If you’re considering dental implants due to missing or decayed teeth, your dentist will first need to determine if you are eligible for the treatment. One of the main factors that may impact your ability to undergo dental implant treatment is your smoking status. Smoking can cause a number of oral health issues that will need to be addressed prior to considering implants. Additionally, smoking can lead to a greater risk of infection pre-implantation, and implant failure during the treatment and healing period. So, can smokers get dental implants? The answer isn’t quite black and white; if you’re a smoker, your eligibility will depend on your oral health, how regularly you smoke, and whether you’re willing to give up smoking for a minimum of two to four weeks. Below, we unpack everything you need to know about dental implants and smoking.
Dental Implants: Your Options
Dental implants are designed to permanently replace one or more missing teeth. They are considered more comfortable, realistic, and effective than dentures. Dentures are known to present a variety of problems for patients, often needing to be regularly adjusted or replaced.
When it comes to dental implants, you have two options: traditional implants, or All On 4 implants. Your implants will be made from acrylic or porcelain material, both of which offer a very natural tooth-like look and mouthfeel.
Traditional implants involve placing a titanium rod into the jawbone to act as tooth roots. Your jawbone will require up to six months to heal, after which a metal fixture will be placed onto the implant. From here, the ‘tooth’ part of the implant (crowns or a full bridge) will be fixed to the implant.
All On 4 implants will replace all of your teeth. They are ideal if you have multiple missing or decayed teeth. You will need to have all teeth removed before the implants can be put in. Once your gums have healed from the extractions, four implants will be placed into the gum lining. Two will be placed on the upper gum, and two on the lower gum. The back two implants are positioned at a 45-degree angle to ensure the full dental bridge is supported. This angling technique is also designed to make up for any bone deficiencies that may be present. The bridges will then be attached to the implants, and your new set of teeth is ready to go!
How Does Smoking Impact Oral Health?
Smoking negatively impacts the body in a number of ways and can cause various life-threatening diseases. It is widely reported that smoking has been linked to 19 different types of cancer — including mouth and throat cancer — as well as 7 cardiovascular conditions.
Smoking also has a significant impact on oral health. Tobacco use can lead to issues such as stained teeth, keratosis, dry mouth, gum disease, poor blood flow, and difficulty healing wounds.
When smoke is inhaled, it burns the soft tissue in the mouth. This causes keratoses to develop, which are hard and whitened wartlike patches on the surface layer of the skin inside the mouth.
Cigarette use also impacts the function of the salivary glands, which is why many smokers experience a dry mouth. A dry oral environment promotes the growth of the bacteria that cause gum disease.
Gingivitis is a milder type of gum disease that usually presents as red, inflamed, and painful gums. Periodontal disease is a severe form of gum disease that can result in significant health issues, including tooth and bone loss. The risk of gum disease for heavy smokers is four to five times higher than the risk for nonsmokers.
Symptoms of gum disease include
- Bleeding gums
- Painful and tender gums
- Gums that recede from your teeth or are loose around the tooth
- Bad breath
- Gaps between teeth
- Pus coming from gums
- Loose teeth
- Tooth loss
Poor Oral Blood Flow
The chemicals in cigarettes, including nicotine, impact the peripheral blood vessels in the mouth. The chemicals affect the function of these blood vessels, which restricts blood flow throughout the mouth and body.
Smoking can result in poor healing after mouth surgery and dental treatments. When surgical wounds are exposed to the bacteria and chemicals in tobacco smoke, they are vulnerable to infection and other complications.
This leads us to our main question.
Can Smokers Get Dental Implants?
Some smokers may be able to undergo dental implant surgery, though not all smokers will be eligible. Your dentist will need to assess your oral health and will ask you a few questions about your smoking habits. This will help them determine if dental implants are a suitable option for you. Some dentists do not allow heavy smokers to receive dental implants under any circumstances.
If you have gum disease as a result of smoking, you will need to be treated before you can consider dental implants. This may involve a number of surgical and non-surgical interventions, depending on the severity of the disease.
For example, in the case of severe periodontal disease where bone loss has occurred, you may require bone grafting surgery to prepare the jawbone for implants. This will be particularly important if you’re opting for traditional implants, as they require thick jawbone for implantation. While All On 4 implants are designed to work around bone deficiencies, your dentist will still need to determine whether they are an option for you. Your eligibility will depend on the severity of your bone loss.
Both implant types require healthy gums, so your dentist will likely perform a non-surgical procedure to remove the plaque and tartar from your gums and teeth.
You will also need to consider whether you are willing to give up smoking for at least two to four weeks. Your dentist will likely ask you to stop smoking entirely or significantly reduce your cigarette consumption during the treatment and healing period, which can be as long as three months in total.
If this is not feasible, you may not be able to get dental implants.
How Does Smoking Affect Dental Implants?
Dental implants generally have a low-failure rate, however, certain risk factors can increase the likelihood of implant failure.
Predictors for the success or failure of dental implants are patient lifestyle factors (including smoking), the characteristics of the implant, the skill of the clinician, and the location of the implant. Research has shown that patient-related factors are more critical to ensuring the success of the implant than factors related to the implant itself.
Smoking is a patient-related factor that can significantly affect dental implants before, during, and after the procedure itself.
Prior To Implantation, Following Tooth Removal
It’s likely that to prepare for dental implants, you will require one or more tooth extractions. Extraction leaves your tooth socket exposed.
Smoking can cause dry socket. Dry socket refers to the slow healing of the gum after tooth removal. This typically occurs when a blood clot doesn’t effectively develop at the site of the tooth removal. Blood clots are vital for your recovery; they act as protective barriers that shield the nerve endings and bone underneath the gum. Blood clots also help your body grow new bone and tissue.
When you smoke, the chemicals you inhale can infect the surgical site and slow down the healing process. Even if a clot has been successfully formed, sucking on a cigarette can cause the clot to become dislodged. This will cause severe pain and expose the vulnerable tooth socket to bacteria.
During The Dental Implant Process
Smoking increases the chance of dental implants failing in the time between procedure stages.
A Spanish study looked at 66 patients who received a combined total of 165 implants. At the five year mark, implants had failed in 15.8% of smokers, while nonsmokers experienced a failure rate of just 1.4%.
Experts believe this can occur because smoking hinders bone and tissue growth.
Smoking can lead to gum disease, which can cause jawbone deterioration. Studies show that heavy smokers (more than 14 cigarettes a day) experience higher rates of bone loss than light smokers (less than 14 cigarettes a day).
If you have bone loss, you have a higher risk of implant failure. This is particularly true for traditional implants, which we know require a strong and thick jawbone to fuse with the titanium implant. This process is known as osseointegration. It should occur within the first few weeks following surgery.
If the bone cannot effectively grow and tighten around the implant due to deterioration or damage, the implant may fail.
Some research suggests that the real problem is that tobacco smoke damages the gum tissue in the time between putting the implants and the prosthesis on.
For traditional implants, there is a three month period between placing the implant in the gum and placing the final prosthesis bridge onto the implant. For All On 4 implants, there are 24 hours between the two stages. In the meantime, you will be given dentures or temporary fittings.
It’s thought that when the implants are uncovered in the time between these two stages, the soft tissues around the implants may become irritated and infected by the tobacco smoke.
So, in this regard, failure during the implant process may have more to do with soft tissue exposure to smoke than osseointegration failure.
After Implant Surgery
Smoking is known to increase complication rates following dental implant surgery.
Cigarette use increases the risk of inflammation and resorption of the bone. This can affect the success rate of any bone grafting you may have had prior to implant surgery. Rates of marginal bone loss after implant procedure are higher in smokers than nonsmokers. It should also be noted that dental implant patients who smoke and have poor oral hygiene are three times likelier to experience bone loss after 10 years than nonsmokers.
If you smoke following surgery, you are also more likely to experience gum tissue damage. As mentioned, smoking damages the blood vessels in the mouth, restricts blood flow to the tissues supporting the implant, and causes mouth dryness. These factors can lead to gum inflammation and infection, which will prevent the gums from effectively tightening around the implant to secure them in place. The implant site will struggle to recover effectively as a result.
Caring For Your Dental Implants If You Smoke
If you have been cleared to receive dental implants, your dentist will likely recommend that you stop smoking at least one week prior to surgery. This will allow the blood vessels in your mouth to function normally again and will reduce the acute effects of dry mouth.
In most cases, you will be asked to avoid smoking for at least two months after your surgery. This will allow the tissue to heal around the implants and ensure the bone osseointegrates effectively.
Below, we outline our aftercare recommendations.
Straight After Treatment
In the days and weeks straight after implant surgery, avoid rinsing your mouth and do not touch the implant site with your fingers or tongue. This could cause the blood clot to become dislodged. As well as refraining from smoking, you will also need to avoid sucking on straws or spitting.
Your dentist will give you specific cleaning instructions to reduce the risk of infection and damage. It’s important to follow these steps closely.
If you plan to continue smoking with your dental implants, you will need to be stringent with your oral care routine.
As we know, smoking increases the risk of gum disease and plaque, so you will need to brush your teeth well at least twice a day and floss daily. If you do notice any signs of gum disease such as bleeding, soreness, or redness, see your dentist immediately.
Ensure you are keeping up with regular dental check-ups. After all, you’ve invested in your dental implants and will want to keep them in top condition.
- Smoking can cause a number of oral health issues including mouth and throat cancer, dry mouth, gum disease, and poor blood flow through the mouth.
- Gum disease can lead to tooth and bone loss, both of which will need to be treated before dental implants can be considered.
- Dental implants are a permanent solution to missing or damaged teeth. They come in the form of traditional implants, or All On 4 implants.
- If you smoke, you will need to consult with your dentist to determine if you are eligible for dental implants.
- Smoking can lead to dental implant failure, so you will be advised to refrain from smoking for at least two to four weeks during the implant process.
Quitting smoking altogether is the best way to keep your implants in excellent condition and ensure they last. While this can be difficult, with the right support network and treatment plan, you will be well-equipped to tackle the challenge.