Dentures or All-on-4® Dental Implants

A proven, research-backed solution for full-arch tooth replacement

Around half of Australians over 65 wear dentures. For many, they are the first solution offered when teeth fail – and for decades, they were the only affordable option. But dentures come with trade-offs that compound over time: bone loss, dietary restrictions, adhesive dependency, declining fit and the social anxiety of teeth that might slip at the wrong moment. 

If you are weighing up your options after being told you need dentures – or you are already wearing them and want something better – the All-on-4® dental implants offers a fixed, long-term alternative that can restore the function, appearance and confidence that dentures cannot fully replicate. 

This is not a marginal improvement. It is a fundamentally different approach to replacing missing teeth. 

What Dentures Can and Cannot Do

Dentures serve a genuine purpose. When teeth are lost to gum disease, decay, injury or age, dentures restore the appearance of a full smile, provide a chewing surface for food and support facial muscles that would otherwise sag without teeth behind them. 

Modern dentures are custom-fitted, available as full or partial sets and made from acrylic, nylon or metal frameworks. They are more comfortable and natural-looking than they were a generation ago. And they remain the most affordable tooth replacement option, with a full set of conventional dentures typically costing $2,000 to $4,000 in Australia. 

But dentures are a prosthetic that sits on top of the gum. They are not anchored to the jawbone, and that distinction creates a set of limitations that no amount of adhesive or relining can fully resolve. 

The Problems Denture Wearers Know Too Well

If you wear dentures, some of these will be familiar. 

  • Bone loss that changes your face. When teeth are removed, the jawbone beneath them begins to shrink. This process, called resorption, is progressive. Without tooth roots (or implants) stimulating the bone, studies suggest the jaw can lose anywhere from 25% to 50% of its width in the first year after extraction, with the most rapid loss occurring in the first three months. As the bone recedes, the lower third of the face shortens, lips lose support and the fit of dentures deteriorates. This is why dentures that fit well initially can become loose and uncomfortable within a year or two. 
  • Reduced chewing force. Research suggests that conventional dentures restore only about 20 to 25% of natural biting force. That is enough for soft foods, but often not enough to comfortably eat steak, raw vegetables, crusty bread, nuts or apples. Many denture wearers gradually eliminate these foods from their diet, which can affect nutrition over time. 
  • Loss of taste and temperature sensation. Upper dentures include a palate plate – a piece of acrylic that covers the roof of the mouth. This plate is necessary for suction and stability, but it covers taste buds and insulates the mouth from the temperature of food and drink. Many denture wearers report that food tastes blander and that they cannot tell if a drink is too hot until it reaches the back of the throat. 
  • Adhesive dependency. Denture adhesives are a daily routine for many wearers, adding cost and inconvenience. Even with adhesive, dentures can shift during eating or speaking – particularly lower dentures, which lack the suction advantage of the upper palate plate. 
  • Ongoing replacement costs. Dentures are not a one-time purchase. As the jawbone changes shape, dentures need to be relined every one to two years ($300 to $600 per reline) and fully replaced every five to eight years ($2,000 to $4,000 per set). Over 20 years, the cumulative cost of de

How the All-on-4® Treatment Concept Works Differently

The All-on-4® treatment concept takes a fundamentally different approach. Instead of sitting on the gum surface, a full arch of fixed teeth is anchored to four titanium implants placed directly into the jawbone. 

 

Two implants are positioned vertically at the front of the jaw, where bone density is naturally highest. Two are placed at an angle toward the back, maximising contact with available bone. This angled placement is the key innovation – it can allow a full arch of teeth to be supported without bone grafting, even in many patients who have experienced significant bone loss. 

The implants gradually fuse with the jawbone through a natural healing process called osseointegration (where the bone grows around and bonds with the titanium), creating a stable, long-term anchor. A custom bridge of teeth is then fixed to the implants. Unlike dentures, this bridge does not move, does not require adhesive and does not cover the palate. 

The technique was developed by Professor Paulo Malo in collaboration with Nobel Biocare and is documented in peer-reviewed research spanning nearly 30 years. 

All-on-4® vs Dentures: A Direct Comparison

 

Conventional Dentures 

All-on-4® Treatment Concept 

Biting force 

Approximately 20-25% of natural biting force 

Can restore up to 85-95% of natural biting force 

Bone preservation 

No – bone loss continues and accelerates 

Yes – implants can stimulate and help maintain bone 

Palate coverage 

Upper dentures cover the palate 

No palate plate – full taste and sensation 

Stability 

Can shift during eating and speaking 

Fixed in place – no movement 

Adhesive required 

Usually, especially lower dentures 

No 

Diet restrictions 

Avoid hard, sticky and chewy foods 

Eat normally once healed – typically no restrictions 

Lifespan 

5-8 years before replacement 

Implant fixtures may last 20+ years with proper care 

Maintenance 

Daily removal, soaking, adhesive application 

Brush and floss as with natural teeth 

Typical cost (per arch) 

$2,000-$4,000 per set 

$20,000-$36,000 

20-year estimated cost 

$10,000-$20,000 (replacements + relines) 

$22,000-$38,000 (including follow-up care) 

Same-day teeth 

Immediate dentures available but temporary 

Provisional teeth can be fixed on the day of treatment 

What to Expect from All-on-4® Treatment

The All-on-4® treatment process typically follows a structured timeline. 

