Centre for Aesthetic and Implant Dentistry
Tobacco smoking has many risks to a person’s health and wellbeing, and it also has an effect on the oral cavity and dental health. The damage to lungs is not easily seen, but has been well illustrated in Quit campaigns and on cigarette packets. In the mouth, apart from the visible staining of teeth, tobacco has been associated with gum disease, diminished sense of smell and taste, and bad breath. But the most severe risk is oral cancer, where combining smoking with alcohol puts you at an even greater risk. This is significant because many patients tell us that they are just ‘social smokers’ and don’t smoke during the day or at work. Such occasional social smokers often believe that they are not at risk like heavier smokers. However, since they usually light up socially when they drink alcohol, they might even be at a greater risk.
Smokers can also be poorer candidates for dental implants as the risks for failure, infection and bone loss are higher than in non-smokers.
Ten to Fifteen years ago ago we would decline to place dental implants in smokers. But our views have changed somewhat over the last decade. Due to our strict criteria in the past, some patients would lie to us about their smoking habit in order to get the treatment, and what we found over the years was that regardless of their smoking, implants can still work. This is not in any way an endorsement of smoking, because although they can still work when we look at failures these are certainly more prevalent among smokers.
Relaxing our criteria somewhat meant that our patients can be more honest with us about their smoking habits, and this allows us to talk to them more effective about the risks. On its own, the increased risk for smokers contemplating dental implants are similar to risks posed individually by diabetes, poor oral hygiene, heavy grinding, etc. In other words, if a smoker has no other risk factors and keeps his teeth very clean with regular home brushing, flossing and sees the dentist or hygienist regularly, then he is far better off than a person with poor hygiene, who has uncontrolled diabetes, grinds their teeth at night and on top of all that, smokes. So its the combination of factors, which makes someone a poor candidate for dental implants.
Nevertheless, whilst the long term risks are still not well documented in this area, it is well established that smoking can reduce the healing potential of wounds. For this reason, we require all our patients to stay off the smokes for the initial 3 months of healing after implant surgery.