All-on-X dental implants are the most-asked-about procedure at SmileOn Dental Implants – and the one that generates the most questions before patients feel ready to schedule. These are the 25 questions Dr. Doshi answers most often, organized by topic.
If your question isn’t here, bring it to your free consultation. There’s no dumb question when $24,000 and your smile are on the table.
All-on-X Cost & financing
1. How much does All-on-X cost in Texas?
$20,000–$33,000 per arch is the Texas range in 2026. At SmileOn, All-on-X with a permanent zirconia bridge is $24,000 per arch. Both arches: $48,000. This includes four implants, abutments, the temporary bridge, and the final permanent bridge. Extractions and IV sedation are typically additional. National corporate chains like ClearChoice often run $28,000–$33,000+ per arch.
2. What does the $24,000 include – and what doesn’t it?
Included: four implants, multi-unit abutments, the temporary fixed bridge worn during healing, the final permanent zirconia bridge, all 3D imaging, surgical planning, and follow-up visits.
Typically additional: extractions of remaining failing teeth ($200–$500 per tooth), IV sedation ($400–$800), bone grafting if indicated ($300–$3,000), and any work on the opposing arch.
A realistic all-in estimate for most patients who need extractions and choose sedation: $26,000–$28,000 per arch.
3. Can I finance All-on-X?
Yes – $0 down, payments from approximately $299/month. SmileOn works with CareCredit (promotional 0% interest options), LendingClub (terms up to 84 months), Cherry (soft credit check), and Sunbit (accessible from a credit score of 450). Approval takes 5 minutes at the consultation. If one provider declines, another usually approves.
4. Does insurance cover All-on-X?
Rarely and minimally. Most dental insurance covers 0–20% of implant procedures and has annual maximums of $1,000–$2,000 – a fraction of the total cost. Some medical insurance covers portions when tooth loss is documented as resulting from trauma, cancer treatment, or congenital conditions. HSA and FSA funds can be applied. We verify your specific coverage at the consultation.
5. Why is All-on-X at one place $13,000 and another $23,000?
The price gap almost always reflects different products. A $13,000 quote is typically for acrylic-over-titanium (a long-term temporary material) and may not include the final bridge, sedation, or extractions. A $24,000–$23,000 quote is typically for permanent zirconia, all-inclusive. Other variables: implant brand (premium vs generic), surgeon credentials, and what’s itemized vs billed separately. Always compare line-by-line written quotes.
The procedure
6. Do I really get teeth in one day?
Yes. On the surgical day (3–5 hours), any failing teeth are extracted, four implants are placed, and a fixed temporary bridge is attached. You walk out the same day with a complete set of teeth that are screwed into the implants – not glued, not removable. Soft-food diet for 6–8 weeks while the implants heal. Your final permanent zirconia bridge is placed 3–6 months later.
7. How long does the All-on-X surgery take?
3–5 hours per arch including extractions, implant placement, and bridge attachment. If you’re doing both arches the same day, expect 5–7 hours. Most of this time you’re under IV sedation and unaware of the procedure.
8. Will I be asleep during the procedure?
Not technically asleep, but you won’t know the difference. Most All-on-X patients choose IV sedation, which puts you in a deeply relaxed, sleep-like state with no memory of the surgery. You breathe on your own and can respond to commands, but you’re unaware of what’s happening. It’s the same level of sedation used for colonoscopies.
9. Can I have both arches done the same day?
Yes, and most patients who need both arches prefer to do them together. It means one surgical day, one recovery period, and one set of follow-up visits. The surgery is longer (5–7 hours instead of 3–5), but the combined recovery is not meaningfully different from a single arch. Cost for both arches: $48,000 at SmileOn.
10. What if I only need one arch?
Each arch is decided independently. Many patients only need All-on-X on the upper arch (where bone loss and tooth failure are more common) and have adequate teeth or simpler restorations on the lower. Dr. Doshi evaluates each arch separately based on your 3D scan.
Candidacy
11. Am I a candidate for All-on-X?
About 90% of patients who need full-arch replacement qualify. The main requirements: adequate bone in the front of the jaw (where the anterior implants go), general health sufficient for a 3–5 hour surgical day, and no active untreated infections. The angled posterior implants are specifically designed to work with reduced posterior bone – which is why All-on-X accepts more patients than traditional implant approaches.
12. Can I get All-on-X if I’ve been told I don’t have enough bone?
In most cases, yes. All-on-X was designed specifically for patients with bone loss. The two posterior implants are angled at 30–45° to engage the dense bone in the front of the jaw, bypassing areas where bone has resorbed. About 90% of patients who’ve been rejected for traditional implants are All-on-X candidates. For the most severe cases, zygomatic implants (anchoring into the cheekbone) extend candidacy further. Full guide →
13. Can I get All-on-X if I still have some teeth?
Yes – remaining failing teeth are extracted during the same surgery. Many All-on-X patients start with a mix of missing teeth, loose teeth, and teeth with severe decay or infection. All failing teeth are removed, and the implants are placed in one surgical session. You go from failing dentition to a full set of fixed teeth in a single day.
