Patient Guide for Your Fixed Full-Arch Implant Bridge (All On X) (Teeth In A Day)

Q: I've seen ads for "permanent teeth in 24 hours." Why is your process different?

This is the most important question a patient can ask. While the idea of a permanent smile in one day is appealing, it comes with significant biological and aesthetic compromises that we find unacceptable. Our phased approach is based on a commitment to a predictable, beautiful, and long-lasting result. Here is why: 1. We Respect Biology: After surgery, your gums and bone will naturally swell, and then shrink as they heal. Placing a “permanent” bridge onto swollen gums is like building a house on an unstable foundation. As your gums heal, a gap will inevitably form under the bridge, creating a food trap and an unhygienic result that often needs a major “repair” or “reline” within months. Our process allows your body to heal completely before we make your final teeth, ensuring a perfect, stable fit from day one. 2. We Perfect Your Smile: A 24-hour final bridge gives you zero opportunity to “test drive” your new smile. This often leads to complaints of bulky teeth, speech impediments, or cheek biting. Our temporary bridge is a beautiful prototype. You get to live with it and show it to your family, which allows us to work together to make any aesthetic changes you desire, ensuring your final, handcrafted bridge is absolutely perfect for you.

Q: What are the different types of final bridges, and what are the real-world risks?

That’s an excellent question about materials and long-term maintenance. There are different designs for a final bridge, and each has its own pros and cons regarding repairability: Monolithic Zirconia: This is a solid, one-piece bridge milled from a block of extremely strong ceramic. It is very beautiful and durable. Its biggest risk is that if a single tooth chips or the bridge fractures, it is a catastrophic failure that requires a complete remake of the entire prosthesis. Metal Substructure with Individual Crowns: This design has a strong metal framework with individual porcelain crowns cemented on top. Its biggest advantage is repairability. If a single crown chips or breaks, we can treat it like an individual tooth—simply making a new crown and cementing it in place without affecting the rest of the bridge. Metal Substructure with PMMA/Composite Overlay: This design also has a metal framework but the teeth are made of a high-end acrylic or composite. It is very wear-friendly, but the teeth will wear down over the years. The advantage is that it is easily repairable in the office with simple composite bonding. We will have a detailed discussion with you about the best material for your specific bite and functional needs.`

Q: What do you do differently to ensure the implants are in the right place?

This gets to the very core of our treatment philosophy. The foundation of success is “prosthetically driven” planning. This means we digitally design your final, perfect smile first, and then use that design as a blueprint to plan the exact implant position needed to support it. This is the opposite of simply placing implants where there is bone and then trying to make teeth fit. Our process involves: 3D CBCT Scans & Surgical Guides: For every case, we use 3D imaging to plan the precise angle and depth of each implant. We then fabricate a custom surgical guide that ensures the implant is placed in that exact, pre-planned position. This is not “freehand” surgery. Avoiding Cantilevers & Bad Angles: This meticulous planning allows us to avoid placing implants at angles that would create excessive leverage (cantilevers) or result in screw access holes coming through the face of your teeth, which can weaken them and look unesthetic. Bone Grafting When Necessary: We will never “cheat” by placing an implant where there isn’t enough bone. If your anatomy requires it, we will perform the necessary bone grafting to create a solid foundation. An implant must be fully encased in healthy bone to be successful. `

Q: How often do I need to come in for professional maintenance?

Your new teeth require a lifelong commitment to professional maintenance. We will need to see you for regular recall appointments, typically every 6 months. At these visits, we will professionally clean the prosthesis, assess the health of your gums and implants, check the bite, and ensure all components are tight and stable. This is not just a cleaning; it is the essential service required to protect your investment for the long term.

Surgical Care Instructions

Pain Management

You have undergone a significant surgical procedure. Post-operative soreness and discomfort are normal and expected. Managing this proactively is the key to a comfortable recovery.

Standard Protocol: For the first 3-5 days, we recommend a scheduled regimen of 600mg of Ibuprofen AND 500mg of Tylenol (Acetaminophen) taken together every 6 hours.
Important Disclaimer: Only take medications as specifically prescribed by our office, considering your unique health history.
Antibiotics: You must finish the entire course of antibiotics as prescribed to prevent infection.

Bleeding Control

Minor oozing of blood from the surgical sites is normal for the first 24-48 hours.

Pressure: Bite down gently but firmly on the provided gauze packs over the surgical areas. Change them as needed.
Avoid: Do not spit, use a straw, or smoke. Avoid vigorous rinsing.

Swelling Management

Significant swelling and bruising are a normal and expected part of the healing process after full-arch surgery.

Ice Packs (CRITICAL): For the first 24-48 hours, consistently apply ice packs to the outside of your face over the surgical areas for 20 minutes on, then 10 minutes off.
Peak Swelling: Swelling and bruising will be at their worst on the third or fourth day and may extend up to your eyes and down your neck. This is normal and will gradually subside.

Oral Hygiene/Site Care

The long-term success of your new teeth depends 100% on your commitment to meticulous daily hygiene. Your new bridge is a single, solid piece, and you must clean underneath it every single day.

Your Immediate Prosthesis (The First 3-4 Months)

You have received a beautiful, functional, but temporary fixed bridge. This prosthesis is designed to allow your implants and gums to heal completely undisturbed before we fabricate your final bridge.

For the first two weeks, your only cleaning tool should be the prescribed medicated rinse (Chlorhexidine). Swish gently and let it fall out of your mouth.
After two weeks, you must begin cleaning under your bridge.

The “Non-Negotiable” Hygiene Protocol (For Life)

Your implants cannot get cavities, but they can get a destructive gum disease called “peri-implantitis.” This is the #1 cause of implant failure and is caused by plaque left under the bridge. You must use the following tools every day:

Water Flosser (Waterpik®): This is your most important tool. Use it on a medium setting to powerfully flush out food particles and plaque from underneath your bridge and around each implant post. This is non-negotiable.
Proxy Brushes / “Go-Betweens”: Use these small, cone-shaped brushes to physically scrub the sides of each implant post that emerges from the gum.
Floss Threaders / “Super Floss”: Use this to thread floss under the bridge to clean the implant posts.

Dietary Recommendations

During the entire healing phase (typically 3-4 months), your implants are integrating with your bone. Any heavy chewing forces can cause them to fail.

<ul>
<li><strong>You must adhere to a strict soft diet.</strong> No hard, crunchy, or tough foods. Think pasta, mashed potatoes, fish, eggs, and well-cooked vegetables.</li>
<li>Do not bite directly into anything with your front teeth (e.g., sandwiches, pizza). Cut everything into small, bite-sized pieces.</li>
</ul>

Activity Restrictions

Avoid all strenuous physical activity, exercise, or heavy lifting for at least 5-7 days. Your body needs to rest to heal properly, and increased blood pressure can cause bleeding and throbbing at the surgical sites.