Both jaws, over six months

The situation

Twenty-two teeth remaining across both jaws, most of them heavily restored, several with failing root treatments and three already mobile. Two bridges had come loose in the previous eighteen months. He described it as everything going at once, which is roughly what happens when a whole mouth was restored around the same time thirty years earlier.

He had a specific goal: his daughter’s wedding, fourteen months away.

What we suggested, and why

We took the deliberate step of slowing this down. A full mouth case is not an emergency, and the temptation to book surgery quickly for somebody who is upset about their teeth is one to resist.

The plan was All-on-4 in both arches: four implants and a fixed bridge in the upper, four and a fixed bridge in the lower, done in a single surgical day. The alternative — saving what could be saved and rebuilding around it — would have cost a similar amount and produced a mouth still containing several teeth with limited life left, which is the worst of both options.

We also discussed doing one arch at a time, six months apart. He preferred a single day, and the lower bone volume was good enough to make that reasonable.

What we did: full mouth, both arches

One surgical day, five and a half hours under intravenous sedation with a registered sedationist. Twenty-two extractions, ridge contouring, eight implants, and temporary fixed bridges in both jaws fitted the same day from the pre-made plan.

The recovery from a case this size is genuinely more demanding than a single arch and we say so beforehand: four or five days of swelling, a week of soft food, and a fortnight before he felt himself. He had a review on day two, day seven, and at one month.

The final bridges were made over three appointments between months four and six. More adjustment than usual went into the bite, because when every tooth is new there is no reference left from the old ones — the position has to be re-established from scratch and then lived with for a few weeks to check it.

Fitted at six months, eight months before the wedding.

Timeline

• Day 0 — extractions, eight implants, temporary bridges both arches
• Week 1 — review and adjustment
• Month 4 — scans and try-in
• Month 6 — final bridges fitted
• Month 12 — review with the hygienist, and every six months since

What it cost

£24,600: £22,900 for both arches, £820 for sedation and £880 for twenty-two extractions. Spread over 60 months at 0% APR — £410 a month.

The treatment is set out on full mouth dental implants. The costs page covers finance in detail.

“I stopped being able to eat an apple in about 2015 and I never mentioned it to anybody. That is the part I would go back and change.”

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