The short answer: possible, but riskier
Many smokers can get dental implants, but smoking raises the chance that an implant fails. A large review of studies found that implants in smokers had about 2.4 times the odds of failure compared with implants in non-smokers. That is a big gap, and it is why dentists bring it up first.
The good news is that the risk is not a fixed sentence. Quitting, even for a while around surgery, can help. Many dentists will place implants in smokers once the person understands the risk and agrees to a plan.
What the research found
A 2021 review pooled data from many studies. It counted 35,511 implants placed in smokers and 114,597 in non-smokers. Failures happened in 2,265 of the smokers' implants, about 6.4%. In the non-smokers' group, 3,827 failed, about 3.3%.
In plain numbers, that is roughly one failure for every 16 implants in smokers versus one for every 30 in non-smokers. The review also found more bone loss around the implants of smokers, about 0.58 millimeters more on average.
A 2024 update of the research reached the same direction. Most of these studies are observational, which means they watch what happens to real patients instead of assigning people to smoke or not. Still, the pattern shows up again and again.
Numbers like these can feel abstract, so think of it this way. If 100 non-smokers each got an implant, about three would be expected to fail in this research. In a group of 100 smokers, about six would. Most implants in both groups still worked. But the smokers' group had about twice as many failures, and each failure means more surgery, more time and more cost.
The researchers also point out that these are averages from many mouths. Your own risk depends on how much you smoke, how healthy your gums are, how much bone you have and who places the implant. A dentist who knows your history can talk about your case instead of the average.
Heavy smoking is likely worse than light smoking, and a few cigarettes a day is not the same as a pack. Ask your dentist how your habit fits into the plan.
Why smoking hurts implants, and what about vaping
An implant works because your jawbone grows into it. That takes good blood flow, healthy bone cells and a calm, clean gum. Smoking works against all three.
Smoke narrows the small blood vessels in the gum, so less oxygen and fewer healing cells reach the area. It changes bone cells and slows new bone growth. It also makes gum disease more likely, and gum disease is the main enemy of implants. The review authors note that the effect of smoking on implant failure did not fade as the years went by.
Cleveland Clinic says plainly that implants may not be a good idea if you smoke or vape, because it can disrupt healing.
Many people switch to vaping and assume it is safe for the mouth. The research on vaping and implants is newer and smaller. Cleveland Clinic includes vaping in the same warning as smoking, since nicotine itself narrows blood vessels and many e-cigarettes also irritate the gums.
Nicotine patches and gum still contain nicotine. Your dentist may still want you to be off nicotine for a period around surgery. Ask what they recommend for your case.
How to improve your odds
If you smoke and want an implant, these steps help:
- Quit, or cut down as much as you can, before surgery and through healing. Many dentists ask for at least a few weeks before and several weeks after. Ask your dentist for the exact timing they want.
- Get your gums healthy first. Treat any gum disease before the implant.
- Keep your cleanings and exams. Smokers need closer follow-up.
- Brush twice a day and clean between your teeth daily.
- Tell your dentist the truth about how much you smoke. They can only plan around what they know.
Bone grafts and smoking
If you need a bone graft before your implant, smoking matters even more. A patient guide from Cambridge University Hospitals says the risk of graft failure is higher in some people, especially smokers. A graft is a bigger investment of time and effort, so it makes sense to protect it.
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Help to quit
Quitting is hard, and an implant can be a good reason to try again. Talk to your doctor about patches, gum, medicine and counseling. In Florida, free help is available through Tobacco Free Florida. Call 1-877-U-CAN-NOW. Your dentist can also support you without judgment.
Even if you do not quit for good, ask your dentist about planning the surgery and healing so the time without smoking is as long as possible.
Quitting, and the rest of your mouth
Quitting helps, and dentists see the benefit in practice. Blood flow in the gums starts to improve within days to weeks of stopping. The longer you stay off, the better your gums and bone heal. The 2024 research update also points to quitting as a key factor in lowering early failure.
If you cannot quit completely, even cutting back during the weeks around surgery is worth it. Be honest with your dentist about how you are doing. They are on your side, and they can adjust the timeline.
Some people find that the implant is the push they needed. A big investment in your smile gives you a reason to stay quit.
Implants are only one part of the picture. Smoking stains teeth, dries the mouth, slows healing after any dental work and makes gum disease more common and more severe. Smokers also face a higher risk of mouth cancer, so regular exams matter.
If you plan to keep smoking, a different option such as a bridge or a partial denture may be easier on your mouth, and your dentist can talk through it with you. If you want implants and are ready to try quitting, ask for a plan that sets surgery after you have been off cigarettes for some time.
A straight talk at KDA
At KDA, we do not lecture. We tell you what the research says, look at your gums and your bone with a 3D scan taken in our office, and help you decide with the facts. Dr. Alfredo Calderon has over 15 years of experience with implants.
Call 305-271-1421 about a free implant evaluation. Our office is at 8833 SW 107th Ave in Kendall, open Monday to Friday, 8:00 AM to 5:00 PM. We accept most dental insurances and most Medicare supplemental plans, and financing is available.
Common questions
Will a dentist refuse to place an implant if I smoke?
Some will, many will not. Most want you to understand the risk and try to quit around surgery.
How long should I quit before implant surgery?
Dentists differ. Many ask for at least a few weeks before and several weeks after. Ask your dentist for their exact plan.
Is vaping safer for implants?
Not clearly. Cleveland Clinic warns about vaping as well as smoking, since both can disrupt healing.
Can I smoke after I get my implant?
It is risky. Smoking raises the chance of infection and bone loss around the implant, and the effect did not fade over time in one large review.
Do smokers need more checkups?
Often, yes. Closer follow-up helps catch gum problems early.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: pmc.ncbi.nlm.nih.gov, pmc.ncbi.nlm.nih.gov, my.clevelandclinic.org, cuh.nhs.uk.