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Candidacy & Suitability

Transitioning Based on Your Current Smile

Published 22 April 2026

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Transitioning to All-On-4 Plus® treatment depends on your current dental condition, oral health and individual clinical assessment. These topics explain how missing teeth, denture wear, gum disease, smoking, diabetes and medication history may influence assessment and treatment planning.

Considerations

Bone loss, gum health, bite function, medical history and existing dentures

Overview

Not every patient begins treatment from the same starting point. Some people are living with missing or failing teeth, while others may already wear removable dentures or have a history of gum disease.

Your current smile can affect how treatment is assessed and planned. Factors such as bone loss, gum health, bite function, medical history and existing dentures may all be considered during the clinical assessment process.

Some health and lifestyle factors may also influence treatment planning.
Smoking status, diabetes management and medication history can form part of the discussion before implant surgery is considered.

Upgrading from Removable Dentures to All-On-4 Plus®

Long-term denture wear can present challenges such as movement, discomfort, reduced bite force and changes in the jawbone over time. All-On-4 Plus® can provide a fixed alternative by anchoring a full arch of teeth to dental implants.

There are differences between removable dentures and implant-supported teeth, including stability, maintenance, jawbone preservation, speech, bite function and the clinical options that may be considered for patients with significant upper jaw bone loss.

Terminal Dentition (Failing Teeth)

Missing or failing teeth can affect eating and speaking in everyday life. Causes may include decay, gum disease, failed dental work, injury or long-term denture use. If left untreated, missing teeth may contribute to bone loss, shifting teeth, bite changes, difficulty chewing, facial changes.

Treatment options may include dentures, traditional dental implants or fixed implant-supported treatment options such as All-On-4 Plus®, depending on the individual clinical situation.

Severe Periodontal (Gum) Disease

Gum disease is caused by plaque accumulation on the root surfaces of the teeth, leading to inflammation and infection in the gums. It may be hereditary but is usually caused by insufficient cleaning.

Over time, gum disease can result in loss of supporting jawbone and loose teeth. Good hygiene and regular gum treatment are generally effective in controlling the disease, although the damage already caused may be difficult or impossible to reverse.

The Impact of Smoking on Implant Success

Smoking is a recognised risk factor for dental implant treatment because nicotine can reduce blood flow, slow bone healing and increase the risk of implant failure. Smoking is also associated with a higher risk of peri-implantitis, greater marginal bone loss and prosthetic complications.

Smoking status forms part of the clinical assessment and treatment planning process and reducing or stopping smoking may be discussed before treatment.

Diabetes and Jawbone Healing

Properly managed blood sugar levels play an important role in osseointegration, the process by which an implant bonds with the jawbone. Diabetes can influence the body’s healing response following dental implant surgery, so diabetes management is considered during the clinical assessment and treatment planning process.

Medications and Implant Surgery

Certain medications should be disclosed to your surgeon before considering All-On-4 Plus® treatment. This is particularly important for medications that may be used for osteoporosis, blood pressure, diabetes, asthma, weight loss etc.

Medication history forms part of the clinical assessment and treatment planning process before implant surgery. Your clinician may ask about prescription medications, over-the-counter medicines and relevant treatments as part of the clinical assessment and treatment planning process.

The All-On-4 Plus® Protocol: A Fixed Clinical Alternative

article

Understanding your options is the first step toward restoring your dental function. In this video, Dr Wesley explores the fundamental differences between traditional removable dentures and the All-On-4 Plus® protocol. By comparing the mechanics of gum-supported plates versus implant-anchored bridges, this presentation provides clinical clarity on how each solution impacts bite force, bone preservation, and long-term oral health.

Not every smile starts from the same place.
Many Australians live with missing teeth whether from severe bone loss, decay, gum disease, failed dental work, injury or long-term denture use.
Missing teeth can affect your ability to eat, speak or feel confident in everyday life.
The good news is that there are effective & permanent solutions that exist.

Good hygiene and regular gum treatment are generally effective in controlling the disease, but the damage caused is often difficult or impossible to reverse.

Smoking is a recognised risk factor for dental implant treatment because nicotine can reduce blood flow, slow bone healing and increase the risk of implant failure. During your consultation, your clinician will assess your smoking status along with other clinical factors as part of the clinical assessment and treatment planning process.

Properly managed blood sugar levels play an important role in osseointegration, the process by which an implant bonds with the jawbone. During your clinical assessment, your clinician will consider your diabetes management alongside other health factors as part of the clinical assessment and treatment planning process.

Why you must disclose certain medications, particularly Bisphosphonates (used for osteoporosis), to your surgeon before considering treatment.

Important Note

All surgical procedures carry risks, including infection or implant failure. Individual recovery times vary based on age, systemic health, and smoking status. Please follow the specific post-operative instructions provided by your All On 4 Plus® Clinician.

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The information contained in this webpage is general in nature and has been provided in good faith, without taking into account your personal circumstances. While all reasonable care has been taken to ensure that the information is accurate and opinions fair and reasonable, nothing is to be construed as any kindof warrantee. Your suitability for any treatment is subject to full assessment by a qualified professional. All cosmetic and surgical procedures carry risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner. The dental, medical, cosmetic and beauty professionals employed by All On 4 Plus Pty Ltd (ACN 164844428) and its network of clinics and licensees trading as All On 4 Clinic, All-On-4 Plus® Premium Provider and All-On-4 Plus® Affiliates are trained, registered and fully qualified to provide second opinions and undertake treatments within their respective scope of practice. The use of the information contained on this page is governed by Australian law and is subject to the Terms and Conditions which can be read by clicking here. View the ALL ON 4 PLUS® Pty Ltd Privacy Policy by clicking here.