All-on-4 — a full set of teeth supported by just four implants — can be genuinely life-changing. It's also a major, often irreversible investment, and the experience varies a lot from one office to the next. The patients who end up happiest are almost always the ones who walked in with good questions. Here are the ones worth asking before you commit.
1. Do I actually need all my teeth removed?
This is the big one — and it's the reason a second opinion matters before any full-arch plan. Full extractions can't be undone, and an implant-only center has every incentive to plan the largest case. Ask whether your natural teeth could be saved instead. A full-suite dental practice can answer that honestly, because it can do either. (At Old Betsy we regularly see patients who were planned for full upper-and-lower extractions whose teeth were actually salvageable — so we always look at that first.)
2. Who places the implants, how, and who makes the teeth?
Traditional implant care often splits the work between two offices — one to place the implants, another to make the final teeth — each charging their own fees. A single-location practice that handles the 3D scan, surgery, and lab work under one roof tends to be simpler, faster, and less expensive; in-house models can cut several thousand dollars per arch. Also ask how the implants are placed: we use Navident dynamic navigation — real-time, GPS-like guidance for greater placement accuracy that many offices don't offer.
3. Will I get teeth the same day?
Some providers send you home in a temporary and have you wait months for your final teeth. Ask whether you'll leave with a working set the same day. With in-house 3D imaging and a milling lab, we provide same-day teeth for most full-arch patients — placed while you're still numb and before any swelling, which is often the smoothest way to do it.
4. What are the final teeth made of — acrylic or zirconia?
This matters for durability and price. All-on-4 restorations often use acrylic, while zirconia is the more durable (and more expensive) option. In Texas, that difference shows up in the numbers — the average All-on-4 runs around $23,500 per arch, while a zirconia full-arch averages closer to $31,000. Ask what you're getting and why.
5. What's actually included in the price?
Get it in writing. A complete quote should spell out extractions, 3D imaging, the surgery, the same-day temporary, the final prosthesis, and follow-up visits. Surprises usually live in what wasn't listed.
6. What will it really cost, and how can I pay for it?
Full-arch pricing in Texas commonly lands somewhere in the $18,000–$38,000 per-arch range depending on materials and your specific needs. Ask about financing, and ask whether the office can bill medical for any portion — many can't, but we do for some procedures.
7. Who's monitoring me during sedation?
Sedation is safest when someone is dedicated to it. Ask whether a separate anesthesia provider oversees your sedation and safety while the dentist focuses entirely on the procedure — that's how we do it.
8. Who handles my cleanings and care after surgery?
Implants need long-term maintenance. Some centers do the surgery and send you elsewhere afterward. Ask whether your cleanings, checkups, and any future care can happen in the same place, with a team that knows you. (We're your dental home for the long haul — not a one-time stop.)
9. Is there pressure to decide today?
A good office will give you the information and let you think. If you feel pushed to sign on the spot, that's worth noting. This is your decision and your timeline.
10. Can I get a second opinion?
Yes — and you should feel free to. A second set of eyes on a decision this size is smart, not rude. (We even offer a free second opinion on quotes from other offices — including an honest look at whether your teeth can be saved.)
Ready to talk it through with no pressure? Learn about implants at Old Betsy or request a visit.