If you’re missing most of your teeth — or looking down the barrel of losing what’s left — someone has probably mentioned All-on-4 to you. Maybe a family member had it done. Maybe you saw an ad. And you’re trying to work out whether it’s the right answer, or whether you should just replace teeth one at a time as they go.
Here’s how I talk patients through that decision in the chair, and — importantly — where Biltoft fits and where we send you elsewhere.
What each option actually is
Individual dental implants
An individual implant is a titanium screw placed into your jawbone that acts as an artificial tooth root. We wait for the bone to grow around it (Healthdirect puts the osseointegration window at around three months), then build a crown on top. One implant, one crown, one missing tooth solved.
If you’re missing two teeth, that’s two implants and two crowns. Three missing teeth, three implants. You can also use a few implants to support a small bridge (for example, two implants carrying a three-tooth bridge), but the principle is the same — you’re replacing teeth in small, independent units.
Best for: patients missing 1–3 teeth, or patients with a mostly healthy mouth who have one or two problem teeth to replace.
All-on-4
All-on-4 is a full-arch solution. Four implants are placed into a single jaw (upper or lower), angled strategically to make the most of the available bone, and a single fixed bridge of teeth is screwed onto those four implants. The whole arch — every tooth on top or bottom — gets replaced in one appliance.
The appeal is obvious: if most of your teeth are failing, you can go from a mouth full of hopeless teeth to a fixed, non-removable set of teeth in a much shorter timeline than doing eight or ten individual implants. The design was developed specifically to avoid bone grafting in the back of the jaw, which used to be a major barrier for people with long-term denture wear.
Best for: patients missing all or most teeth on an arch, or facing the loss of an entire arch — often people who’ve been in dentures and hate them, or people with advanced gum disease affecting every remaining tooth.
When individual implants are the right call
If you’ve got a solid set of teeth and you’re missing one — a tooth that was knocked out playing footy twenty years ago, a molar that cracked and couldn’t be saved, a congenitally missing front tooth — an individual implant is almost always the answer. You’re not going to pull out healthy teeth to fit a full-arch solution you don’t need.
A few situations where individual implants genuinely win:
- One to three teeth missing. The maths is straightforward — you’re not saving much by going full-arch, and you keep your natural teeth.
- You want each tooth to feel and floss like a natural tooth. Individual implants let you floss between every tooth, because they’re separate units.
- Your remaining teeth are healthy and worth keeping. Pulling healthy teeth to fit an All-on-4 is a trade-off most people wouldn’t make.
- You want the option to replace the crown later without redoing everything. If a crown chips in 15 years, it’s one crown. Not a full bridge.
At our Murwillumbah practice, a single dental implant (the implant, abutment, and crown) is $5,000–$6,000 per tooth. Two implants is two lots of that, three is three. The cost is linear. For a few teeth that’s very fair value compared with the alternatives — you can see the full cost breakdown in our implant pricing guide.
When All-on-4 starts to make sense
The honest inflection point is somewhere around “most of the teeth on this arch are failing or already gone.” When you’re looking at eight, ten, twelve missing or hopeless teeth on one arch, the calculation changes.
Here’s what shifts the sums:
- Fewer implants, faster surgery. Four strategic implants instead of eight to twelve. One surgical day (in most cases) instead of several.
- Often avoids bone grafting. The angled back implants in the All-on-4 design are placed in areas of existing bone, which is a big deal if you’ve been in dentures for years and the back of your jaw has shrunk.
- Fixed teeth, not a denture. You don’t take them out at night, they don’t rock when you eat steak, they don’t need denture adhesive.
- Predictable cost for the whole arch. One big number, rather than eight to ten implant quotes plus bridgework.
That said — All-on-4 is a bigger procedure, a longer appointment, and involves removing any remaining teeth on that arch. It’s not a decision made lightly, and anyone who pushes you toward it before fully discussing individual-tooth alternatives deserves a second opinion.
The cost conversation — honestly
This is where patients often get blindsided, so let’s be straight.
Individual implants at Biltoft: $5,000–$6,000 per tooth. That’s surgery, abutment, and crown. If you’re replacing three teeth, you’re looking at roughly $15,000–$18,000. For a single front tooth after a footy accident, it’s one of the best investments in dental work you’ll ever make.
Full arches of individual implants stack up fast. If you tried to replace an entire arch with individual implants and bridgework, you’re easily past $40,000–$60,000 per arch once you include the restorations.
All-on-4 in Australia is typically quoted as a package by specialist clinics — the figure varies a lot depending on materials (acrylic bridge vs zirconia), the clinician’s experience, the lab, and whether immediate teeth are placed on the day of surgery. We don’t quote All-on-4 ourselves because we don’t do it, and I’m not going to pretend otherwise. Your specialist will give you a full itemised quote.
The “individual implants add up fast” reality is exactly why All-on-4 exists — it’s a purpose-built solution for the full-arch problem. But if you only need a few teeth replaced, don’t let anyone talk you into a full-arch plan. That’s not what it’s for.
If you’re weighing implants against dentures or bridges more broadly, we’ve written a comparison of implants, bridges and dentures here.
