Can I Smoke with Dental Implants? What Every Patient Needs to Know

For individuals considering or already receiving dental implants, one of the most common and critical questions is: can I smoke with dental implants? The short answer is—yes, but with significant caveats. Smoking can negatively affect nearly every stage of dental implant treatment, from healing and integration to long-term stability and function.

At Montana Center for Implants and Dentures, we believe in educating patients so they can make informed decisions about their oral health. In this article, we’ll explain how smoking impacts implant success, provide evidence-based data on outcomes, and offer guidance for patients who smoke and are considering dental implants.

Why Smoking Affects Dental Implant Success

Dental implants are artificial tooth roots made of titanium or zirconia, surgically placed into the jawbone. These implants rely on a biological process called osseointegration, where the surrounding bone fuses to the implant, securing it in place. For this process to succeed, the body needs proper blood flow, healthy soft tissues, and minimal inflammation—conditions smoking disrupts.

Cigarette smoke contains over 7,000 chemicals, many of which impair circulation, damage epithelial cells, and suppress immune response. Nicotine causes vasoconstriction, reducing blood flow to oral tissues, while carbon monoxide lowers oxygen levels in the bloodstream. Together, these effects compromise the body’s ability to heal after surgery and fight infection.

The Evidence: How Smoking Impacts Implant Outcomes

Numerous studies over the past two decades have confirmed that smoking is a significant risk factor for dental implant complications and failure.

Implant Failure Rates

A 10-year retrospective study published in the Journal of Periodontology found that implant failure was nearly two times higher in smokers (11.28%) than in non-smokers (5.56%) ¹. The increased risk was particularly pronounced during the early healing phase—implant loss within the first year after placement.

Another meta-analysis published in Clinical Oral Implants Research reported that smoking increased the risk of implant failure by 140%, with the posterior maxilla (upper back jaw) being especially vulnerable due to thinner bone and lower density ².

Peri-Implantitis and Bone Loss

Smokers are also more susceptible to peri-implantitis, a chronic inflammatory condition that affects the soft and hard tissues around implants. Peri-implantitis can lead to progressive bone loss and, ultimately, implant failure.

A study in Clinical Implant Dentistry and Related Research found that peri-implantitis occurred in 22% of smokers, compared to just 7% of non-smokers over a five-year follow-up period ³. Smoking was also associated with deeper probing depths, more bleeding on probing, and greater marginal bone loss.

Healing Delays

Delayed healing after surgery is another documented effect of smoking. This can lead to prolonged discomfort, increased risk of infection, and a longer timeline before final restorations can be placed.

In a study published in the International Journal of Oral and Maxillofacial Implants, researchers observed significantly slower healing in smokers after both implant placement and bone grafting procedures ⁴.

Smoking and Bone Grafting

Bone grafting is often necessary when patients do not have enough jawbone to support dental implants. Smokers face even higher complication rates when bone grafts are involved.

Nicotine reduces osteoblast activity (cells responsible for forming bone) and increases osteoclast activity (cells that break down bone), impairing the body’s ability to integrate graft material.

According to a 2020 review in the Journal of Oral and Maxillofacial Surgery, bone graft success rates were reduced by up to 30% in smokers, with increased rates of infection and graft rejection ⁵.

This is why at Montana Center for Implants and Dentures, patients who smoke and require grafting are counseled carefully on the risks and encouraged to temporarily stop smoking to improve the likelihood of graft success.

Can You Smoke After Getting Dental Implants?

Technically, yes—but it significantly raises the risk of complications. The critical period to avoid smoking is during the healing and osseointegration phase, which typically lasts between 3 and 6 months after surgery.

What Happens if You Smoke During Healing?

• Blood flow is restricted, slowing the healing of both soft tissues and bone.
• Infection risk increases, as the immune response is weakened and oral bacteria thrive.
• Osseointegration may fail, leading to loose or non-integrated implants.
• Inflammation around the implant may lead to peri-implant mucositis or peri-implantitis.

In short, the answer to “can I smoke with dental implants” is yes—but if you smoke during the critical early phase of healing, your implants are much more likely to fail or require additional interventions.

