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One of the common dilemmas in dentistry is knowing when to “pull the plug” on conservative treatment and re-think how to address an ongoing cycle of dental problems. One of my first bosses as a graduate dentist was treating his friend for many years and recently faced this dilemma. Not knowing much about the all on 4 treatment, he gave her my email address for an opinion about her options. She wrote: Dear Dr. Fibishenko, I am a patient and friend of a colleague of yours who referred me to you. I had trouble with an old bridge on the top right (my right) of my mouth and a (new replacement) bridge is no longer feasible (because the teeth are broken down). I went to see an oral surgeon, and together with my dentist they suggested two implants to support four teeth. I have to have two extractions and wait ten weeks, followed by implants and another period of ten weeks. But, I have the two front teeth on a bridge which I have had a lot of problems with. It was replace