One of the first questions your dentist will ask you if you express an interest in getting dental implants is — "Do you smoke?"
The effects of smoking on oral health include the staining of teeth, gum disease, and cancers of the tongue and throat. Nicotine and tobacco also affect the way in which dental implants heal in a big way.
Can smokers even get dental implants?
In an ideal scenario, any dentist will want you to give up — or rather, perhaps, triumphantly beat — smoking completely. However, like all addictions, smoking can be very difficult to quit. Your dentist will assess the amount of damage already your teeth and gums have already sustained because of your smoking, and accordingly give you a prognosis for the implant procedure.
In a generally healthy patient, the rate of failure of dental implants is only around 2-3%. According to the literature and the studies conducted on smokers receiving dental implants, the rate of failure is exponentially higher at around 15%.
If it is not possible for a patient to quit smoking, a significant reduction in the number of cigarettes you smoke per day is expected. Though smoking less is nowhere near as good as not smoking at all, it is still better than smoking lots.
How does smoking contribute to the failure of dental implants?
Smoking has many detrimental effects on your oral health.
Cigarettes — and any other tobacco product — contain nicotine. Nicotine is a vasoconstrictor, which means smoking reduces the blood flow into the gums, affecting the oxygen levels of the gum tissue. Lower oxygen and blood flow decrease the body's ability to fight off infections, leading to an increased incidence of gum diseases.
It has also been conclusively found that the microorganisms (bacteria and other germs) present in the mouth of smokers have a much higher percentage of disease-causing bacteria, which can affect every aspect of dental implant healing and longevity.
Can smoking affect the lifespan of dental implants you've already had for a while?
Cigarette smoking can certainly affect the longevity of dental implants as well as cause the failure of those dental implants that have already been in the oral cavity for a long time. The tissues of the mouth are affected by the heat and smoke that cigarettes, but also smokeless tobacco systems (vaping), cause. The smoke and high temperatures can cause scarring in the mouth, and a reduction in the amount of saliva produced in your oral cavity.
As a result of these kinds of smoking-related oral conditions, the protective functions of the saliva are lost — leading to a faster development and progression of gum disease around the dental implants.
Precautions a smoker should take after dental implant surgery
In spite of smoking, if your dentist feels that you are a suitable candidate for dental implant surgery, you can still take certain precautions to increase the chances of a successful implant surgery outcome.
The patient should stop smoking at least a week prior to surgery. This gives the dentist a better chance to assess the overall health of your gums. Oral prophylaxis is advised to remove any plaque and tartar attached to the remaining natural teeth, followed by maintaining meticulous oral hygiene.
If needed, medicines are given to reduce any swelling and infections in gums.
Smoking should strictly be avoided for at least 48 hours after surgery, to allow the formation of a healthy blood clot at the surgery site, and to prevent it from getting dislodged.
If possible, smoking should be avoided for the entire healing phase of 4 to 6 months. This gives your new implant a better chance to integrate with the surrounding bone, leading to successful implant treatment. Quitting smoking, even if it's only temporary, also gives any bone graft you may receive as part of the dental implant procedure a better chance at surviving and providing support to the implants.
E-cigarettes and dental implants: What do you need to know?
Recently, e-cigarettes or "vapes" have been marketed as a safer, less health-damaging, alternative to smoking. No actual smoke is inhaled while using an e-cigarette. Instead, electronic cigarettes contain vapors with nicotine.
The exact effects of e-cigarettes on the survival of dental implants needs to be studied since these products are still relatively new on the market, but it is safe to assume them to be the same as regular cigarettes unless proven otherwise.
Conclusion
Quitting smoking is the best way forward while planning for dental implants that will last you a long time. Support from family and proper counseling by the dentist or a therapist can definitely help you quit the habit of smoking completely.
Not everyone can quit smoking at will, though. The attending dentist can make a judgmental call on a case to case basis, depending on the patient’s oral health, and their commitment towards decreasing the number of cigarettes by at least half.
Regular follow-up after surgery, regular prophylaxis by an oral hygienist, and good oral hygiene maintenance at home by the patient can help increase the chance of success for your implant treatment.
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