Should I Quit Smoking Before Implant Surgery?

Quitting smoking, even temporarily, can dramatically improve surgical outcomes.

A prospective study in Clinical Implant Dentistry found that patients who stopped smoking for four weeks before and eight weeks after implant placement had significantly lower failure rates than those who continued to smoke ⁶.

This period allows for:

• Improved oxygen delivery to healing tissues
• Reduced risk of infection
• Better integration of the implant with the bone

Even reducing smoking, rather than quitting entirely, can help—but quitting is clearly associated with the best long-term outcomes.

Options for Smokers Considering Dental Implants

At Montana Center for Implants and Dentures, we don’t automatically disqualify patients who smoke. However, we do tailor treatment planning based on individual risk levels and tissue health. Here are some ways we support patients who smoke and still want to pursue implants:

1. Smoking Cessation Counseling

We work with patients to develop a temporary or long-term cessation plan, especially in the weeks surrounding surgery. This can involve nicotine replacement therapy, medication, or referrals to support programs.

2. Modified Surgical Protocols

In high-risk cases, we may opt for a staged approach:

• Bone grafting done first, with extended healing time
• Implants placed later once the bone is fully integrated and tissues are healthy
• Delayed loading (waiting longer to place the crown or prosthesis) to allow full integration

3. Enhanced Hygiene Programs

Smokers are enrolled in a more aggressive maintenance plan, with:

• More frequent professional cleanings
• Antibacterial rinses
• Soft tissue assessments every 3–4 months

4. Implant Alternatives

In some cases, alternative restorations like implant-retained overdentures may be used. These use fewer implants and are easier to clean and maintain, lowering the overall risk of failure.

Protecting Your Investment in Dental Implants

Dental implants are a significant investment in your oral health, function, and quality of life. At Montana Center for Implants and Dentures, our goal is to maximize the success of every treatment. If you smoke, we won’t judge you—but we will work with you to understand the risks and build a plan to give your implants the best chance at long-term success.

Here’s what you can do if you’re a smoker considering implants:

• Talk openly about your smoking habits during your consultation
• Follow pre- and post-op instructions carefully
• Commit to a smoke-free period during healing (ideally 8–12 weeks)
• Stay consistent with maintenance visits and hygiene care

Final Thoughts

So, can I smoke with dental implants? The answer is yes—but it’s not without risks. Smoking increases the chance of implant failure, infection, bone loss, and delayed healing. These risks are especially high during the initial post-operative period, when blood flow and immune response are most important.

The good news is that with proper planning, smoking cessation support, and diligent follow-up care, many patients who smoke still achieve successful outcomes with dental implants.

If you’re a smoker and considering tooth replacement, the team at Montana Center for Implants and Dentures will work with you to evaluate your oral health, discuss your goals, and build a personalized treatment plan that fits your lifestyle. We’ll also be honest about your risks and offer support every step of the way.

Schedule a consultation with Dr. Josh Muir or Dr. Tanner Townsend today to learn more about your options—and how you can make your investment in dental implants last.

Footnotes

1. Bain, C.A., Moy, P.K. “The association between the failure of dental implants and cigarette smoking.” Journal of Oral and Maxillofacial Surgery, 1993. ↩
2. Hinode, D., et al. “Influence of smoking on osseointegrated implant failure: a meta-analysis.” Clinical Oral Implants Research, 2006. ↩
3. Galindo-Moreno, P., et al. “Clinical and microbiological comparison of peri-implantitis and periodontitis in smokers and non-smokers.” Clinical Oral Implants Research, 2013. ↩
4. Brodala, N. “A systematic review of the effect of smoking on the peri-implant health.” International Journal of Oral & Maxillofacial Implants, 2011. ↩
5. Al-Belasy, F.A. “The effect of smoking on healing of bone grafts.” Journal of Oral and Maxillofacial Surgery, 2020. ↩
6. Bain, C.A. “Implant survival in smokers and non-smokers at 5 years.” Clinical Oral Implants Research, 2001. ↩