What a Before-and-After Photograph Cannot Tell You

A before-and-after photograph can show you one thing: how one person's teeth looked in two images, taken at times and under conditions chosen by whoever published them. It cannot show whether the prosthesis fits, whether the bite works, how much bone was there, how the healing went, what the maintenance is like, or what any of it looked like three years later.

This site publishes no patient photographs, real or generated, and no case galleries. The drawings here are diagrams, labelled as illustrations, and they are not pretending to be anybody's mouth.

Why the pairs are persuasive and uninformative

The "before" and the "after" in a marketing pair are rarely comparable images. The lighting, the angle, the distance, the expression and the moisture on the teeth all change between them, and every one of those changes appearance more than most people expect. A dry, retracted, close-lit "before" and a relaxed, well-lit "after" would look transformed even if nothing at all had been done.

Then there is selection. A gallery contains the cases the publisher chose. Nothing about it tells you how many cases there were, how the unchosen ones look, or how these particular ones aged — and the things that go wrong in full-arch work, on the evidence of the literature, are mechanical and gradual: a 2024 review of the field names "screw loosening and acrylic component fracture" as the common complications of one approach, and "fractures, component debonding, chipping, screw fracture or loosening" for another. None of those is visible in a photograph taken on the day the prosthesis was fitted.

What the rules say about testimonials

The Federal Trade Commission's Rule on the Use of Consumer Reviews and Testimonials went into effect on 21 October 2024. It defines a testimonial as "an advertising message that consumers are likely to believe reflects the opinions, beliefs, or experiences of a consumer or celebrity who has purchased, used, or otherwise had experience with a product, service, or business", and a consumer review as a consumer's — or purported consumer's — evaluation submitted to and published on a platform for such evaluations.

The rule prohibits businesses from writing or creating fake reviews, and from buying reviews they knew or should have known were false. It also requires disclosure, clear and conspicuous, where insiders post testimonials and the relationship is not otherwise clear to the audience.

What that means for a reader is modest but real: fabricated patient stories are against a federal rule, not merely distasteful. It does not mean that any particular gallery is fake, and it does not turn a photograph into evidence. A genuine photograph of a genuine case still cannot tell you what you need.

The questions a photograph invites you to skip

If an image has impressed you, these are the things to ask about the case behind it:

1. How long after fitting was the photograph taken?
2. Is there a photograph of the same case several years later?
3. What was done — how many implants, which arch, fixed or removable, what material?
4. What did that case cost, itemised?
5. What complications occurred in it, and what did fixing them involve?
6. Was the patient compensated, employed by the practice, or related to it?

Question two is the one a gallery can almost never answer, and it is the one that matters, because the published survival figures for this work are reported over years and separate the implants from the prosthesis on top of them.

What the literature measures instead of appearance

It is worth noticing what published studies of this work actually count, because none of it is photogenic. The 2024 review we cite reports implant survival and prosthetic survival as two separate figures over a follow-up period — for the fixed acrylic approach, "exceeding 95% for implant survival and 97% for prosthetic survival during a 1–6-year follow-up", attributed to a retrospective study.

Two survival rates, a defined window, and a named material. That is what an evidence-shaped claim looks like, and it is unlike anything a gallery can offer: no photograph carries a follow-up period, a denominator, or a definition of failure.

The same review also notes that wear of a fixed acrylic prosthesis over time is well documented and depends on the opposing dentition, and that some studies count severe wear as a failure. A picture taken at fitting is, by definition, taken before any of that has happened.

What is worth looking at instead

• The itemised plan. It describes your case, which a photograph of another person's case does not. What one should contain is set out in what a full arch costs, line by line.
• Your own imaging, explained to you by the person proposing the surgery.
• The maintenance schedule — what is checked, how often, and at what cost after the first year.
• The failure plan — what happens if an implant does not integrate, or a screw loosens in year four.

None of those photograph well, which is exactly why they end up at the bottom of a sales conversation.

Looking at your own records instead

There is one set of images worth studying closely, and it is yours. The imaging taken at your consultation is the only picture in this process that describes your jaw, and a practice proposing surgery should be willing to put it on a screen and walk you through what it shows: where there is bone, where there is not, and why the proposed implant positions are the proposed implant positions.

That conversation is worth more than any gallery, and it is also a good test of the consultation. A clinician comfortable explaining their plan from your imaging is in a different business from one who answers questions about your case with photographs of other people's.

Ask for copies of your own imaging and reports, too. They belong to your record, they are useful for a second opinion, and having them makes the second opinion a proper review rather than a fresh guess.

Our own rule about images

Every drawing on this site is an original line illustration, made for the page it sits on, and labelled as an illustration where positions or shapes could be mistaken for a plan. There are no photographs of mouths, no simulated results, no galleries and no patient stories — not as a stylistic preference, but because we have no cases, no patients and no clinical standing, and inventing the appearance of any of those would be a lie in the form of a picture.

It also means there is nothing here to compare yourself against, which we think is the right trade. The comparison that helps is between two written plans; the arch word in those plans is often where they stop being comparable at all.