Medically reviewed by Dr. Sam Wood
Permanent dentures are full-arch replacement teeth fixed to four to six dental implants in the jaw, so they stay in your mouth permanently and can only be removed by a dentist. The best-known version is All-on-4. They look and function much like natural teeth, do not need adhesive or nightly removal, and preserve jawbone. In the US, permanent implant dentures cost $15,000 to $35,000 per arch, compared with $1,000 to $3,000 for conventional removable dentures and $6,000 to $20,000 for snap-in implant dentures.
What “permanent dentures” means
The phrase is used loosely. Strictly, no denture is permanent; every prosthesis eventually wears and is replaced. In practice people mean one of two things:
Fixed implant dentures (the usual meaning). A full arch of teeth, usually acrylic on a titanium frame or all zirconia, screwed onto implants. It stays in 24 hours a day. This article focuses on these.
The permanent denture after an immediate denture. When teeth are extracted, a temporary “immediate” denture is placed the same day. After the gums heal and shrink over several months, a new, better-fitting “permanent” conventional denture is made. This is still a removable denture; it is permanent only in the sense of being the final one.
If a dentist quotes you for “permanent dentures,” ask which one they mean. The price difference is tenfold.
How fixed implant dentures work
Four to six implants are placed in the jaw, often angled to make the most of available bone and avoid the sinus and nerve. A full arch of twelve to fourteen teeth is attached to them with screws. The prosthesis sits just above the gum with no palate coverage, so taste and speech are normal. You brush it in place and clean underneath it with floss threaders or a water flosser. The dentist removes it once a year or so for a thorough cleaning and inspection.
Most patients receive a temporary fixed arch on the day of surgery, then a final, stronger prosthesis after three to six months of healing. This is the “teeth in a day” approach.
Fixed vs. snap-in vs. conventional dentures
| Conventional denture | Snap-in (implant-retained) | Fixed implant denture | |
|---|---|---|---|
| Typical US cost per arch | $1,000 – $3,000 | $6,000 – $20,000 | $15,000 – $35,000 |
| Implants | None | 2 – 4 | 4 – 6 |
| Removable by you | Yes | Yes | No |
| Stability | Fair (upper), poor (lower) | Good | Excellent |
| Chewing ability | Limited | Good | Near natural |
| Covers the palate | Usually | Sometimes | No |
| Bone preservation | No; bone shrinks | Partial | Yes |
| Maintenance | Relines, replacement every 5 – 10 yrs | Insert changes, relines | Annual cleaning; prosthesis 10 – 15+ yrs |
| Surgery | None | Minor | Moderate; often with extractions |
Snap-in dentures are covered in our snap-in dentures guide and All-on-4 in detail at All-on-4 dental implants.
What permanent dentures cost
| Item | Typical US cost per arch |
|---|---|
| Fixed arch on 4 implants (acrylic/titanium) | $15,000 – $28,000 |
| Fixed arch on 4 – 6 implants (zirconia) | $22,000 – $35,000+ |
| Extractions of remaining teeth | $1,000 – $3,000 |
| Bone grafting, if needed | $500 – $5,000 |
| CT scan and planning | $250 – $600 |
| Temporary arch (same day) | Often included |
| Both arches | $30,000 – $70,000 |
Zirconia costs more but resists wear and staining better than acrylic. Get itemized quotes from at least two practices, and confirm what the final prosthesis is made of and whether the temporary and the final are both included.
Dental insurance rarely covers implants; it may cover the extractions and contribute toward the denture portion at 50 percent of a conventional denture’s cost. Medicare does not cover routine dental care. Practices offer financing, and dental schools with implant programs are a lower-cost route for straightforward cases. See dental costs and insurance for the full range.
Who qualifies
- Missing all or most of the teeth in an arch, or teeth that cannot be saved
- Enough jawbone to anchor four implants, or bone that can be built with grafting; angled implants often avoid the need for grafts
- Healthy enough for minor oral surgery; uncontrolled diabetes, heavy smoking, and certain medications raise failure risk
- Committed to daily cleaning and regular checkups; peri-implantitis is the main long-term threat
Age is not a barrier. Many patients are in their sixties, seventies, and eighties.
Advantages and drawbacks
Advantages: teeth that stay in; near-normal chewing; no palate; no adhesive; preserved bone and facial structure; a stable, long-term solution.
Drawbacks: the highest upfront cost of any denture option; surgery and healing; cleaning underneath requires effort; if an implant fails, repairs are complex; the prosthesis still needs replacement after 10 to 15 years; acrylic teeth wear and chip and zirconia costs more.
Caring for fixed implant dentures
Brush twice daily, including where the prosthesis meets the gum. Clean underneath every day with a water flosser, superfloss, or interdental brushes. Use a night guard if you grind. See your dentist every six months and expect the arch to be removed periodically for professional cleaning and to check the implants.
When to see a dentist
See a dentist if you have loose, painful, or failing teeth, or a removable denture you can no longer tolerate; fixed implant dentures are one of several options, and a consultation with a prosthodontist or implant dentist will lay them out. After treatment, see a dentist promptly for a loose or moving prosthesis, a broken tooth on the arch, pain or swelling at an implant site, bleeding when cleaning under the arch, or a bad taste or odor that cleaning does not resolve. These are early signs of a mechanical problem or peri-implantitis, both of which are far easier to fix early.
Frequently asked questions
Are permanent dentures really permanent?
The implants can last a lifetime. The prosthesis attached to them typically lasts 10 to 15 years or more before needing replacement due to wear. “Permanent” refers to their staying in your mouth full-time, not to lasting forever.
How much do permanent dentures cost?
$15,000 to $35,000 per arch in the US, or $30,000 to $70,000 for both arches, depending on the number of implants, the prosthesis material, and whether extractions or grafting are needed.
Can you get permanent dentures in one day?
Often, yes. Extractions, implant placement, and a temporary fixed arch can be done in a single surgical appointment. The final, more durable prosthesis is made after three to six months of healing.
How do you clean permanent dentures?
Brush them like natural teeth, and clean underneath the arch daily with a water flosser or floss threaders. A dentist removes the arch periodically for a deep cleaning.
What is the difference between permanent dentures and All-on-4?
All-on-4 is a specific technique for fixed implant dentures using four implants, two of them angled, to support a full arch. Most permanent dentures are All-on-4 or a close variant with five or six implants.
Does Medicare cover permanent dentures?
Original Medicare does not cover dentures or implants. Some Medicare Advantage plans include limited dental benefits that may contribute toward a conventional denture; implant coverage is rare.
Sources
- American College of Prosthodontists – Dental implants and dentures
- American Dental Association (MouthHealthy) – Dentures
- Cleveland Clinic – Dentures
- American Association of Oral and Maxillofacial Surgeons – Full-mouth dental implants
This article is for general information only and is not a substitute for professional dental advice, diagnosis, or treatment. Always consult a licensed dentist about your specific situation.