If you want a straight answer on which path suits your mouth, book a consult with me at Biltoft and we’ll x-ray, talk honestly, and map out the options — including who we’d refer you to if specialist care is the right call.
Why Biltoft refers out for All-on-4
I’ll be direct about this. Full-arch implant work is a specialist discipline. The planning, the angulation of the back implants, the immediate load protocols, the prosthetic side — it’s done best by clinicians who do it every week and have a lab they work with day-in, day-out.
At Biltoft we place individual implants under local anaesthetic. That’s a procedure I do regularly, and I’m comfortable quoting the outcome and the cost. For full-arch rehabilitations — All-on-4, All-on-6, full-arch zirconia bridges — we refer to a prosthodontist or implantologist we trust. It’s not the kind of work you want done by someone doing it occasionally.
I’d rather send you to someone who does hundreds a year than do your case myself. That’s the honest version, and it’s how I’d want it done for my own family.
We also don’t offer IV sedation in-house. For individual implants that’s rarely an issue — local anaesthetic is plenty, and most patients are genuinely surprised how straightforward the appointment feels. For All-on-4, many patients opt for IV sedation, and your specialist will handle that.
Am I even a candidate?
Some patients ask All-on-4 vs individual implants, when the honest answer is “neither yet — let’s see what bone and health we’re working with first.” A few things your dentist (and specialist) will be looking at:
- Bone volume. Both options need bone. All-on-4 is designed to work around reduced back-of-jaw bone, but all implants need something to anchor into.
- General health. Healthdirect notes that diabetes, smoking, osteoporosis, and certain medications can increase implant complication risk. Individual results vary.
- Gum health. Active gum disease needs to be controlled first.
- Bite and TMJ. A heavy grinder puts more load on any implant work — sometimes a night guard is part of the plan.
We’ve written more about who makes a good implant candidate here — worth a read if you’re early in the thinking.
You can also read our full dental implants guide for the broader picture.
A quick side-by-side
| Individual implants | All-on-4 | |
|---|---|---|
| Replaces | One tooth at a time | Whole arch (upper or lower) |
| Implants needed | One per tooth (or 2 per small bridge) | Four per arch |
| Best for | 1–3 missing teeth, healthy remaining teeth | Most/all teeth failing on an arch |
| Cost | $5,000–$6,000 per tooth at Biltoft | Package pricing via specialist |
| Where we do it | In-house at Biltoft | Referred to a specialist |
| Anaesthesia | Local anaesthetic | Often IV sedation (via specialist) |
| Flossing | Between each implant like a natural tooth | Under the bridge with special floss/brush |
The short answer
If you’re missing a few teeth and the rest are healthy — individual implants, almost always. If you’re facing a full arch of failing teeth or you’re already in a denture you can’t stand — All-on-4 is worth a proper specialist conversation. If you’re somewhere in the middle, come and see us, and we’ll x-ray, talk it through, and either quote you or refer you. Either way you’ll get a straight answer.
To book a consult with me in Murwillumbah, head to our booking page or call (02) 6672 1980. Happy to have the conversation.
Frequently asked questions
What's the basic difference between All-on-4 and individual implants? +
Individual implants replace one tooth at a time — each implant gets its own crown, like replacing missing teeth one-by-one. All-on-4 uses four implants to support a full fixed bridge across an entire arch (upper or lower), replacing every tooth on that arch in one appliance. Different problems, different solutions.
If I'm missing most of my teeth, why not just do individual implants for each one? +
You can, but the cost stacks up fast and it's a much bigger surgical job. A full arch of individual implants can mean 8–10 implants per arch instead of four. All-on-4 was designed specifically to get people out of dentures with fewer implants and a faster turnaround. For some patients that trade-off makes sense, for others it doesn't.
Does Biltoft Dental do All-on-4? +
Not in-house. Full-arch cases like All-on-4 are complex and benefit from a clinician who does them week-in week-out — usually a prosthodontist or implantologist. We place individual implants at our Murwillumbah practice ($5,000–$6,000 per tooth), and we refer All-on-4 and similar full-arch rehabilitations to a specialist we trust. Happy to help you work out which path fits.
How long do All-on-4 implants last? +
The published research on All-on-4 goes back over 20 years and the survival rates are generally reported as high when the case is planned and maintained well. The fixed bridge on top is a separate question — these are mechanical restorations that can chip, wear, or need relining and eventually replacement. Individual results vary. Your specialist will walk you through realistic timelines for your case.
Can I convert individual implants into an All-on-4 later, or the other way around? +
Going from individual implants to a full-arch solution usually means starting over — you can't really combine the two. That's why the planning conversation matters so much up front. If you're borderline (missing several teeth with a few remaining that are questionable long-term), we'll often x-ray and assess the rest honestly before committing to a plan.
Do I need sedation for All-on-4 or individual implant surgery? +
Most individual implant placements are done comfortably under local anaesthetic — that's how we do it at Biltoft. All-on-4 is a longer procedure and many patients prefer IV sedation for it. We don't offer IV sedation in-house, so for sedation cases (or full-arch surgery) we refer to a specialist who does. No pressure either way.