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What are the Issues with All-on-4 Dental Implants? – Understanding the Risks

July 5, 2024

Did you know All-on-4 dental implants have a success rate of 98%?

That's right! For people who are currently losing or have lost their teeth, All-on-4 dental implants are a great solution. 

However, in spite of the high success rate, this procedure, like most dental treatments, comes with several complications and risks. The decision to get all-on-4 dental implants is a major undertaking, so it's important that you understand the risks associated with this treatment. 

Read on to find out what are the issues with All-on-4 dental implants, which groups are most at risk from these issues, and how these problems can be minimized. 

What are All-on-4 Dental Implants?

All-on-4 dental implants are a dental restoration technique designed to replace an entire arch of teeth using just four strategically placed implants. This method offers a fixed, non-removable solution for individuals who have lost most or all of their teeth in one or both jaws. 

The "All-on-4" name comes from the fact that an entire set of teeth (an arch) is supported by only four dental implants.

Issues with All-on-4 Dental Implants

Implant Failure

Implant failure is a significant concern with All-on-4 dental implants. When the implant fails to fuse to the surrounding bone, it can lead to instability and eventual failure.

Symptoms of Implant Failure

  • Pain or discomfort
  • Swelling in gums
  • Loose implant


As with all dental restoration procedures, there is a small risk of infection with All-on-4 dental implants. Commonly referred to as peri-implantitis, implant infection can cause swelling and inflammation in the bone and soft tissue surrounding the implants. This can lead to eventual bone loss and implant failure. 

Symptoms of Implant Infection

  • Bad taste or breath
  • Loose implant
  • Pain around the implant
  • Bleeding around the implant
  • Pus discharge
  • Fever 

Misaligned Bite

All-on-4 dental implants are designed to mimic the feel and function of natural teeth. If you experience challenges with chewing or biting, it could indicate a misaligned bite. This usually happens due to the incorrect placement of an implant. It could also stem from mismatches in the shape or size of the implants.

Symptoms of Misaligned Bite

  • Jaw pain and discomfort
  • Clicking sensation in the jaw
  • Visible changes in the alignment of your teeth and smile

Gum Recession

Gum recession refers to the gum tissue pulling back from the teeth, exposing more of the tooth or root. Improper placement of All-on-4 dental implants can lead to this recession, such as placing the implant too close to the gum line or at an incorrect angle.

Other factors that can cause gum recession after getting an implant include smoking, inadequate oral hygiene practices, existing gum disease, and habitual teeth grinding. Insufficient gum tissue around the implant can lead to instability and a higher likelihood of implant failure.

Nerve Damage

While uncommon, nerve damage is a potential risk of dental implant surgery. This may happen if the implant is placed too deeply in the jaw or if it puts pressure on a nerve.

Symptoms of Nerve Damage

  • Numbness
  • Tingling
  • Pain
  • Reduced sensation around the tooth
  • Limited movement of the tooth

Sinus Inflammation

Sinus problems are a less common complication associated with All-on-4 implants, typically occurring after implants are placed in the upper jaw. Issues with All-on-4 dental implants may arise if the implants extend into the sinus cavity, potentially leading to sinus inflammation, known as sinusitis.

Symptoms of Sinus Inflammation

  • Facial pain
  • Nasal congestion
  • Mucus discharge
  • Headache
  • Tooth pain
  • Fatigue 

Sinus inflammation mostly affects individuals with insufficient bone in the upper jaw to support the implants. You can prevent this issue from occurring by opting for procedures like bone grafting or sinus lifts before you even begin the All-on-4 dental implant process.

Who is Most at Risk from All-on-4 Implant Issues?

People with insufficient bone volume in the jaw may face challenges with implant stability and integration.

  • People who are smokers, impairing dental implant healing
  • Patients with pre-existing gum disease
  • Patients with poor oral hygiene
  • Patients with chronic health conditions like diabetes
  • Elderly patients with compromised immune systems or lower healing rates

Best Practices to Avoid Issues with All-on-4 Dental Implants

  • Choose a Qualified Implant Specialist: Select a skilled and experienced implant dentist or oral surgeon who specializes in All-on-4 dental implant procedures.
  • Comprehensive Evaluation: Make sure to undergo a thorough dental and medical evaluation to assess bone density, oral health, and implant suitability.
  • Preventive Care: Maintain excellent oral hygiene before and after implant placement to minimize the risk of infections and gum disease.
  • Quit Smoking: If you smoke, quit before undergoing implant surgery to improve healing and reduce the risk of complications.
  • Control Chronic Conditions: Manage chronic health conditions such as diabetes or autoimmune disorders under the guidance of healthcare providers to optimize healing and reduce risks.
  • Follow Post-Operative Instructions: Adhere to all post-operative care instructions provided by your dental team, including medication schedules and oral hygiene practices.
  • Regular Check-ups: Attend follow-up appointments as scheduled to monitor healing progress and detect any issues early.


All-on-4 dental implants offer a highly promising solution for people seeking comprehensive tooth replacement, but they are not without potential complications. 

Knowing what are the issues with all-on-4 dental implants can help you become aware of what you are going for if you wish to opt for this procedure.

It is also important to note that most of the issues that can arise with All-on-4 dental implants can be addressed with a thorough evaluation and consultation before the procedure and by practicing diligent care post-procedure. 

Want to Know if You Qualify for All-on-4 Dental Implants?

Contact Cambridge Dental Group today and learn about your eligibility for All-on-4 dental implants! 

Schedule your consultation today and experience the transformative power of our advanced dental solutions. 


How can I prevent gum recession with All-on-4 implants?

Gum recession around All-on-4 implants can sometimes result from improper placement or excessive force on the gums. Maintaining excellent oral hygiene and following your dentist's post-operative instructions diligently can help reduce the risk of gum recession.

What should I do if I experience discomfort or pain after getting All-on-4 implants? 

Discomfort or pain after implant placement can indicate various issues, such as infection, bite misalignment, or implant instability. It's crucial to contact your dental provider immediately if you experience persistent pain, swelling, or any other unusual symptoms. 

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