We’ve been hearing more questions lately from patients about smile design and dental implants, so we sat down with Dr. Mefford and Dr. Turner to get your questions answered!

Dr. Mefford and Dr. Turner collaborated on these answers, just as they collaborate on “All on X” cases at Bellano.

• How do whole-mouth dental implants differ from traditional dentures?

Traditional dentures are made to rest on the gum tissue, with no physical bond to keep them in place other than the suction between the denture and the roof of your mouth. Even with the best dentures money can buy, patients typically retain only 40% of their normal chewing power. Because dentures can move around and are difficult to keep in place, patients often have to re-learn to chew.

In contrast, permanent dentures on implants are firmly attached to the jaw and behave more like original teeth. Implants also stay in all the time, only to be removed occasionally when patients come in for their regular cleanings.

• What does “All on X” mean?

“All On X” is a procedure that results in permanent dentures supported by implants.

This process was formerly called “All on Four,” meaning “all of your teeth on four implants.” Here at Bellano, we call it ‘All on X’ because we select the number of implants that best suit the case.

• What does the “All on X” process entail?

This process starts with a good clinical examination where we look at the teeth, the soft tissues, and the supporting structure of the mouth. We also take plenty of x-rays, including a 3D x-ray that allows us to ascertain whether the patient is a good candidate. We essentially take a cat scan of the patient’s head. What we’re looking for at the initial stage is the right amount of bone in key areas, in order to be able to place implants and have a successful restoration.

With this 3D x-ray, the impressions and models we create, and the planning software, we’re able to plan the entire case virtually before the patient is even in the chair. We can plan the parts we need, the size of implants and how many, and placement.

From initial exam to device fabrication, this planning stage takes around a month to a month and a half. Because of the time and effort put into the planning process, patients leave the office on procedure day with a screwed-in temporary denture.

Patients walk out that day with teeth! It’s not the final denture, as we have to wait a few months to assess the healing process before making the final denture - but seeing patients walk out of our office with a smile they didn’t think was possible is amazing. It’s a very cool feeling for us and for our staff to be able to give patients that kind of an experience.

• What does the healing process look like?

After the procedure, patients get an interim denture. After 4-6 months of healing, depending on the case, we bring the patient in for an assessment. At this stage we’re looking to make sure everything has healed the way it was supposed to, and whether the bone was softer than we thought it was - in a way that may cause complications. We then make the final denture.

• Who would be a good candidate for implant-supported dentures?

The “All on X” process is for patients whose original teeth do not have the potential to be repaired with a bridge, veneers, or other restorative work. Restorative work relies heavily on the integrity of the teeth on which they rest in order to be successful.

Bone density and amount of bone are also important factors. Because this treatment depends on implants screwed into the jaw bone, patients must have sufficient bone and bone health in the right areas. Some medications for osteoporosis can preclude us from doing implants, and the failure rate of implants in smokers is higher. For these reasons and more, it’s very important to share your accurate medical history with us.

• What causes teeth to be “beyond repair?” Can this be avoided?

Proper home care and oral hygiene are really important for keeping your teeth healthy, including regular visits to the dentist, reduced sugar, etc. Unfortunately, by the time someone gets to the point where we’re discussing permanent dentures, the damage has already been done and is impossible to undo.

Some circumstances are unavoidable though, such as a lack of access to dental care when growing up, or accidents that caused trauma to the teeth.

• What are the benefits of doing “All on X” at Bellano?

You can go elsewhere to get this treatment, but we are able to do the entire process in-house. Being referred out to another facility can be a headache, both for the patients and for the teams involved because they have to collaborate.

People have busy lives - we do this all under one roof to simplify the process for our patients. If they’re an existing patient, we also already have a relationship with them and know their dental history.

• What training do you have?

Dr. Tuner has been placing implants for about 4-5 years now and has been restoring implants for over 20 years. Dr. Mefford has been restoring implants for about 16-17 years and has had training and education specific to “All on X” restorations for at least 5 years.

• What results have you seen for “All on X” patients?

We’ve seen patients really be more confident and don’t hold their smile back. The confidence of being able to walk around, eat, smile, and not have to worry about your dentures falling out really makes a big difference. Patients often reflect later about how much of their mental health and self esteem was tied up in their smile. Getting to see that confidence in our patients is really special.

• Anything else we need to know about “All on X” or implants?

While this process can have great results, the ideal scenario is to take care of your teeth with regular dental care as much as possible beforehand, as this process is definitely more involved and expensive than routine care. But for patients who need it, "All on X" can be a great resource to restore their smile, help them maintain adequate nutrition, and regain their confidence!"

We’re here to help you smile confidently, and would love to talk with you about restoring your smile. If you have more questions for our team, please contact us: