We all know that smoking is bad for you. But if you’re getting dental implants, there’s another very good reason to quit, it could compromise the success of the implants. If you were looking for an excuse to stop smoking, this is it.
Dental implant success relies on one very crucial detail: The strength of the implant in the jaw. The titanium implant is made from biocompatible material, and every aspect of its size, shape and coating is analysed to ensure that it will be accepted by your body and fuse strongly with the bone. This process of bone and implant fusing is called osseointegration, and it is the reason implants are so strong. In smokers, this osseointegration process is hampered by smoking. It could spell failure for your new teeth.
In NZ, 12.5% of adults smoke daily, and hundreds of people are affected by second hand smoke. What are the risks?
In a word, yes. Smoking has more than 4,000 bioactive chemical components. Some of these are potentially toxic for human tissue, including bones. This includes nicotine, which is known to impact bone healing[1]. In general, the long term failure rate of dental implants is around 5 to 10%[2]. The failure rate among smokers is considerably higher, with one meta-study showing failure rate is proportional to tobacco use and can be twice as high as in non-smokers[3][4], up to 20%.
[1] https://www.ncbi.nlm.nih.gov/pubmed/23733082
[2] https://www.semanticscholar.org/paper/Clinical-and-microbiological-determinants-of-ailing-Tabanella-Nowzari/7312d75a5a9b512cd104e18cc8af53c2d349175c#related-papers
To get technical, smoking increases the production of inflammatory cytokines. This increases the risk of bone loss in the mouth, as well as a host of other problems including periodontal disease, another cause of dental implant failure[1]. It’s unknown why smoking compromises wound healing, but theories include the toxicity of nicotine, carbon monoxide and hydrogen cyanide to the cells that help with wound healing. There’s also a decrease in blood flow which minimises oxygen and nutrients to the wound, as well as a range of other blood problems[2].
A meta-analysis showed that mineral density in bone was higher in those who were not involuntary smokers, and negatively impacted the osseointegration process, leading to a higher failure rate[1]. Put simply, even being around someone else who is smoking can lead to a higher failure rate of dental implants.
[1] https://www.ijoms.com/article/S0901-5027(17)31683-1/fulltext
Vaping is a relatively new phenomenon and the outcomes in regards to dental implants are unknown[1]. However preliminary studies show increased rates of inflammatory cytokines, the same as smoking, which suggests similar rates of failure as cigarette smoking[2].
If you’re a smoker, the very best outcome for your implant—and your general health—is to quit smoking altogether. However, this is not always possible for some people. As a result, dentists recommend you stop smoking one week before the surgery, and then stop for as long as possible afterwards, up to two months is best[1]. This will give you the best chance for the bone and implant integration, and the best chance of success.
While smoking does impact the success rate for implants, it doesn’t mean you can’t get implants at all. Speak to your dentist about what you want and if it’s possible. They can give you personalised recommendations and set out a treatment plan that works for you.