  •  Before treatment: A cone beam CT scan maps your jawbone in three dimensions. This scan is used to plan the exact position, angle and depth of each implant. If teeth need to be extracted, this is planned as part of the same appointment. 
  • Treatment day: Under IV sedation or general anaesthesia, remaining teeth are extracted (if applicable), implants are placed and a provisional bridge is fitted – all in a single session. Where clinically appropriate, most patients can leave the clinic with a full set of provisional teeth within 24 hours. 
  • Healing period (3-6 months): The implants gradually fuse with the jawbone during this phase. You eat and function with the provisional bridge, following dietary guidelines from your clinician (softer foods initially, gradually returning to a full diet). 
  • Final bridge (4-6 months post-treatment): Once the implants have fully integrated, impressions are taken for your final prosthesis. This is a custom-designed bridge – typically made from high-strength zirconia or acrylic – that is precision-fitted and fixed to your implants. 
  • Ongoing care: Annual check-ups and professional cleans. Daily care mirrors natural teeth: brush twice daily and use interdental brushes or a water flosser around the implant-supported bridge. 

Is All-on-4® Right for Everyone?

The All-on-4® treatment concept is designed for patients who are missing most or all of their teeth in one or both arches, or whose remaining teeth are failing and may need to be extracted. It can also be suitable for patients who currently wear dentures and want a fixed, long-term alternative. 

 The angled implant placement means that many patients who have been told they do not have enough bone for traditional implants may still be candidates for All-on-4® treatment. However, certain medical conditions, medications and lifestyle factors can affect healing and implant integration. A clinical assessment – including a CT scan and medical history review – is the most reliable way to determine suitability. 

For patients who want implant support but are not ready for a fully fixed solution, implant-retained overdentures offer a middle ground. These use two to four implants to stabilise a removable denture, improving retention and reducing adhesive dependency without the full commitment of a fixed bridge. 

The Cost Question

The All-on-4® treatment concept is a larger upfront investment than dentures. Treatment in Australia typically ranges from $20,000 to $36,000 per arch, depending on the implant system, prosthetic material and case complexity. 

But the cost equation can shift over time. Dentures are a recurring expense – relines, replacements and adhesives add up across decades. All-on-4® treatment, once placed, typically requires only routine check-ups and occasional professional maintenance. Over a 20-year horizon, the total cost difference between the two options may be smaller than the initial price gap suggests. 

Payment plans, using super for dental early release (where eligible) and private health insurance rebates can also help manage the upfront cost. Your clinician can provide a detailed treatment plan with itemised costs to help you understand exactly what is included. 

Take the first step toward a confident, fixed smile.

Frequently Asked Questions About Dentures or All-on-4® Dental Implants

In many cases, yes. Long-term denture wearers are common All-on-4® candidates. Even if bone loss has occurred over years of denture use, the angled implant placement technique is specifically designed to work with reduced bone volume. A CT scan will help confirm whether you have sufficient bone for the treatment. 

With proper care, the titanium implant fixtures can potentially last many decades. The prosthetic bridge typically lasts 15 to 20 years or more, depending on the material (zirconia bridges tend to outlast acrylic). Some patients may need a bridge replacement after 15 to 20 years, but the implants themselves can remain in place. 

 All-on-4® treatment is performed under IV sedation or general anaesthesia, so you should not feel pain during the treatment itself. Post-operative discomfort is managed with prescribed pain medication and is typically described by patients as less uncomfortable than expected. Most patients can return to light daily activities within two to three days. 

Once the healing period is complete and your final bridge is in place, there are typically no dietary restrictions. Patients regularly eat steak, apples, corn on the cob, nuts and other foods that denture wearers avoid. During the initial healing phase (first three to six months), a softer diet is recommended to protect the integrating implants. 

Published research reports All-on-4® success rates of 95 to 98% over ten years. Next Smile Australia, the only Australian provider personally endorsed by Professor Paulo Malo (the inventor of the All-on-4® treatment concept), maintains a 98% clinical success rate across its network of Nobel Biocare Centres of Excellence, using the original Malo Protocol. 

Traditional dental implants replace teeth one at a time, with each implant supporting a single crown. Replacing a full mouth dental implants this way could require 12 to 14 implants and often needs bone grafting. The All-on-4® treatment concept can achieve the same result – a full arch of fixed teeth – using only four strategically angled implants, typically without bone grafting. This can reduce treatment time, recovery and cost. 

Reference

  1. NIH Pub Med, A longitudinal study of the survival of All-on-4® dental implants in the mandible with up to 10 years of follow-up (Research Article), Paulo Malo, Miguel de Araújo Nobre, Armando Lopes, Steve M Moss, Guillermo J Molina, 14 March 2011, https://pubmed.ncbi.nlm.nih.gov/21357865/ 

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