All-on-4 Dental Implants & Periodontal Disease


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The modern world is rich in foods that can, in excess, take their toll on our dental health. Overexposure to sweet and acidic foods can wear down our teeth, and in many cases lead to complex infections that are classed under the umbrella term of ‘periodontal disease’. This type of illness can have profound effects on the health of the mouth as a whole, as well as future dental treatments and decisions. In this article we look at whether or not you can have all-on-4 dental implants if you suffer from this condition.

What is periodontal disease?

The term ‘periodontal disease’ encompasses a broad range of different illnesses that can affect a number of different structures and tissues in the mouth. These structures are tooth related, and a hallmark of the disease is a bacterial plaque responsible for inflammation. In its early stages, this condition is more often known as gingivitis, and if left unattended or untreated, gingivitis can progress to the more serious infectious state known as periodontitis.


Our mouth always contain some amount of small microorganisms, usually bacteria, which can damage structures of the mouth. This is simply because the warmth and moisture of the mouth, and its constant exposure to nutrients, make it an ideal environment in which these organisms can live, reproduce, and ultimately flourish.

In a healthy mouth, regular brushing and good all-round oral hygiene will maintain its health and keep these microorganisms from damaging any of the structures of the mouth. Their growth will be restricted to the point where they won’t form the characteristic plaque which is a risk factor for periodontal disease. Plaque is also known as a biofilm, and can die off to form a solid, calcified coating called tartar or calculus. This can compound the condition, and is one of many factors contributing to a condition that is quite complex but always needs regular monitoring and treatment by a dentist.

Periodontal disease and all-on-4 dental implants

The major effect periodontal disease can have on whether or not a person can make use of all-on-4 dental implants is to do with bone loss. The disease can lead to a loss of teeth which can warrant the need for implants, but even if tooth loss had another cause, long term periodontal disease can cause a loss of jawbone which can affect whether or not dental implants can be used.

Dental implants act as artificial tooth roots, embedding into the bone beneath the gums to provide a firm support to which prosthetic teeth can be fixed securely and safely. Most implants require a minimum amount of bone which is determined by the dentist, and if a person has suffered a loss of bone as a consequence of periodontal disease, or in fact any other illness, then they will not be considered suitable for most kinds of implant.

This is because standard dental implants will need as much as 6-10 sites within a single jawbone for insertion. These sites will need to also possess a certain amount of bone, or demonstrate a particular bone density.

All-on-4 implants are different, however, in that they are designed to make the most use of the implant-bone contact, thereby allowing for the use of just 4 implants positioned in a manner that retains the structure’s overall stability, but makes it accessible to people who have lost bone density in their lower jaw.

2 of the 4 implants are in a forward position to make use of the thicker bone at the forefront of the jaw, while the final 2 are angled towards the back. Regular use across the world and the many benefits these implants have offered people have shown that all-on-4 implants retain stability and durability despite the use of fewer implants.

Another concern when it comes to providing implants to people suffering from periodontal disease is to do with overall oral hygiene and health. The insertion of implants involves first making an opening through the gums and down to the bone beneath, which is in turn drilled for the insertion of the implant. Such an invasive procedure can leave a person vulnerable to infection, and periodontal disease involves an active infection that can impede recovery and affect the implant site. This is an important consideration for dentists looking to provide implants, as good hygiene after treatment is key to a healthy, long living implant.

Ultimately if you have a history of periodontal disease, you will need to speak to your dentist about your suitability for implant placement. In many cases you should be fine for the treatment, provided you follow your dentist’s advice on maintaining oral hygiene, however there may be instances where the condition of a mouth is not suited to implants due to periodontal disease.

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