Smoking

Smoking is the single most important modifiable risk factor for implant complications and failure. The evidence is clear and consistent: smokers have significantly higher rates of implant failure, peri-implantitis, and post-surgical complications than non-smokers.

Why smoking affects implants

• Reduced blood supply: Nicotine causes vasoconstriction — narrowing of blood vessels — reducing oxygen and nutrient supply to healing tissues
• Impaired immune response: Smokers have reduced ability to fight bacterial infection around implants
• Delayed wound healing: Healing of the surgical wound and bone graft takes longer and is less reliable
• Impaired osseointegration: Bone-to-implant contact is reduced in smokers
• Gum disease risk: Smokers have higher rates of periodontitis and peri-implantitis

The numbers

Studies consistently show implant failure rates of 6–10% in smokers compared to 1–2% in non-smokers over 10 years. Bone graft success rates are also lower. The risk increases with the number of cigarettes smoked per day.

What about vaping?

Evidence on e-cigarettes is still emerging, but nicotine-containing vaping products are expected to cause similar vasoconstrictive effects. The prudent advice is to treat vaping similarly to smoking for implant risk purposes.

Our recommendation

We strongly advise stopping smoking before implant treatment. Stopping at least 1–2 weeks before surgery and continuing to abstain during the healing phase (minimum 8–12 weeks) significantly improves outcomes. We will discuss this openly and supportively at your consultation.