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All on Four Costa Rica: Five factors to consider for an All on 4 in Costa Rica

Only ten years ago, most patients were unaware of the All-on-4 dental implants procedure. Full arch fixed dental implant bridges, providing patients with a full set of teeth, are a relatively new advance in dental science. All on Four Costa Rica is at the forefront of this cutting-edge procedure and is recognized by Costa Rica Dental Guide as one of the leading All on 4 dental tourism clinics in Costa Rica.

A growing number of Costa Rica dental tourism patients request the All on 4 dental implants treatment specifically, but is it always in their best interests? In a recent interview with Dr. Alejandro Freer of All on Four Costa Rica, he shared that every dental implants case is different and why it is critical to assess five factors before recommending the All-on-4 treatment.

According to Dr. Freer, it’s important for specialists to assess multiple factors and to listen carefully to their patients prior to offering a specific treatment plan.

“Some specialists rush patients into a treatment, when it may not be the right treatment,” Dr. Freer said. “By taking the time to properly examine a patient, we can determine the proper treatment that is the best fit for each individual patient.”

The All on 4 procedure uses two full-arch fixed implant bridges. These bridges are usually supported by four to six dental implants and offered to patients as a comprehensive package. The All-on-4 procedure is generally the best treatment option for patients with few or no teeth.

Aggressive marketing by companies such as Clear Choice has generated a significant amount of information on the internet. Most patients are well aware of the benefits of All-on-4 bridges and the stability of dental implants. Following are the five top factors for patients considering the All on 4 dental implants procedure.

  1. Speech Concerns

Speech issues are an important consideration for patients. Minor speech impediments are possible after the All on 4 procedure. These are most often manageable, and 99% of patients adapt and overcome speech challenges quickly. However, it is important to share these concerns with patients prior to the procedure. Implant-supported bridges require both vertical and horizontal bulk for strength. Specialists must often replace more than just the volume of the missing teeth in order to achieve the needed strength and durability. Sometimes bone and soft-tissue must also be replaced. The result is often slightly bulkier than the original teeth, bone and soft-tissue volume. Consequently, this can have an impact on speech sounds such as “D,” “T,” and “N,”.  Likewise, horizontal bulk in the posterior can affect the “S” sound, where the lateral borders of the tongue make the sound. Most patients quickly retrain their tongues to compensate for the changes. It’s important to discuss this concern with the patient prior to treatment.

  1. Bulky Feeling

Bulky feeling The bulky feeling of the bridges may cause some speech issues. But for some patients, the bridges may also feel strange and may cause some initial anxiety. It can be difficult for some patients to adapt to the different feel of an All-on-4 bridge. They are used to feeling the transition from their soft tissue to their teeth. With the All-on-4 bridge, patients feel real soft tissue and then fake soft tissue (the tissue portion of the bridge) prior to transitioning to the teeth. This can feel awkward for some patients. The key is for the patient to understand these concerns prior to treatment, so they are not surprised.

“In my experience, almost all of my patients have managed these concerns and grown accustomed to their new bridges in a matter of weeks,” Dr. Freer said. “But it is important to have detailed conversations about what the patient will experience prior to finalizing the treatment plan to prevent surprises. I show my patients an All-on-4 model and then a model of a traditional bridge to help them see the issues they will face. This makes all the difference.”

If the bulk of dental bridges will be an issue, patients should consider options that only replace tooth volume. Less bulky restorations will likely require more dental implants to support the bridge and to reduce the risk of fracture. This adds additional cost to the procedure. In the end, patients may choose the traditional All-on-4 bridges, but it’ important to share these options to allow the patient to make an informed decision.

  1. Change in Bite/Feeling

The issue of proprioception is an important one. Natural teeth are sensitive to forces in the mouth. It’s second nature to sense how hard you need to bite on a piece of food or how to chew. When you receive dental implants with bridges, you will need to learn some of these things all over again. Because the teeth are new, patients require additional time to get used to the bridges. Patients may bite harder than necessary at first but will generally adjust quickly to the new bridges, increasing chewing efficiency and comfort. Occasionally, excessively hard biting can result in a fractured bridge.

  1. Teeth Grinding Concerns

Habits such as bruxism, clenching, and irregular chewing cycles may impact whether a patient should receive an All on 4. Natural teeth can detect forces much more readily than implants with bridges. Saving a few natural teeth may enable patients to sense if they grind their teeth or clench, increasing the chances of modifying the negative behavior. If the patient suffers from bruxism but requires an All on 4, a bar-supported overdenture may be recommended. Bar overdentures are often suggested for patients who have aggressive bruxism. The overdenture may be removed at night and replaced with a flat-planed night guard that snaps onto the bar for retention. This protects the final prosthesis and reduces strain on the supporting implants and bone.

  1. Pricing

The All on 4 dental implants procedure can be quite costly. Clear Choice patients routinely pay $60,000 to $90,000 for an All on 4 in major cities across the United States. This same procedure at All on Four Costa Rica, is priced at around $25,000 with everything included. This is a huge savings for American patients.

“The majority of our patients are from the USA and Canada,” Dr. Freer said. “They choose our Costa Rica dental clinic because they can get the same care that American dental clinics offer, for much less.”

It’s refreshing to see a dental clinic in Costa Rica that takes the time to assess a patient’s needs and to discuss customized individual options for patients. All on Four Costa Rica educates patients about the hurdles they will need to overcome, as well as the benefits of the treatment. In the end, clinics like this will have improved treatment outcomes and more satisfied patients.

Costa Rica Dental Guide is pleased to endorse All on Four Costa Rica as one of the best All on 4 and dental implants clinics in Costa Rica.

James Madigan is the CEO of

This story was sponsored by Costa Rica Dental Guide. 


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