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Many patients tell us during their first consultation that they’ve given up on the idea of a dental implant because they “have diabetes,” “have been smoking for 30 years,” or “are too old.” Sometimes they’ve heard this from acquaintances; other times, they’ve assumed it on their own. In reality, none of these situations automatically rules out a dental implant. What matters is how well the condition is managed, which habits can be changed before the procedure, and the condition of the bone into which the implant will be placed.
At Dr. Nicolau’s Dental Clinic, every implant plan begins with a CT scan and a discussion with the patient about their medical history and current treatments. Below, you’ll find what the dentist focuses on in each of the three situations and what you can do to ensure the implant integrates successfully.
Diabetes: It Matters How Well It's Managed
A patient with diabetes can have dental implants. The question the dentist asks is not whether you have diabetes, but how stable your blood sugar levels are. Uncontrolled diabetes slows healing and increases the risk of infection around the implant, because the tissues have a harder time receiving the blood and nutrients they need to heal.
That is why, before the procedure, your doctor may ask you for a recent glycated hemoglobin (HbA1c) test, which shows your average blood glucose level over the past three months. If the results are good, treatment is planned just as it would be for any other patient. If not, the procedure is postponed until, in consultation with your diabetes doctor, your blood sugar levels are within the appropriate range.
There are a few things that actually help:
- bring your latest test results and a list of the medications you take to the consultation;
- schedule the procedure at a time when you can eat normally before and after;
- check your blood sugar more often in the days after the procedure;
- don’t skip the check-ups after the implants are placed.
Smoking: The Risk Decreases If You Take a Break
Smoking does not preclude getting an implant, but it is one of the factors that most significantly influence the outcome. Nicotine constricts the blood vessels in the gums, and the bone heals more slowly around the implant. Studies show that the risk of an implant failing to integrate is higher in smokers than in nonsmokers. In the long term, smokers are also more likely to develop gum inflammation around the implant.
The good news is that the risk decreases when you quit smoking, even temporarily. Your doctor will recommend that you not smoke for at least one week before the procedure and for several weeks afterward, during which time the bone fuses with the implant. If you manage to quit for good, so much the better for your implants and your teeth.
Tell your doctor how much you smoke and for how long, including whether you use e-cigarettes or heated tobacco products. Your treatment plan and post-procedure follow-up appointments will be determined based on this information.
After 70 Years: Age Is No Barrier
There is no upper age limit for dental implants. We have patients who received implants after turning 70 or 80 and who are now able to eat without removable dentures. What matters is your overall health, the amount of bone you have, and the treatments you are undergoing.
Before the procedure, the doctor will ask you about:
- blood-thinning medications (anticoagulants), which should only be adjusted in consultation with a cardiologist;
- treatments for osteoporosis, especially those involving bisphosphonates, which can affect the healing of the jawbone;
- heart disease, high blood pressure, and any recent surgeries.
For patients who have lost all their teeth on one arch, the All-on-4 or All-on-6 solution secures a complete dental prosthesis to four or six implants. The procedure is performed under local anesthesia, and the patient leaves with a fixed temporary prosthesis within 24 hours. The permanent prosthesis is fitted after approximately 3 months. Details about the steps and costs can be found on the page Fixed teeth on implants.
Frequently Asked Questions About Dental Implants in Relation to Diabetes, Smoking, and Age
Yes, as long as your blood sugar is under control. The doctor will ask for recent test results and, if necessary, will consult with your endocrinologist. The procedure will be scheduled so that you can stick to your meal times and insulin doses.
The usual recommendation is to stop smoking for at least one week before the procedure and for a few weeks after it. Your doctor will tell you exactly how long, depending on the number of implants and how quickly your gums heal.
No. The decision is based on the patient’s health and the amount of bone, not on age. The CT scan performed before treatment shows whether there is enough bone or whether additional bone is needed.
Do not stop taking them on your own. Tell your dentist what medications you are taking and in what doses. Any changes should only be made with the approval of the doctor who prescribed them.
A list of the medications you are taking, your recent lab results (including glycated hemoglobin for patients with diabetes), and, if you have them, any previous dental X-rays. The rest of the tests, including the CT scan, will be determined during your appointment.
