The All-on-6 Treatment Journey: What Happens at Each Stage

Stage 1: Initial Consultation and CT Scan

The treatment journey begins before any surgery takes place. At the initial consultation, the dentist reviews your full dental and medical history, examines the mouth (any remaining teeth, gum health, bite), and takes diagnostic X-rays for a preliminary view. The critical next step is a cone beam CT (CBCT) scan.

The CBCT produces a three-dimensional image of the jaw, showing the precise bone volume and density at every proposed implant site, the exact location of anatomical structures that must not be disturbed (the sinus cavity in the upper jaw, the inferior alveolar nerve canal in the lower jaw), and any pathology such as cysts or infection. This imaging is not an optional extra — it is the foundation on which the surgical plan is built.

From the CT scan, the surgeon can determine: whether sufficient bone exists for six implants, whether bone grafting is needed and where, the optimal angle and depth of each implant, and whether All-on-6 is actually the most appropriate approach or whether a variant (such as All-on-4) would be more suitable for the anatomy.

Only once the CT scan has been reviewed can a complete, accurate treatment plan and itemised cost be produced. Any quote given before a CT scan is not a complete clinical plan — it is an estimate. See our cost breakdown guide for what each component costs and why the CT scan is the starting point.

Stage 2: Pre-Surgical Preparation

Depending on what the assessment reveals, there may be preparatory steps before implant surgery can take place.

Extractions — remaining teeth that are failing or incompatible with the implant plan need to be removed. Some of these may be done at the same appointment as implant surgery; others need to be extracted in advance to allow the bone to heal first, particularly if there is infection around the root.

Gum disease treatment — active periodontal disease is a contraindication for implant surgery. The infection needs to be resolved before implants are placed, as placing implants in an infected environment is a significant risk factor for failure.

Bone grafting — if the CT scan shows insufficient bone volume at one or more implant sites, grafting may be required before surgery. This is the step that most significantly extends the treatment timeline. A bone graft needs to integrate over 4-9 months before implants can be safely placed into the grafted area. Sinus lift procedures (for upper jaw implants where the sinus cavity leaves insufficient vertical bone) are at the more involved end of this spectrum.

Not all patients require preparatory work. For some, the assessment confirms sufficient bone and healthy gums, and implant surgery can proceed at the first appointment after the consultation.

Stage 3: Implant Surgery Day

Implant surgery for All-on-6 is carried out under local anaesthetic. The area is thoroughly numbed before any work begins — most patients report that the local anaesthetic injections themselves are the most uncomfortable part. Once numb, you should feel pressure and vibration but no sharp pain.

The surgeon makes incisions in the gum to expose the bone, prepares precise pilot holes using a calibrated surgical guide (often made from the CT data), and places the six implants in the planned positions. The gum is then sutured around the implants. For patients who are having an immediate load procedure — which is standard for All-on-6 — the temporary prosthesis is fitted on the same day or the following day.

The surgery itself typically takes 2-4 hours per arch. Patients go home with the temporary prosthesis in place, a prescription for antibiotics and pain relief, and written post-operative instructions.

Stage 4: Immediate Post-Surgery

The first 48 hours after surgery are the most physically demanding part of the recovery. Swelling typically peaks at around 48 hours rather than immediately after the procedure — many patients feel fine on the day of surgery and are surprised by how swollen they are the following morning. This is normal.

During this period, the priority is managing swelling (ice packs applied to the outside of the face for the first 24 hours, not directly on the skin), staying on a liquid diet, and taking medications as prescribed. Keeping the head elevated while sleeping reduces swelling. Strenuous physical activity should be avoided entirely.

The detailed dos and don'ts of recovery are covered in our All-on-6 recovery guide, including warning signs that require immediate contact with the clinic.

Stage 5: The Osseointegration Period

After surgery, the implants must integrate with the surrounding bone before a permanent prosthesis can be fitted. This process — osseointegration — takes 3-6 months for most patients. During this time, the temporary prosthesis is worn and the healing takes place beneath it.

The temporary prosthesis is functional — you can eat soft foods and speak normally — but it must not be subjected to excessive biting load. Hard, crunchy, or very chewy foods put stress on implants that are not yet fully integrated, which can compromise the outcome. This is the period that requires the most patience and discipline from patients.

During the osseointegration period, most patients have at least one follow-up appointment at around the 4-6 week mark, and again at 3 months. These appointments confirm healing is progressing normally, check the temporary prosthesis for fit and any needed adjustments, and monitor gum tissue health around the implants.

Signs that integration is proceeding well include: no pain from the implants themselves (some soreness of the overlying gum is normal early on), no mobility of the prosthesis, and healthy gum tissue without signs of infection. Persistent pain, any mobility of an individual implant, or discharge with an unpleasant odour are signs that require prompt clinical assessment.

Stage 6: The Final Prosthesis Appointment

Once the surgeon has confirmed that the implants have integrated successfully — typically at the 4-6 month mark — work begins on the permanent prosthesis. This involves taking precise impressions or digital scans of the implant positions, designing the prosthesis in consultation with the patient (tooth shape, colour, and in the case of zirconia, the exact shade and translucency), and sending this to a dental laboratory for fabrication.

The permanent prosthesis is then fitted and adjusted at a follow-up appointment. Bite adjustment is particularly important — the way the upper and lower teeth meet affects comfort, chewing efficiency, and long-term durability of the prosthesis. Getting the bite right may take one or two adjustment appointments.

At this point, you are given detailed instructions on home care — the cleaning routine specific to the implant prosthesis, which includes interdental brushes and a water flosser designed for implant work, and how to manage the areas under the prosthesis where food can accumulate.

Stage 7: Long-Term Maintenance

All-on-6 implants require committed long-term maintenance. This is not optional — poor hygiene around implant prostheses leads to peri-implantitis (infection of the tissue around the implant), which is one of the leading causes of late implant failure.

The home care routine for All-on-6 is more involved than brushing natural teeth. Patients need to clean under the prosthesis where it meets the gum, using interdental brushes and a water flosser (sometimes called an oral irrigator). The brushing itself is similar to natural teeth, but the beneath-prosthesis cleaning is the part that makes the difference long term.

Professional maintenance appointments are needed every 6 months with a hygienist experienced in implant care, plus an annual clinical implant check where the stability of the prosthesis and the health of the bone around the implants is assessed — typically with an X-ray. These appointments are the foundation of long-term implant success and should be viewed as part of the ongoing cost of treatment.