14. Can I get All-on-X if I currently wear dentures?
Yes, and denture wearers are among the most common All-on-X candidates. Even after years of denture wear and the associated bone loss, the All-on-X technique typically finds sufficient bone. If you’re frustrated with denture slipping, adhesive, and eating limitations, All-on-X addresses all three permanently.
15. Is there an age limit for All-on-X?
No upper limit. Dr. Doshi has performed All-on-X on patients in their early 40s through their mid-80s. What matters is cardiovascular health, healing capacity, and bone – not age. Patients in their 70s and 80s routinely undergo the procedure with excellent outcomes. The youngest candidates are typically in their late 30s or early 40s.
Recovery & daily life
16. How painful is All-on-X recovery?
Days 1–3 are the peak: significant swelling and moderate discomfort managed with prescription pain medication. Days 4–7: discomfort declines rapidly; most patients switch to over-the-counter Tylenol/Advil. Most patients return to non-physical work by day 5–7. By week 2, most feel close to normal. Patients who’ve had wisdom teeth removed describe it as “similar or easier.” Full pain guide →
17. When can I eat normally after All-on-X?
Soft foods for 6–8 weeks, then gradual progression to firmer foods. During the soft-food phase: smoothies, yogurt, eggs, soup, soft pasta, mashed potatoes, soft fish. By week 8–10: most patients can eat a near-normal diet with the temporary bridge. Once the final permanent zirconia bridge is placed (3–6 months), full eating function returns – steak, apples, crusty bread, corn on the cob.
18. Will All-on-X teeth look real?
Yes – often better than the patient’s original teeth. The bridge is custom-designed to match your facial proportions, skin tone, and preference for color and shape. During the design process, you can review and approve the planned smile before the final bridge is manufactured. Most patients’ friends and family can’t tell the teeth aren’t natural unless told.
19. How do I clean All-on-X teeth?
Brush twice daily and use a water flosser. The bridge is fixed (not removable), so you clean it in your mouth like natural teeth. An electric toothbrush works well for the surfaces. A water flosser (Waterpik) is essential for flushing underneath the bridge where food particles can collect. Professional cleanings every 6 months – the hygienist uses specialized instruments designed for implant restorations.
20. Can All-on-X teeth get cavities?
No. The bridge is made of zirconia or acrylic, neither of which can decay. However, the gum tissue and bone around the implants can develop peri-implantitis (gum disease around implants), which is preventable with good hygiene and regular cleanings.
Longevity & complications
21. How long does All-on-X last?
The four implants typically last 20+ years, often a lifetime. The zirconia bridge typically lasts 15–25 years before it may need to be refreshed or replaced. Acrylic bridges last 7–12 years. When the bridge needs replacement, the implants stay – new bridge, same foundation. Full lifespan guide →
22. What if one of the four implants fails?
Implant failure occurs in about 3% of cases. When it happens (most often in the first 3–12 months), the failed implant is removed, the site heals for 3–4 months, and a replacement is placed. In many cases, the remaining three implants can support the bridge temporarily during healing. SmileOn warrants the surgical placement – replacement at no additional fixture cost within the warranty period.
23. What happens after 20 years – do I need to do it all over?
No. The implants stay in the bone. If the bridge wears out after 15–25 years, a new bridge is fabricated and attached to the existing implants. This costs $6,000–$10,000 for a new zirconia bridge – significantly less than the original procedure because no surgery is involved.
Comparisons
24. All-on-X vs dentures – what’s the real difference?
Everything that matters day-to-day. All-on-X restores ~90% of bite force; dentures restore ~20%. All-on-X never comes out; dentures come out nightly. All-on-X needs no adhesive; dentures often do. All-on-X preserves bone; dentures accelerate bone loss. All-on-X costs $24,000; dentures cost $1,500–$3,500 upfront but $9,000–$18,000 over 20 years with relines, remakes, and adhesive.
25. All-on-X vs All-on-6 – which do I need?
All-on-X is appropriate for about 70–80% of full-arch cases. All-on-6 (two additional implants) is indicated for larger jaw arches, severe grinders, upper arches with specific sinus limitations, and revision cases. The decision is based on your 3D scan, not a marketing preference. Same procedure, same-day teeth – just more anchor points when the anatomy requires it.
Your question not here?
Dr. Doshi has answered every All-on-X question there is across 100+ full-arch cases per year. Bring yours to the free consultation – there’s no question too basic and no concern too small.
The consultation includes a 3D cone-beam CT scan, clinical exam, treatment plan, itemized cost quote, and financing pre-qualification. No obligation, no pressure.
Call (682) 563-5663 or schedule online.
Available at three DFW locations: Mansfield (360 Dental Lounge), Arlington (Arlington Dental Lounge), and Irving (Irving Family Dental).
Consultation is complimentary for new patients. Treatment plan recommendations require diagnostic evaluation, including imaging. Not applicable to patients with active untreated periodontal disease. Cannot be combined with insurance. Subject to clinical eligibility.