Am I a Candidate for Full-Arch Implants? The Screening Criteria

The short answer for most people: probably yes. Full-arch implant protocols — particularly All-on-4 — were designed to work for the widest possible range of patients, including those previously told they "don't have enough bone." But "probably yes" is not the same as "definitely yes," and understanding the screening criteria helps you walk into a consultation prepared.

Medical factors

Diabetes: Controlled diabetes (HbA1c at or below 8%) is generally compatible with implant surgery. Uncontrolled diabetes impairs healing and increases infection risk. If your diabetes is not well managed, your surgeon may ask you to work with your physician to improve control before scheduling surgery.

Blood thinners: Patients on anticoagulants (warfarin, Eliquis, Xarelto) may need to coordinate with their prescribing physician to adjust medication around surgery. This is routine — it does not disqualify you, but it requires communication between your medical and dental teams.

Osteoporosis and bisphosphonates: Long-term bisphosphonate use (Fosamax, Boniva, Reclast) carries a small risk of medication-related osteonecrosis of the jaw (MRONJ) with dental surgery. The risk is low with oral bisphosphonates but higher with IV formulations. Discuss your medication history with your surgeon — many patients on oral bisphosphonates proceed safely with appropriate protocols.

Heart conditions: Most cardiac patients can undergo implant surgery with clearance from their cardiologist. Surgery is performed under local anesthesia with sedation, not general anesthesia, which reduces cardiac risk.

Smoking: Smoking significantly increases implant failure rates. Most surgeons strongly recommend quitting at least 4 weeks before and 8 weeks after surgery. Some surgeons decline to perform implant surgery on active smokers. This is one of the few lifestyle factors that can genuinely disqualify a candidate.

Dental and bone factors

Bone volume: Assessed via CBCT scan. All-on-4's angled implant technique works with less bone than individual implant protocols. If anterior bone is present (it usually is), All-on-4 is typically feasible. For severe bone loss, zygomatic implants offer an alternative that does not require grafting. See the zygomatic implant guide.

Active gum disease: Active periodontal disease must be treated before implant placement. Implants placed in infected tissue have higher failure rates. Treatment may involve deep cleaning, antibiotic therapy, and extraction of hopelessly compromised teeth — often handled as part of the surgical visit.

Age: There is no upper age limit for implant surgery. Patients in their 70s and 80s routinely receive All-on-4 with excellent outcomes. General health matters more than age. The lower age boundary is skeletal maturity (typically 18+, confirmed by growth plate assessment).

The fastest way to find out

Get a CBCT scan from any dental imaging center or your local dentist ($150 to $350 in the US, $40 to $120 in Colombia). With that scan file in hand, you can send it to surgeons for virtual evaluation — most will review the scan and provide a preliminary assessment at no charge or for a nominal consultation fee. This gives you a definitive answer about candidacy before you commit to travel or schedule surgery.

For cost and destination planning after you confirm candidacy, see All-on-4 Cost by Country.