Critical Purpose for Implant Hygiene Maintenance for ALL-ON-X and ALL-ON-4

By | All on 4 dental implants | No Comments

The unfortunate outcome when all-on-4 patients don't return for regular maintenance

Most doctors that perform ALL-ON-X and/or ALL-ON-4 use the best products available, intending to last a lifetime, but failure to return for maintenance every 4-6 months is like jumping on the Titanic and hoping it all works out. At each maintenance visit, we closely examine the health of your bridge, gums, and bone and their direct interaction with the implant. Only after comparing the results against your previous appointment can we give you feedback and specific instructions.

What I have seen too many times is that patients love their new teeth, and they unfortunately get distracted by life. The feeling that everything is fine until a sudden shift occurs is a common pitfall. Like the iceberg that is out of site, patients overlook the all-too-subtle bridge loosening, leading to broken screws or even catastrophic broken bridges. The most common thing seen is increased inflammation and redness due to slow bacteria accumulation. Patients may even be brushing and waterpiking daily but not doing it correctly. The unfortunate result is always bone loss, leading to exposed implant threads, worsening the problem because exposed implant threads are exponentially more challenging to keep clean due to the rough surface intended to integrate with the bone.

Intervention is possible but most often requires expensive and painful surgery to stop the worsening bone loss. Still, even the most skilled doctors cannot undo the damage that has occurred. If there isn’t an intervention, the lost bone will leave the implant unsupported, causing implant failure and bridge failure. This leaves the patient without teeth and back to the original problem.

Top Factors that Influence the Cost of All on 4 Dental Implants

By | All on 4 dental implants | 2 Comments

Are you confused about how much All on 4 dental implants costs? The price can can vary so much from office to office. From an outside perspective, this can be frustrating and cause you to pause in your journey. We hope this post will help you understand what factors affect cost and what to keep in mind as you get quotes from different doctors. Here are the questions that you should answer?

