All on 4 dental implants

[dontgivea]

After many many years I have now decided to go ahead with the above. All teeth will be replaced.

Having studied many photos over the years of other people's full mouth implants (and also people's full mouths of natural teeth) I have noticed that some of the centres of the dental arches (top and bottom) don't always line up. By this I mean the line between the two top front teeth doesn't necessarily continue straight down to the two bottom front teeth so that the line is completely central. The line might be off on the bottom teeth by a couple of millimetres.

I mentioned this to the implant dentist at my last appointment (no actual work has started yet). I've only had a couple of appointments so far, one for a consultation and the second one for a scan. The dentist is very qualified in implant dentistry but didn't seem that happy when I said I wanted the centre of the dental arches to line up exactly. He pulled a face like a cat's bum! He said he would speak to the different dental laboratories that he uses to see if this could be done. I find this puzzling because surely with all teeth being replaced it must be easy enough to ensure they line up?

As this is going to be the biggest financial outlay of my life, after the cost of my house, I want the work to be spot on.

AIBU to expect the centre of the dental arches to line up exactly?

You aren't being unreasonable in your thinking, but teeth just don't usually do that. The likely reason the Dentist reacted that way is because your teeth would stand out like a sore thumb in a crowd and they probably would look like a bad job, so who would want to be associated with that?

It really depends on the bone structure of your skull under the gumline. Most people are not perfectly symmetrical.

I think dentists can only do their best with implants as they are replacing something imperfect - a broken and faulty tooth or gap.

Sometimes they need to do a bone graft, sometimes they need to leave a gap (if e.g. you grind your teeth), sometimes the colour won't be exact and sometimes they fail.

But if they succeed they'll be much better than nothing (as they'll look better, will mean you can eat more easily and there won't be so much stress on the remaining teeth).

They are patching up something so they won't be perfect!

My husband has just had full implants (top and bottom). They're perfect and quite frankly, they look fake. Tiny imperfections would look more natural.

They will look really fake if you insist in that. Naturally teeth are not perfectly lined up because it depends on your jaw bone and mouth shape. They will look fake if you do insist.

Instead of looking like perfect natural teeth (with the overlap due the shape of the arch in the top of the mouth the front teeth should be slightly in front of the bottom set) they will look like bad false teeth if they meet when you smile, and put strain on your nerves and jaw bones

You’d expect a good dentist to explain the difficulties and pros and cons, natural vs perfect, though wouldn’t you. They have the info and experience patients don’t have.

Not just pull a face and do what the client asks for. If they do that it’s no wonder people end up disappointed.

I'm a restorative dental nurse. I know what you mean about the centre lines and I see no reason why the lab can't do this. However most peoples centrelines are not exact.

It is a big investment and your dentist should be making sure you are happy with the final result. My husband is a dentist and when he is doing an all on 4 the patient is involved in choosing the teeth/shade and will see a digital mock up then have approval of the bridges. The correct position of your upper midline is important. So is making sure the bite (the way your upper and lower teeth fit together) is right.

I sm really surprised to learn that most people's teeth don't line up in the middle!

Roughly how much is this

Thank you for all your very helpful feedback. It's given me plenty to think about!