Diabetes, Dental Implants and Bone Grafts…Is it Safe?

Diabetes, Dental Implants and Bone Grafts…Is it Safe?

Diabetes, Dental Implants and Bone Grafts…Is it Safe?

You may be reading this because you are at a diabetic in need of an extraction and bone graft or full mouth dental implants.  You are probably well aware that diabetes can cause slow healing from dental surgery or any type of surgery.  You can be at a higher risk of complications because of being a diabetic.

So how do I do dental implants and bone grafts on diabetics?  VERY Carefully!!!

bone-graft-squareDiabetes affects all organ systems.  Big fluctuations in blood sugar cause your healing to be impaired.  Diabetics are prone to problems with feet, eyes and kidneys but oftentimes develop periodontal disease/gum disease which has likely led you to this point to read about implants and extractions.  I tell all my diabetic patients that you must be extremely diligent in the care of your teeth even more so than someone that does not have diabetes.  This is because you are more prone to lose them and replacing teeth with implants is more difficult than your situation… difficult but not impossible.

In these photographs I show two patients that have had similar treatment at the same 7-10 day follow-up.   I treated both patients. You can see that the patient that  has diabetes that is not well managed is healing much slower than the patient that does not have diabetes.  This is not always the case but this is a great example! 

Diabetic that is not well managed is healing much slower
Diabetic that is not well managed is healing much slower
Non-diabetic with normal healing
Non-diabetic with normal healing

Neither one of these patients had bone grafting in addition to the implants they only had four implants placed in the same area for a lower dental implant overdenture.  They are both females in their 60’s.

You are probably familiar with taking your blood sugar. These numbers need to be as low as possible in the good range.  Blood sugar testing should be routine and a very important number called the “hemoglobin A1c” gives me an idea of how well you will heal after a dental implant/bone graft procedure.

Ideally the lower the A1c number the better because that gives me an idea over the last 3 months how stable your blood sugar control is.  If the A1c and daily blood sugar readings are high, then perhaps we need to consult with your endocrinologist to get it into better health.  Of course your diet and lifestyle have a lot to do with diabetes control.  Sometimes just switching meds does the trick while others need to be managed with an insulin pump.

In the weeks prior and at least 4-6 weeks after a dental surgical procedure, try to be as strict is possible with your diet and diabetes control.  It is in this critical early-phase that major complications can happen and failures or infections are most likely to happen.

diabetes-squareI use some special techniques to try to help my diabetic patients heal as quickly as possible.  For the last 14 years or so, I have used the patient’s own blood to make special concentrated versions that carry growth factors, which aid in the healing process.  Also a strict aseptic/sterile technique of placing implants, bone grafts helps reduce your chance of infection by having a very clean environment to start with.  Antibiotics are almost always necessary often in the IV and given by mouth for 7-10 days afterwards and occasionally longer.

Keep in mind that some implants and bone grafts are **far more** complicated than others.  The more complex the situation, the higher the risk of having some sort of complications.   For example, full mouth dental implants and block bone grafting is more complex than a single socket graft.

I would suggest that you work with a very skilled and experienced provider who has done hundreds of implants successfully on diabetics to figure out what is right for you.  Be very open and honest with your implant dentist so you can safely treated and have it done right the first time.  You can be succesfully treated!  Type 2 diabetes is better than Type 1 but both can be treated. You must be managed a bit differently to prevent implant failure and bone loss.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

8 Comments

  1. I’m age 70 and Type II diabetic with very high A1C usually about 12.1. I’ve been as low as 10.1. I’ve also had past heart attack about 5 years ago. With my teeth falling out and perhaps 8 remaining, I MUST get all pulled and replaced. I’d prefer to go all on 4’s permanent for the lower with conventional upper denture.

    Still, I’m extremely worried about implant failure. My dentist has told me I’m at greater risk, but permanent implants are very possible. I need to make a decision on going with merely conventional lower dentures (much cheaper) or 4 permanent implants with the the zirconia (?) teeth.

    My fear is failing implants — including medical bills that I don’t suspect would be covered by Medicare. If infection would occur, I don’t know if Medicare (plus my supplement) would cover those expenses. What type warranty should I expect from a provider??? Any comments appreciated.

    June 6, 2020 at 7:55 am Reply
    1. Ramsey Amin

      Your hemoglobin A1c is dangerously high. Even in the most skilled of hands, an A1c of 8-9 would be pushing it for a procedure as substantial as a full mouth dental implant replacement. Your fear of failure is real.Your fear of failure is real. I personally would suggest you get in the hands of a very good endocrinologist before even attempting any of these procedures. Some people require an insulin pump in order to get better control even though they are only type II diabetic.

      June 7, 2020 at 5:01 pm Reply
  2. Jessica Aviles

    I have type two diabetes and I have Periodontal severe, I’m afraid to go to the dentist, I need help.

    March 1, 2020 at 9:12 pm Reply
    1. Ramsey Amin

      It is important that you go to the dentist. Your teeth effect your diabetes and your diabetes affects your teeth. The more you avoid the worse it gets! You can do this! 😉

      March 12, 2020 at 1:09 am Reply
  3. Khaleda

    Hi ,I am always afraid that I will lose my teeth. For this ,my whole day is depressed .doctor said that I need to be surgery in almost all teeth . But I am diabetic patients . That’s why I’ am afraid of surgery .what am I doing ?

    September 26, 2018 at 2:14 pm Reply
    1. RamseyAminDDS

      I treat patients with diabetes all the time. Keep in mind that diabetes can lead to tooth loss. Also the reverses true and that gum disease can worsen the diabetes.

      October 8, 2018 at 3:12 am Reply
  4. Khaleda

    Hi , I am diabetic patient . So I am scare this sugary .I like to know that any kind of treatment for safe my teeth without surgery? Like home treatment ?

    September 26, 2018 at 9:27 am Reply
    1. RamseyAminDDS

      Everyone even a dentist needs a dentist. There are many resources online on how to care for your teeth. 😁

      September 28, 2018 at 4:19 pm Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!