Is smoking bad for dental implants? 10 facts backed by research and medical studies

Smokers and former smokers have generally more teeth missing than those who never got into the habit. Many are wondering if they can replace dentition with dental implants. And yes, it is possible. You should be aware, however, that smoking carries a lot of risk.

Below are 10 facts on how cigarettes affect your dental implant procedure. All verified by medical studies and our dental team. Read them carefully and make an informed decision.

Creative Commons

#1: Smoking is the number-one risk factor for implant loss when it comes to what patients can control

Many aspects to do with implant survival are at the responsibility of the specialist performing the procedure, the practice, and the quality of materials used. There are also patient-oriented considerations such as the general health status as well as the amount and quality of bone.

In terms of what the patient can control the most there are:

  • adherence to post-op instructions,
  • hygiene maintenance, and
  • smoking habits.

Such an addiction has a huge impact on dental implant success. Studies showed that smokers have a success rate of 84.2%, while for non-smokers it is 98.6%. Even when tobacco users have a better bone quality, the rate of failure is still higher than in non-smokers.

#2: The more cigarettes you smoke per day, the more likely that your implant will fail

A meta analysis conducted in 2020 shows that those who are heavy tobacco users (smoke over 20 cigarettes a day) are more likely to lose their implant. 23 articles were considered and any that did not report the number of cigarettes per day were rejected.

This leads to the conclusion that light smokers have a higher chance of implant survival that those who smoke heavily.

#3: If you are considering dental implants, you should be ready to quit smoking at least temporarily

Ceasing from smoking for a week prior to your surgery allows the short-term effects of nicotine to reverse. This greatly increases the chances of implant survival in levels comparable to non-smokers.

In order to achieve the osteoblastic phase (when the bone cells reproduce most) of healing, you should also refrain from smoking for 2 months after your surgery. This way osseointegration can begin to take place without interference of nicotine and tobacco.

#4: Smoking can be responsible for bone loss and peri-implantitis which lead to implant failure

Smoking can induce bone loss, especially in the upper ridge. When there is less bone, the placed implant (if it can be mounted at all) has a less sturdy base.

Additionally, smoking-induced peri-implantitis puts the implant at an even higher risk. This is because inflammation and mucosal pockets which form around the implant make the ridge too weak to support a restoration in the long term.

#5: Upper-teeth implants in smokers are more likely to fail than lower ones

Smokers were more likely to develop peri-implantitis in maxillary implants, leading to implant failure. This trend is not so visible in mandibular restorations.

Maxillary cavities are closer to the respiratory tract, which makes them more vulnerable to the damaging effects of tobacco. That may be why upper teeth implants fail more often than bottom ones.

#6: Implants placed in smokers who underwent sinus lifting fail twice as often as those of non-smokers

When the maxillary ridge is too thin or if the roots of upper teeth poke through into the hollow spaces in the skull called sinuses, augmentation is necessary.

Thankfully, even those complications are not a contraindication to implantation. Regardless of whether you are a heavy smoker or not, however, that habit is going to negatively affect the success rate.

#7: Smoking has a negative effect on an implant’s survival after the second-stage surgery

The second-stage surgery is attaching an abutment to secure a crown in place. It is then that smoking causes the most damage, not during the first step, which is implantation and osseointegration.

Tobacco use is significantly destructive just before insertion of prosthesis takes place. That’s because the most damage happens when the tissues immediately around the implant have contact with smoke.

#8: Smoking increases arginase activity in the saliva, making smokers more susceptible to infection

Arginase is an enzyme that is found to be present in the saliva of smokers in higher concentration than in non-smokers. Scientists argue that it may cause lower nitric oxide production, which makes patients more prone to bacterial infection.

Infections lower the chances of implant survival. If they are left untreated they can also have catastrophic consequences for your general health.

#9: Studies link smoking to a weaker immune system, which makes fighting infection and healing more difficult

It may be surprising, but cigarette smoke can promote autoimmunity (fighting off conditions caused by our own body, e.g. celiac disease). On the other hand, it makes the immune system weaker against outside infections.

Smokers are more vulnerable to infections which can happen during the implant process. Their immune systems are incapacitated and it is harder for their bodies to fight those infections off. That is why symptoms are usually more severe and failure of implants increasingly likely.

#10: E-cigarettes also have a bad effect on healing after implant placement

Smoking is not only harmful to the healing process due to the smoke itself but also due to the nicotine content. The substance works to constrict capillaries preventing proper blood flow. This can impair healing and bone growth, both very important processes in implant placement.

E-cigarettes may be less damaging to your lungs, but they still contain nicotine. This means they can prevent proper restoration of soft and hard tissues after surgery.

Can you reduce the negative impact of smoking on implants?

Yes, you can. If you are considering dental implants you should say goodbye to cigarettes. At least temporarily. The best solution, however, would be to definitively quit.

Studies show that the negative effects can be reversed. If you stop smoking now, the state of your mouth won’t continue to deteriorate. This can save you the cost of future treatment and restorations as well as improve your general health state.

If you don’t feel like you can defeat the habit on your own, you can find support and quitting tips at SmokeFree.gov.