  • Office location and the local All-ON-4 market
    • Geography can play a big role in the cost of dental implants. Depending on where you live and your willingness to travel, the cost of All-on-4 dental implants can vary dramatically. The lower the cost of living generally leads to lower price but not always. Other factors below also play an important role in the overall ALL ON 4 dental implant cost. Our patients come from all over the United States and even internationally because the the cost of All on 4 dental implants is less than other places. Some cities have a greater number of All-on-4 doctors and because the supply is high, the price drops. Dental tourism is becoming more and more popular. Warning: We highly recommend finding an office that is within the United States or has strict regulations with regards to dentistry.
      • Questions to ask the doctor
        • Who is your top three competitors and how are you the same or different?
        • Where do your patients travel from?
  • Number of doctors managing my transformation
    • Two office Approach – Historically, two different doctors (and their accompanying offices) handled larger complex cases such as All-on-4 dental implants. This means that a surgeon required his own separate fees for the surgical phase of treatment and a restorative doctor would charge you for the second phase of making your permanent teeth . Having two specialists in their respective field to manage treatment can be a great thing for the patient if they are good at communicating with each other. Dr. Hendriks uses the analogy of building a new home and making sure that you have the contractor in charge of the foundation communicating well with the general contractor in charge of framing and roofing. Often times, doctors are so busy that inter office communication can be a challenge.
      • Here is a practical example. Imagine if your dream was to have a beautiful home built on a large piece of property with the house toward the back so yo have a large and grand front appearance as you enter. What if you leave on a trip for a couple weeks and come back to find that the foundation was built in the middle of the property? Its poured perfectly but in the wrong location for you dream house. Who’s fault is this? How do you remedy it? How much longer will it take to have this fixed? This is the sort of the thing that can occur when both parties aren’t clear about the outcome and work in tandem.
    • One Office Approach– In contrast to this approach, a well trained doctor, committed to excellence, can be trained surgically and restoratively to do both phases. This is What we do at Dream Dental Implant Center. This makes it very convenient for you to go to just one office for all your visits and know that any unforeseen problems will be managed by his/her office. The advantages of having one office can often outweigh the two office approach but only if the One office has the surgical and restorative experience. Warning: Its easy to be fooled by good marketing that gives the appearance of experience and expertise so it behooves you to do your homework and ask tons of questions, do a background check on the business and the doctor, look for legitimate reviews, and anything else that gives you the feeling that this office can give you the dream smile you want.
      • Great questions to ask the doctor
        • Who will be the doctor doing the surgery and what are the associated fees?
        • Who will be the doctor providing the temporary teeth and the fees associated, as well as, when will they be provided?
        • Who will be the doctor providing the permanent teeth and the fees associated, as well as, when will they be provided?
  • Successful All-On-4 experience – This includes the doctor, as well as the team that supports him. Unfortunately good intentions don’t always lead to good outcomes. Dr. Hendriks always says that Something magical happens when you do what you love, you do it often, and you enjoy teaching it.
    • When you love what you do – A doctor with tons of passion and love for transforming lives with ALL-ON-4 Dental Implants
    • You do it every day – doctor who decides that he/she ONLY wants to do life changing All-on-4 dental implant transformations and decides to limits his practice to this one procedure.
    • You teach it – A doctor who unselfishly is willing to teach what he knows to other doctors. Dr. Hendriks believes teaching is the highest calling in life and that sharing knowledge with the world can have an even greater positive affect on the world. Dr. Hendriks has many doctors from all over the United States who travel to Utah to attend his courses. many dentists have a desire to begin doing All-on-4 implant procedures, but they also have so little experience that they will often lower the cost to win a case. This is often done without letting the patient know of the level of experience. This is a big factor in the price, and their inadequacy will usually result in tacking on costly and often times unnecessary warranty fees. Labs that have more experience and provide extra customization charge more to the doctor and therefore the price increases. Some doctors do not disclose that they send their work overseas to other countries with lower cost of labor and no regulation of materials. These devices often look similar to other dental offices but lack the integrity and can fail 3-5 years later.
      • Great questions to ask the doctor
        • How many ALL-ON-4 Dental Implant transformations have you completed and are at least 5 – 10 years out and doing well?
        • Where did you go to get trained in ALL-ON-4 surgery and prosthetics?
        • When did you start performing ALL-ON-4 surgery?
        • How many All-ON-4 Transformations do you do monthly? Last year?
        • Do you provide other services besides ALL-ON-4?
        • Do you educate your peers or have a teaching center?
        • What’s the hardest case you have done?
        • Can you show me before and after pictures of your favorite case?
        • What’s the most difficult complication you have dealt with?
  • Breadth of Surgical treatment plan
    • Implant number – Although four implants per jaw is the most common number, at times additional implants should and need to be placed to ensure short term and long term success. Factors that can affect this include excessive bone loss, severe bone infection, bone quality with relation to vascularity, density and healing ability, bone quantity in key implant position locations.
    • Implant Type – Most implants are placed in the maxilla or mandible but in some cases, longer implants are needed, which are more invasive and placed in the face/zygoma bone just below the eye.
    • Bone Grafting Needed
    • Gum grafting Needed
      • Great Questions to ask the doctor
        • What is unique or different about my case that you plan to do differently than others?
        • Have you been trained and have experience with zygoma dental implants?
        • What types of implants do you intend to place?
        • What brand of implants will you place in my surgery?
        • Will you do additional bone and gum grafting for my case?
  • Prosthetic plan and timeline
    • This is a critical factor that could make all the difference to you. Understanding the smile building plan and how it is intended to play out, will ensure success or failure depending on the person. Some offices can do a permanent device (although the selection would be very limited) within 24 hours of surgery and charge extra for it. Other offices will do a device within 24 hours of surgery and charge less but the teeth couldn’t be classified as permanent. This is why its so important for you to ask lots of questions and get clear documentation.
    • Type of All-on-4 temporary teeth?
      • Many offices use an inexpensive denture and than convert it into a temporary for the patient. These types of of devices generally are the hardest to heal in because they tend to be too bulky and cosmetically inferior to a custom made bridge that is designed prior to surgery and than modified digitally after implants are placed. Bulky converted dentures break easier and are hard to clean.
    • Type of All-on-4 permanent teeth?
      • This is one of the most important factors that affect ALL-ON-4 dental implant costs. Here are the most common type of bridges fabricated as an ALL-ON-4 bridge. These are presented from cheapest to most expensive and can be categorized into two classes: Polylithic or monolithic.
      • Polylithic – Means that something is built out of multiple pieces that are put together. Each of these types of devices have a sub-structure that provides the strength and a superstructure that isn’t as strong but provides the beauty that the substructure can’t provide.
        • Substructures
          • Titanium Base most commonly fabricated and will usually be cheaper than zirconia because stock denture teeth are used to save money in most cases.
          • Trinia Base
          • Trilor Base
          • Pekton Base
        • Superstructures
          • Denture Teeth and pink acrylic gums
          • Ceramic crowns with pink composite gums
          • PolyMethyl Methacrylate (PMMA) for crowns and pink composite for gums
          • Porceain teeth with pink porcelain gums
          • Crystal Ultra nano ceramic
      • Monolithic
        • Zirconia – One material that is milled to exact fit and then custom colored
  • Who makes my teeth? – Most offices have to send teeth out to be made by a 3rd party lab, which can create a substantial variability in the quality of your device. Some offices have cases sent to the lowest bidder even though they still charge the same price. Offices with an in house lab are unique and
  • Will I be asleep? – This procedure can be done under local anesthetic, I.V Sedation, or General Anesthesia, which increases the price with each level of anesthesia, as well as the location it is rendered in. A hospital setting will be much more expensive than a dental office that brings in an Anesthesiologist.
  • What makes my case hard?
    • Teeth Grinders – Often break temporaries and have more failures and some doctors will increase the price in anticipation of the higher likelihood of complications
    • Smokers – Carry an implant complication risk that is 3 times higher than a healthy patient that does not smoke.
    • Diabetics – As long as the diabetic is controlled with an A1c of 7 or lower, there is no need for higher fees.
    • Previous drug abuse – Can make the treatment more complicated depending on the likelihood of rebound
    • High smile pull – One of the most challenging presentations that often carries with it added surgical procedures and restorative appointments in order to satisfy the patient and produce a bridge that is comfortable and easy to clean.
    • Skeletal deficiencies – Can increase the price because more visits are often needed to systematically create the skeletal appearance that is pleasing, as well as comfortable for the jaw.

