All-on-4 Implants

All-on-4 Dental Implant Marketing

By popular demand, here are all three parts of the All-on-4 series in one place regarding dental implant marketing.


Recently I met with a two doc practice who has been providing implant services for 30+ years and an active client for 6+ years. I meet with them 2 times per year (5 years ago the senior doc brought in a new graduate) and depending on how a particular year is going these guys they will do from $4M to close to $6M with of the production coming from implants or implant restorations.

The face-time I have during the year with high performing niche oriented practices like this one is invaluable in that it gives me the opportunity to ask questions related to what patients say, do and ask when they are coming to their consultations for specific procedures; in this case implants.

Few practices really have what it takes when it comes to actually marketing and doing niche cases. Many have the skills. Few do the cases. If you want to unravel the mystery of niche services and how to find cases, this guide is a mandatory starting point.

As awareness of implants has changed and more practitioners have climbed on board the implant bandwagon what patients understand and respond to related to messages about implants has changed dramatically. I saw a major shift in this more than 10 years ago (personally with patients in the chair) related to immediate loading concepts and now via ongoing conversations with clinicians I’ve watched this shift in awareness play out beyond simply immediate loading to the All-on-4 trade-marked term that now describes a specific procedure using a specific implant.

Part of the shift that has happened is related to the fact that “dental implants” are now as ubiquitous as “cosmetic dentistry.”  Patients can get generic implant procedures in so many different practices that marketing/advertising a generic implant procedure or single teeth implants no longer has a good return on time or investment.

If you are paying for advertising (online or offline for) single tooth general “dental implants” or thinking about it….. Here’s some advice.  Don’t bother.
Paying for advertising for “dental implants” is now the equivalent of your local Walgreen’s buying ads to announce they sell a great device called “Kleenex.”  A hundred other shops carry the same thing and they are all trying to be cheaper than the other guy.

[Yes, a few curmudgeons are going to disagree but I have a unique perspective peering into implant practices all over North America and the shift has been broad and dramatic. Yes, there are also backwater (mostly un-populated) areas served by less than 5% of the profession, to which the rules of competitiveness that the 95%+ contend with don’t apply.]

Now for those with advanced implant training (GPs, OMFS, Prosth, Perio, etc.), there is still a type of implant case that the publicly desperately is interested in called the “All-on-4.”  If you are willing to do some very specific things, you can see 50-100 of these cases every year.  An abundance of All-on-4 is available to at least 1-2 docs in even the smallest markets. Needless to say, larger markets can support even more docs with an abundance of cases.  In most markets, there is room for more dentists who “specialize” in All-on-4 implants.

Putting all of the above together, it should come as no surprise, that unless your advertising messages are focused specifically on All-on-4 AND some form of same day teeth being placed on the implants, patients are not going to be as interested in you as compared to those who understand where patient thinking has shifted and then deliver a better message about the state of dental implants and specifically the All-on-4 procedure.

While many will see this as “bad” news in reality it’s very good news.  There are a lot of barriers for practices to be successful at the All-on-4 implant concept and we’ll get to those in a bit. Those barriers greatly limit the number of clinicians (even with great training) who will access these cases.

Before too many docs who like doing single tooth cases get discouraged, there is some other good news.

Take a look at any competitive market and you will find that practices focusing on advertising single tooth implants dwell on one single sales strategy and that is to be cheaper than other providers as a differentiator. While that (I’m the cheapest!) might be appealing from a short-term perspective, few dentists for the long-term enjoy daily practice as the lowest cost provider of any service. It is very difficult to maintain a high degree of ethics AND be the lowest cost provider since high quality and lowest cost are mutually exclusive in the technical professions. Corners have to be cut to make the model work for the long term and eventually corner cutting is problematic.

As an aside, some of the worst dentist reviews you’ll read are from the lowest cost providers in any given market. Google a few low cost docs/clinics around you or check them out on Yelp and you’ll come to the same conclusion. Here’s the reality: even when cost is low, patients have high expectations.

Now there is an essentially free way to find occasional single tooth implant cases geographically around any practice and that is by way of online patient reviews. Yes, that means having your existing patients talk about implant treatment they have had with you via your online reviews.  FYI – The #1 smartphone based review app (Text2Review) that allows any dental practice to get hundreds of reviews annually lives here.

Outside of reviews, MONTHLY offline internal marketing and 2X WEEKLY email internal marketing to your existing patient base is the other low cost avenue to generate new patient flow and a source of your occasional single tooth implant cases annually.

Until a better technique arrives, the All-on-4 implant procedure provides more of what patients want (and less of what they don’t want) than any other option we can offer them.

Less time.

Fewer procedures.

Fewer visits.

A simple exit strategy from terminal dentitions.

Fixed teeth.

Less cost than traditional implants.

As I mentioned earlier, there are also considerable barriers to entry to being successful at the All-on-4 procedure.

These include:

1 – A mindset barrier about the All-on-4 procedure. Many implantologists have been closed minded about the procedure and haven’t upgraded their technique.

2 – An administrative barrier with delivering All-on-4 restorations on the same day as All-on-4 surgery.

3 – A need to use Nobel’s products to advertise the All-on-4 trade-name. Those dentists using other devices for a similar procedure are missing out from the total marketing dollars in use focusing on promoting a specific procedure/term.

4 – A clinical patient perception barrier –Patients want the All-on-4 surgery and restoration in one office location if given the choice.  While there are very simple solutions to this, oral surgeons can’t see past their biases to the solution and periodontists are even more handicapped at arriving at the “workaround” for having All-on-4 in their practices. As soon as multiple locations are involved with All-on-4 (or any advanced service), sales go down.

5 – An All-on-4 training barrier – it’s a very specialized procedure and requires specific expertise beyond simply dental implant training. The procedure has continued to evolve and there are specific All-on-4 courses that are more relevant than others. Few dentists have the foundational training necessary to be fully competent in the sub-specialized training of All-on-4.

6 – An All-on-4 sales issues – sales process (on phone and the specific steps in person) matter a lot at this price point. Fee’s for the All-on-4 procedure range from $12K-$25K per arch and a large part of the fee variation revolves around quality of sales process. Those adopting a legitimate sales process (e.g. Sandler, McAnally, etc.)

7 – An All-on-4 marketing barrier – most simply won’t spend what’s required to separate themselves from others in their market (minimum starting costs for advertising All-on-4 ranges from $1500-$5500 per month depending on market size/competitiveness), most don’t have access to the right All-on-4 advertising (specifically PPC gurus), and lastly most practices are unwilling to commit to 6-12 months of intense investment to put systems in place and to do what’s necessary to have ongoing cases going into treatment.

If you already have all-on-4 training and want to go to the next level as discussed in this series, then let’s have a private discussion on how to reduce the hassle and risk of getting the All-on-4 cases you want.

You can schedule that discussion here.