All-on-4: What to expect?

Posted on Wednesday, May 22nd, 2013 at 12:05 am

I recently had the pleasure of exchanging emails with Howard M. Steinberg DMD, MDS in regards to what patients can expect after receiving the All-on-4 implants. I thought there was so much useful information in his message that I asked if he would mind me sharing it on my blog. Here is some information he shared with me:

Hi Kristi,I am responding to your question for a list of what patients should expect after getting the All-on-4 dental implant procedure. Of course, dental implant surgery is experienced differently by different people but most find the adaptation very easy.

Most of my All-on-4 patients have fairly minimal pain the day of surgery and require only Ibuprofen and extra strength Tylenol that they can take up to 4 times a day for the first few days after surgery. I rarely prescribe narcotic analgesics, and several studies show that the Ibuprofen/Tylenol regimen prevents pain better than most narcotics. If a patient is experiencing an unusual amount of pain after the All-on-4 dental implant procedure, we can prescribe a small amount of narcotic analgesics.

Another issue for most All-on-4 patients is that they can expect a certain amount of inflammation. Swelling is a normal response to injury. When the body senses injury, including injury from a surgical procedure, the affected area immediately becomes inflamed. Swelling is part of the normal healing process. Once swelling occurs, it takes 7-10 days for it to subside. However, applying external ice bags along with ice chips or ice water inside the mouth for the first 12 hours after surgery will minimize swelling. Some All-on-4 patients that have received I.V. sedation may fall asleep at home right after surgery and not do the ice therapy. The application of ice to control swelling should commence immediately upon returning home after the surgery and should continue for at least 12 hours.

Probably the biggest issue I have seen with All-on-4 dental implant patients is that they can sound hollow in their speech for the first few days. This is due to the fact that there is a space where the gums meet the new All-on-4 temporary prosthesis that allows for cleaning under it. When patients speak shortly after the procedure, they can force air under the new prosthesis that causes a whistling or hollow sound. All of my patients learn how to speak without forcing the air under the prosthesis, and this adjustment usually only takes a few days.

Another issue with some All-on-4 patients is the feeling of a border on the inside of either the upper or lower prosthesis. The border signifies the end of the prosthesis, and it helps with cleaning. Once again, most patients adapt to this very quickly.

We do ask our patients to go on a clear liquid diet immediately after the All-on-4 dental implant surgery. The two-day liquid diet prevents large food particles from getting into the surgical area. If they want to have chicken soup, I ask them to strain it, so that large particles of chicken or noodles don’t get under the surgical flap. After the first two days, patients can start eating soft foods. We define soft foods as being something you can cut with a fork easily. If you have to use a knife to cut the food, then it is not soft. This allows for many foods to be eaten, and most of our All-on-4 patients adapt to this change in diet fairly quickly.

We also make our patients an immediate night guard that is delivered at the time of the surgery. The night guard prevents patients from grinding their teeth while they sleep. For patients that have the habit, the grinding forces can be quite strong and can damage the fresh implants. Just to be sure that nighttime tooth grinding doesn’t occur, we provide a custom night guard for every All-on-4 dental implant patient.

I believe these are some of the main things that All-on-4 dental implant patients can expect. Let me know if there are any other issues you would like me to address.

Best Regards,Howard M. Steinberg DMD, MDS

7 thoughts on “All-on-4: What to expect?

  1. Excellent information Kristi! Thank you so much for your support and sharing your experiences with the rest of the world!!

  2. is it true that with all on 4 you only get 12 teeth on the top and on the bottom? that would mean you don't have molars! so how can you start eating solid food without molars? you need them to chew!

  3. Glad you appreciate the post. The author of this blog, Kristi Lind, recently had the All-on-4 dental implant procedure done. Unfortunately, she was not provided with a night guard by the clinic that performed the procedure. The complications she experienced may have been the result of nighttime tooth grinding. I am glad Kristi asked me to share my experience with the All-on-4 dental implant procedure.

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