If you're weighing up All-on-4, one question comes up again and again: are All-on-4 dental implants permanent, or do you take them out like a denture? The honest answer is both, in a way. For you, day to day, they're fixed. You don't pop them out at night, and there's no adhesive. But your dentist can unscrew and remove the teeth when it's time for a proper clean or check. At ArtSmiles, we find clearing up this one point settles a lot of nerves before treatment even begins.
The short answer: fixed, but retrievable
All-on-4 is a full-arch replacement. That means a single fixed bridge (a complete set of upper or lower teeth) supported by four dental implants placed in your jaw, sometimes more. From your point of view, it's permanent. The teeth stay put. You eat, talk, and sleep with them in, and you clean them in your mouth just like natural teeth.
The teeth are screwed onto the implants, so a dentist can unscrew them when needed. That's why we describe All-on-4 as fixed but retrievable. Permanent for you, removable only in the chair. You can read more about how the full-arch treatment works on our full-arch dental implants page.
What "permanent" means with All-on-4
When patients hear "permanent," they sometimes picture something that can never be touched again. That's not quite it. Permanent here means the teeth are a fixed part of your mouth that you don't remove yourself.
There's no taking them out to soak overnight, no denture cup by the bathroom sink, and no adhesive paste. The bridge is held firmly in place, so it feels stable when you bite and chew. Most people find fixed teeth tend to function more like natural teeth than a removable denture, because they stay fixed in place while you eat and speak. That stability is one of the main reasons people choose this option.
Why it can still be removed (by your dentist)
Here's the part that surprises people. Because the bridge is screw-retained (held on with small screws rather than cement), your dentist can take it off when there's a good reason to.
The usual reason is maintenance. Removing the bridge lets us clean underneath it and inspect the implants and gums properly, then screw it straight back on. How often this happens varies from person to person, but somewhere around once a year is common. Far from being a weakness, this retrievability is a real benefit. It means the implants supporting your teeth can be looked after for the long term.
All-on-4 vs a removable implant overdenture
This is where most of the confusion sits, so it's worth slowing down. All-on-4 is a fixed bridge. An implant-retained overdenture is a different treatment.
An overdenture clips onto implants using small attachments, and you take it out yourself every day to clean it and to sleep. It's removable by design. All-on-4 is not. So if someone tells you their implant teeth come out at night, they almost certainly have an overdenture, not All-on-4.
Neither option is simply better than the other. They suit different needs, budgets, and jaws. The point is just to know which one you're actually being offered, because "removable All-on-4" isn't really a thing. If you want a removable option, that's the overdenture conversation.
Are All-on-4 implants screwed in?
Yes. The implants themselves sit in your jawbone, and the bridge of teeth is screwed onto those implants. Nothing is glued in your day-to-day life.
The screw access points are usually tucked on the inner or chewing surfaces of the teeth and filled in so you can't see or feel them. When your dentist needs to remove the bridge, they uncover those points, undo the screws, lift the teeth off, do the work, and reattach everything. It's a routine part of looking after the treatment, not a sign anything has gone wrong.
How you clean a fixed All-on-4
Because the teeth stay in, you clean them in place every day, much like natural teeth. A soft toothbrush handles the outer and biting surfaces.
The bit that needs a little extra attention is underneath the bridge, where it meets your gum. Plaque (the sticky layer of bacteria) likes to gather there. Tools like superfloss or a water flosser help you reach under the bridge and keep that area clean. Good daily cleaning genuinely matters for the health of the implants holding everything up. We walk through the technique step by step in our guide on how to clean All-on-4 implants.
Is fixed or removable better for you?
That depends on what you want from your teeth and what your jaw and gums can support. Fixed All-on-4 tends to suit people who want teeth that feel and behave like natural ones, with no nightly routine of taking anything out.
A removable overdenture can be a lower-cost path and is sometimes easier to clean, since you take it out to do so. Both rely on implants, and both need ongoing care. The right choice is best worked out with your dentist, looking at your bone, your budget, and how you'd like to live with your teeth. It can help to read our guides on All-on-4 cost in Australia and what recovery is like before you decide.
References
Healthdirect Australia. (n.d.). Dental care. healthdirect.gov.au
Australian Dental Association. (n.d.). Oral health information. teeth.org.au
A note on this article
This article is general information only and isn't a substitute for personal dental advice. Whether All-on-4 or another option suits you depends on your own mouth, health, and goals, so please talk to a dentist before making any decisions.
The cover image for this article was generated using AI and is for illustration only. It isn't a clinical photograph of a real patient or a real All-on-4 result.
Frequently asked questions
Are All-on-4 dental implants permanent?
Yes, in the way that matters most day to day. All-on-4 gives you a fixed set of teeth that stay in your mouth. You don't take them out at night, and there's no adhesive or soaking. You clean them in place, just like natural teeth. The one thing to know is that the teeth are screwed on, so your dentist can remove them in the chair for cleaning and maintenance, then refit them. So they're permanent for you, and removable only by your clinician.
Can you take All-on-4 implants out?
Not yourself, no. All-on-4 is designed to stay fixed in your mouth, so it isn't something you remove at night or to clean. Your dentist, on the other hand, can unscrew and lift off the bridge when it's time for a thorough professional clean or to check the implants underneath. This usually happens around once a year, though it varies. They reattach everything afterwards. If you want teeth you can take out daily yourself, that's a removable implant overdenture, which is a different treatment.
Are All-on-4 implants screwed in or glued?
Screwed in. The implants sit in your jawbone, and the bridge of teeth is held on with small screws rather than cement or glue. The screw access points are tucked away on the inner or biting surfaces and filled in, so you won't see or feel them. Being screw-retained is deliberate. It lets your dentist remove the bridge cleanly when maintenance is due and then secure it back in place, without damaging the teeth or the implants.
What is the difference between All-on-4 and an implant overdenture?
All-on-4 is a fixed full-arch bridge. It stays in your mouth, and only your dentist removes it. An implant overdenture clips onto implants using small attachments, and you take it out yourself every day to clean it and at night. So the key difference is who removes it and how often. All-on-4 feels more like natural teeth, while an overdenture is removable by design and is often a lower-cost path. Your dentist can help you work out which suits your jaw, budget, and preferences.
Written by Dr. Cristian Dunker, BDSc, MBA.
Medically reviewed by Dr. Cristian Dunker.