Who would pay the least for All on 4 Dental Implants?

  • Someone living in, or willing to, travel to an area with a lower cost of living and a competitive market (such as Salt Lake City, Utah!)
  • A denture-wearer who hasn’t experienced excessive bone deterioration and still has healthy, leathery tissue
  • Someone who chooses a titanium bar with denture teeth
  • Being awake for the surgery
  • Choosing a single office that does the surgical and restorative work with an in-house lab

The price could be as low as $15,000 per arch!

Who would pay the most for All on 4 Dental Implants?

  • Someone who lives in a city with a high cost of living such as LA, NYC or Miami
  • Someone who needs additional implants or zygoma implants
  • Someone whose teeth are extremely infected
  • Someone who has severe bone loss in the areas where the implants need to be placed
  • Someone with high cosmetic and functional needs
  • Anyone wanting a zirconia bridge with individual porcelain crowns and porcelain gums
  • Choosing to have it done by two offices, an oral surgery and restorative without an in-house lab
  • Choosing to use Full General Anesthesia (generally patients with high anxiety choose this option)
  • Someone requiring removal of existing implants
  • Someone with a high smile pull
  • Anyone who is a smoker, has diabetes, grinds their teeth, or has a history of drug abuse with a deep bite

The price could be as high as $35,000 per arch!


Want to know your cost? Schedule your free consultation today: Book Consultation

Changes made to keep you safe for your dream smile procedure

By | Dentist | No Comments

People are feeling more isolated than ever, and ready to socialize. But for those who can’t smile, they already know what it feels like to feel trapped, to not be able to go out to eat, and we want to get people ready and smiling again for when we’re able to see each other again.

Dr. Bryan Hendriks DDS joins us to talk about the changes Dream Dental has made to keep you safe for your dream smile procedure.

Dream Dental offers FREE consultations, and now accepting competitor’s coupons! Through the end of June.

Featured on KUTV’s Fresh Living: