Smoking and Dental Implants

Dental implants are an excellent solution for the replacement of missing teeth whether they are used for the replacement of one tooth or incorporated in a denture to increase function and esthetics. However, tobacco usage can greatly influence the success of dental implants in the long term.

Smoking in general can adversely affect oral health in a variety of ways including increasing the risk of periodontal disease, which can lead to significant bone loss, oral cancer, and inflammation with implants, called peri-implantitis. Smoking can also cause poor wound healing in the mouth such as after extractions, bone grafting, or any oral surgery procedures. Smokers are at a higher risk of dry socket compared to non-smokers.

Most importantly, success rates for implants in smokers are greatly decreased with failure rates ranging from 6.5% to 20%.

Nicotine in tobacco decreases blood flow and oxygen to bone and tissue, which causes these adverse effects.

WHAT ABOUT VAPING AND DENTAL IMPLANTS?

Vaping or e-cigarettes have become widely popular. Although e-cigarettes have less nicotine than traditional cigarettes (0.3%-1.8% nicotine in the e-liquid), one electronic cartridge can be the equivalent to smoking 2-3 packs of regular cigarettes in terms of nicotine content. Ultimately, e-cigarettes can pose as much risk as traditional cigarette smoking for implant success rates.

RECOMMENDATIONS TO INCREASE SUCCESS OF IMPLANTS IN SMOKERS

• Cease smoking for at least 1 week prior to implant placement
• Avoid tobacco for at least 2 months after implant placement. Once an implant is placed, the bone needs to fuse to the implant or titanium post. Smoking can impair the bone healing to the implant.

Written by Sarah Bong-Thakur, DDS, Oral and Maxillofacial Surgeon

REFERENCES:
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Meechan JG, Macgregor ID, Rogers SN, Hobson RS, Bate JP, Dennison M. The effect of smoking on immediate post-extraction socket filling with blood and on the incidence of painful socket. Br J Oral Maxillofac Surg. 1988;26:402-9.
Sanchez-Perez A, Moya-Villaescusa MJ, Caffesse RG. Tobacco as a risk factor for survival of dental implants. J Periodontol. 2007;78:351-9
Kasat V, Ladda R. Smoking and dental implants. J Int Soc Community Dent. 2012;2:38-41.
Rouabhia M, Alanazi H, Park HJ, Goncalves B. Ciagrette Smoke and E-Cigarette Vapor Dysregulate Osteoblast Interaction With Titanium Dental Implant Surface. J Oral Implantol. 2019;45:2-11.