How does smoking affect my implant treatment?
When it comes to dental implant treatment, smoking is an important factor we consider when making a recommendation to have implants. While smoking doesn’t necessarily disqualify you, it does reduce the chances of success.
You might be wondering, “How exactly does smoking impact the success rate?” Well, it’s well-known that smoking negatively affects the success rates of medical procedures in general, and dental implants are no exception. When we place an implant in your jaw, the goal is for your bone to heal around it, a process known as implant osseointegration. For this to happen successfully, the jaw bone needs a good blood supply.
Unfortunately, smoking reduces blood flow, which can delay or impair the healing process. This means that the implant might not be as stable as we’d like in the critical early stages, making it harder for it to reliably integrate with your jaw bone.
But that’s not the only risk. Smoking can affect not just the initial healing phase but also the long-term success of the implant. Even if the implant integrates successfully at first, smokers are more likely to develop gum disease of the protective gum tissue that surrounds the implant. This “cuff” of gum acts as a barrier against infection, and without it, the implant is more vulnerable. Smoking increases the level of inflammatory factors called cytokines in the body. These contribute to inflammation, which can cause a breakdown of both supporting gum and bone around natural teeth as well as dental implants. Over time, this can result in gum recession, leaving the implant exposed to harmful bacteria.
Moreover, the bone supporting your implant is also at risk of receding. Even after an implant has been in place for several years, smokers are still more likely to experience bone loss around dental implants. This can lead to a condition called peri-implantitis, which is essentially an infection around the implant. Over time, this infection can lead to the loss of the implant entirely.
So, while smoking doesn’t rule out dental implants, it certainly poses challenges. The initial healing process may be slower, and the long-term health of your implant could be at greater risk. For the best chance of success, quitting smoking before and after your implant treatment is ideal. Reducing or stopping smoking can help your body heal better and protect your implants in the long run. Ultimately, your dental team will consider all these factors when creating a treatment plan that works for you.
Smoking and Bone grafting
Smoking and bone grafting go hand in hand with dental implants in terms of risk factors, but when it comes to bone grafting, it’s even more crucial to avoid smoking. Bone grafts depend heavily on good blood circulation, and smoking significantly reduces blood flow, which can have a major impact on the success of the procedure.
Here’s how I explain it to my patients: “If you smoke and don’t feel confident about quitting, we might still go ahead with dental implants, as long as you understand there’s a higher risk of failure.” While the success rates for implants in smokers can still be reasonable, depending on how much you smoke, bone grafting is a different story. If the blood circulation is compromised due to smoking, the graft is unlikely to take, meaning the bone won’t grow as we need it to. Essentially, all the effort, time, and money invested in the graft could go to waste.
For this reason, I strongly advise my patients to quit smoking before undergoing a bone graft. Quitting smoking not only improves your chances of success for the graft itself but also sets you up for better results with future dental implants. In short, if you’re considering an implant that requires a bone graft, the best thing you can do for yourself is to quit smoking. This gives your body the best chance of healing and ensures that the investment you make is likely to pay off.
Realistically, what are your chances of success if you continue smoking?
When it comes to dental implants, the chances of success for smokers are still reasonable, but they’re not as high as they could be. I always aim for success rates as close to 90% as possible, but studies show that smoking reduces those odds by anywhere from 6% to 20%. The exact number depends on the study and, more importantly, how much you smoke. For example, someone who smokes just one cigarette a day has a better chance of success than someone who smokes a pack a day.
Yes, it’s possible to go ahead with implants while you’re still smoking, but it’s important to weigh the risks carefully. You need to decide how much risk you’re willing to accept. Sometimes, implants in smokers do well in the early stages of healing but develop complications down the line. Other times, the implant might not integrate with the bone properly from the start. Of course, there are also cases where everything works out well, but the unpredictability is something none of us like.
While we’ll do everything we can to support you with your treatment, my recommendation is clear: if you’re thinking about getting dental implants, quitting smoking first will give you the best chance of success. However, if quitting feels impossible right now, it’s important to understand and calculate the risk before moving forward. The decision is ultimately up to you, but the less you smoke, the better your chances will be for a smooth and lasting result.
Chances of Success in the Top Vs the Bottom Jaw
It’s interesting to note that the success rate for dental implants differs between the top and bottom jaw, especially in people who smoke. Studies consistently show that implants in the upper jaw are more likely to face complications than those in the lower jaw. This doesn’t mean they will automatically fail, but the chances of success are slightly lower. The main reason is the difference in bone density. The bone in the lower jaw is typically denser, while the upper jaw is more porous. With denser bone, there is more of it that comes in close contact with the implant, thus better integration.
Another factor that affects implant success in smokers is nicotine exposure. The lower jaw, particularly the back part, is partly protected by the tongue, which means it’s not as exposed to nicotine. This can contribute to a higher chance of success for implants in that area. On the other hand, the upper jaw, being more porous and exposed, tends to have a higher failure rate when smoking is involved.
When planning for full-mouth implants, dentists often place more implants in the upper jaw than in the lower one. This is not always necessary, but it depends on the condition of the bone. If there’s enough bone to support longer implants in the upper jaw, fewer implants may be needed. However, if the bone is thinner or shorter implants are required, adding a few extra implants can help. The lower jaw, with its denser bone, often requires fewer implants.
Another thing to consider is the risk of failure when a sinus graft or sinus lift is performed before placing implants in the upper jaw. For smokers, even if the sinus graft is successful and the implant is placed into the grafted bone, the failure rate for that implant is still twice as high compared to non-smokers. This is particularly true for implants at the back of the upper jaw.
In summary, smoking impacts the success of dental implants, especially in the upper jaw, where bone density is lower and nicotine exposure is higher. While implants can still be successful, the risks are greater, and careful planning is essential to achieve the best possible outcome.
What’s the Best Time to Quit Smoking?
The best time to quit smoking is as soon as possible, especially if you’re considering dental implants or any other surgery. The sooner you quit, the better your chances of success. The body takes up to five years to fully recover from smoking, so even if you quit a few years ago, your success rates with implants may still be lower than someone who has never smoked.
That being said, the longer you’ve been smoke-free before your surgery, the better. Research shows that quitting smoking at least two weeks before surgery can significantly improve your chances of success. If you can avoid smoking for at least one to two months after the procedure, your success rates will increase even more. This is particularly important because smoking reduces blood flow, which is critical for healing after any surgery, including dental implants.
I understand that quitting smoking is no easy task. It’s a difficult challenge, but the sooner you stop, the better the outcome will be for your health and your dental treatment. If you’re undergoing a bone grafting procedure, I’d recommend quitting even earlier—ideally a few months before the surgery—to ensure the best possible results. Your body needs time to recover and optimise its healing capacity, so every day without smoking makes a difference.
Suggestions to help you Quit Smoking
Quitting smoking is a personal and often challenging journey, and while I don’t have a one-size-fits-all solution, I’ve seen many of my patients successfully quit, and their stories continue to inspire me. One story in particular stands out—the story of Claire, one of our patients who had to undergo an All-on-4 implant procedure.
When I first spoke with Claire, she was very realistic about her smoking habit. She told me, “Look, I’ve smoked for so many years. Realistically, I’m not going to quit.” I responded, “Claire, do you realise that the success of this procedure could be at risk if you continue smoking?” She acknowledged the risks but was determined to proceed with the treatment, fully aware of the potential consequences.
What happened next was remarkable. Despite her initial mindset, Claire managed to quit smoking. When I asked her how she did it, her response was simple and inspiring. She said, “What’s smoking? I’ve never quit!” She explained that she didn’t put pressure on herself to quit immediately. Instead, she took it one moment at a time. “I just told myself that I might not have the next one,” she said. “And then I thought, maybe I’ll skip the one after that. Let’s see if I can stay away from cigarettes for a day or so.” And before she knew it, days turned into weeks, and weeks turned into months. When Claire came back for her six-month check-up, she proudly told me that she hadn’t had a cigarette since the day before her surgery—more than a year ago.
What makes Claire’s story so powerful is that she didn’t quit by sheer force of will. She didn’t pressure herself into a strict “no-smoking” regime, which often causes added stress and anxiety. Instead, she took it day by day, focusing on the small steps, which eventually led to her quitting smoking altogether. She also had the support of her husband, which she said was crucial to her success. His support made the process a lot more manageable for her. Quitting smoking isn’t just about strong willpower—it’s about having people around you who understand and support your decision.
Smoking, like many addictions, often has deep roots in a person’s past. For many people, smoking is a way to manage emotions, especially in times of stress. It’s not just a habit; it’s a coping mechanism that can be difficult to break. The psychological and emotional aspects of smoking are complex, and there’s no single solution that works for everyone. Some people are able to quit cold turkey, while others need to gradually reduce their smoking. The process is different for each person, and that’s okay.
If you’re thinking about quitting smoking, I encourage you to reach out to your family and friends for support. Quitting isn’t just about personal strength; it’s about having people around you who can help you through the tough moments. It’s also important to recognise that smoking is often tied to managing emotions, so having a support system can help you find healthier ways to cope with stress.
In addition to emotional support, there are medical options that can help. Doctors can prescribe medications like Zyban or Champix, which have been effective for many people trying to quit. These medications work by reducing cravings and withdrawal symptoms, making it easier to stay off cigarettes. However, they’re not for everyone. Some people experience side effects like vivid dreams, and others find the medications hard to tolerate. But for those who can use them, they can be a long-term solution to staying smoke-free.
There are also other aids, such as nicotine patches or chewing gum, that can be helpful for gradually reducing your dependence on cigarettes. But in my experience talking to patients who have quit, it’s often not just one thing that works. It’s usually a combination of several approaches—whether it’s medication, nicotine replacement, emotional support, or simply taking it one step at a time, like Claire did.
I know that quitting smoking isn’t easy, and I understand how difficult it can be when someone tells you, during a quick consultation, that you need to quit for the sake of your health or the success of your dental implants. It’s easy for a doctor or dentist to say it, but it’s much harder for you to make it happen. I fully appreciate that. My role is to support you in any way I can during this journey. Whether it’s through recommending treatments or just offering encouragement, I’m here to help.
At the end of the day, quitting smoking is a personal journey, and I believe we can go through it together. Whether you’re considering dental implants or simply want to improve your health, I’m here to help in any way I can. We may not have all the answers, but together, we can find a path forward that works for you.
If you’re ready to take the next step toward a healthier smile, book a consultation today!
