants in each arch. It’s suitable for patients struggling with dentures that move, large gaps or failing natural teeth.

The outcomes of this treatment is often life changing because all on 4:

  • prevents or reverses the ageing effect tooth loss can have on the face
  • offers convenience — the patient receives their new teeth on the same day
  • is cost effective, usually avoiding the need for bone augmentation
  • is almost completely painless before and after the procedure

Preventing bone loss

When a tooth is lost, the bone it was rooted to is no longer needed and begins to recede. Patients can lose as much as a quarter of their jaw bone ridge width within a year, and with all the teeth gone there is likely to be a noticeable ageing effect as the facial structure changes.

Preventing the ageing effect

Without a dental implant solution for multiple tooth loss the face can change considerably. The undesirable side-effects might include:

  • facial height collapse, making the nose appear larger, and vertical lines on the face can deepen, while lip definition flattens
  • deteriorating bite. Apart from storing up future problems with headaches and jaw and neck pain this can create a permanent scowl expression, even in a state of rest
  • the chin rotating forward, which in combination with the jutting nose can produce a so called “witch’s chin” appearance
  • muscles in the lower jaw being affected, creating jowls as the tissue sags
  • loss of tone in muscles around the mouth and a pronounced upper lip, with more wrinkles appearing around the mouth

What happens in a consultation for all on 4?

The clinician will examine how much bone is available and ask about the patient’s preference regarding surgery. If they would like to minimise surgery and avoid sinus lifts, and they have large gaps, failing teeth or have been wearing full dentures, all on 4 may be recommended. All on 4 treatments avoid sinus lifts because the implants are placed at an angle into the jawbone.

What happens during all on 4 treatment?

The implants are spread around the dental arch to spread the stress on the fixtures, which are case dependent and patient specific. The patient receives any necessary extractions of failing teeth and has the implants placed, walking out with a full set of new teeth fixed to their implants on the same day, hence the treatment is also known as teeth in a day.

These teeth are not the final permanent fixed teeth, they are temporary fixed restorations that restore confidence and the ability to eat, giving the jawbone time to fuse around the implants. About three months later, once the bone is completely healed, new implant bridges can be made.

Benefits of all on 4 treatment at The Bristol Dental Practice

  • restore full function and aesthetics after losing all natural teeth
  • eat anything, talk and feel confident again
  • over 7,500 implants placed
  • reverse the effects of tooth loss on oral health and appearance
  • treatment is led by Dr Jonathan Cochrane, a rising star in his field
  • conscious sedation is available for nervous patients
  • a painless and straightforward procedure, with predictable results
  • follow-up hygiene guidance to help implants last as long as natural teeth
  • good value: more permanent teeth with less implants

Dr Jonathan Cochrane – Principal (GDC No: 228321)

BDS, MFGDP(UK), MFDS RCS, CertConSed, MSc (Dental Implantology), CertImpDent (DGZI)

  • Member of two Royal College of Surgeons; Edinburgh and England
  • Special interests in Dental Implants, Oral Surgery and Sedation


Dr Sherif Elbarbary – Specialist Prosthodontist (GDC No: 260014)

BDS, MFDS RCSEd, M Pros RCSEd (Fixed and Removable Prosthodontics), MJDF RCSEng

  • Specialist in Prosthodontics
  • Special interests in Dental Implants, Smile Makeovers (DSD) and Full Mouth Rehabilitation


Dr Devin Vaghela – Dentist (GDC No: 85948)

BDS, MFDS RCS, Cert. Adv Aesthetic Dentistry (UCL)

  • Member of The Royal College of Surgeons of England
  • Special interests in Aesthetic Dentistry, TMD and Dental Sleep Medicine

Before & Afters