Smoking has a negative effect on dental implants and bone grafting procedures.
You can either smoke or you can have teeth, but you cannot have both!
Smoking anything of any kind has a negative effect on dental implant procedures. The nicotine constricts the blood vessels leading to poor healing and much higher incidence of infection with pain.
Even after the implants are installed, smokers typically lose gum and bone around implants.
Watch the video below to learn a lot more about dental implants and tobacco cigarettes, electronic cigarettes (vape) and marijuana use. I also mention some ways of how to continue to smoke lightly if quitting is not a reality.
Do you have to stop smoking before getting a dental implant?
The topic today is smoking and dental implants. Well, do you have to stop smoking to have a dental implant? Can I smoke the night of having an implant?
These are all questions I’ve been asked numerous times. So, the bottom line, let’s just clear the air, for sure with 100%, smoking affects the healing of all surgeries, whether you’re having spinal fusion in your back or dental implant procedure or any type of medical procedure.
It slows down healing because it decreases the amount of oxygen that goes to your cells, which in general, just make them heal poorly. We need our immune system and our healing ability to be at 100% in order to have an implant heal (and the implant has to integrate properly to your bone). And a lot of other things have to go right, too.
Kind of like if you think about a pregnant woman who is drinking alcohol during the first trimester — a lot can go wrong — we can kind of poison the baby, which would not be a good thing, and really can end up with some terrible consequences.
So, think of the dental implant especially in its first four to six weeks of healing, that a lot has to go right for it to work. Smokers, besides all the things, have an increased risk for heart and lung problems and there’s issues with sedation, being put under or moderately sedated.
Sometimes people who smoke have breathing issues while being sedated (compared to somebody who is a non-smoker and breathes normally while sedated). But obviously smoking causes a lot of preventable diseases, but in general, broken bones just take longer to heal.
So, if you go to the doctor with a broken arm and you have to be put back together with screws and everything else, and an orthopedic surgeon, they’re going to tell you the same thing…nicotine affects bone healing.
Vaping and dental implants — good idea or no?
And nicotine in any form, so we’re talking about e-cigarettes, the JUUL, vaping, any of those types of things. In fact, e-cigarettes may be worse than regular smoking.
In the last 10 years, I’ve actually seen worse case scenarios with patients who have quit smoking, but gone to e-cigarettes, thinking that it’s healthier, it’s not the case at all.
Besides poor wound healing, poor wound healing leads to infection. So, we see a lot more postoperative infection in patients who are smokers, which then leads to pain. They get pain and their bone gets exposed, so we want to reduce smoking as much as possible.
A lot of what I do is full mouth dental implants…we take out all the teeth, put all the implants in the same day. You leave with great looking teeth within 24 hours. And then sometimes it takes zygomatic implants, pterygoid implants, special implants to make it all work.
But smoking has a bigger effect on the bigger procedures. Not that it’s not going to affect a one tooth implant, but there’s a bigger difference when you have to open up the gums (this big versus this big), but regardless, I don’t want you to smoke with a single tooth implant or full mouth dental implants.
What about comorbidities or drinking alcohol?
And also…comorbidities. That means if you smoke and have diabetes and have high blood pressure and have issues with your immune system or take prednisone or have diabetes, those things, they all add up.
And they’re not necessarily one plus one plus one, it’s exponential in how much risk it can become when you smoke.
Well what about drinking alcohol and getting dental implants? Let’s say somebody is a heavy smoker and they also drink heavily. Well, drinking alcohol causes heavy bleeding in interactions with medications and also slows down healing, then just add smoking to the mix and it makes it worse.
So, I mean, if you want to have a successful procedure, you have to be part of the team.
The same reasons why you might be losing your teeth right now if you think about it…you probably have bone loss, pocketing, periodontal disease, gum disease, all the same thing. Gum disease — number one cause is smoking — smoking and poor dental hygiene.
Can you smoke after getting dental implants?
And with dental implants, even after you have them, let’s say it’s successful, you quit smoking, then you start again. Well, then you just end up losing bone and gum on the new implants.
So, implants aren’t forever, right? They don’t last forever [I’ve got a page written on that (failed dental implants), as well (read it here).]
We want to get things to last as long as possible so we have to make some lifestyle changes, some soul searching, self-reflection to make sure we find success. If we want teeth and a great smile and for things to work out, it’s going to take some work on your part to get there.
But regardless, I’m on your team. I’m not trying to take away all the fun and make life to be where you can’t do anything at all.
It’s really important for the success of your dental implant surgery, for the short success and longevity with the implants to quit smoking now. Right? That’s going to increase your success for a great outcome.
You can either smoke or you can have teeth, but you can’t have both. Either way, it’s going to catch up with you.
How about marijuana and implants? Not a good mix.
And talk to your doctor about it, whether it’s me or whoever else, these are things you want to know. You want to talk about e-cigarettes and vaping and all of the things.
And another discussion altogether is marijuana, right? Marijuana (smoking weed) is not great for your teeth. It causes a whole lot of problems with your natural teeth. It causes healing issues with the implants, as well.
People who smoke marijuana long-term end up with really soft bone, I found, over time. Gosh, your bone is like butter. I mean, it may seem hard on the outside, but the bone is just like butter on the inside, and you want the implant to go in really tight.
And plus it’s very difficult to undergo anesthesia if you’re a heavy marijuana smoker. So, we’re finding big problems, especially with today’s marijuana, which is wow, it’s way stronger than what it was in the past.
So now what?
Back to tobacco in general…quit now, try a nicotine patch, try CHANTIX®, try those or other medications after speaking with your doctor, of course. Or you can also try hypnosis. I’ve had a lot of patients who have had success with hypnosis.
And maybe this is not the time for you to have a dental implant procedure. Maybe work on getting the smoking under control (or reducing) so that you can have a successful procedure. You don’t want to put all this time and money and then end up throwing it all away or losing a few implants. You’re just going to be upset. So make the commitment.
Leave some comments below. I’ll try to answer all questions.
This is Dr. Ramsey Amin, Burbank, California. And talk to you soon. Thanks. Bye.
My tooth just slightly broke (it’s an upper back right side) and I’ve been an active weed user for PTSD for a while, I’m just wondering if that’s the cause? I honestly don’t think it is since I brush my teeth regularly but (I did struggle with it prior to the use of weed) I am going to the dentist I guess I’d like an opinion?
Likely internal decay weakened the tooth causing it to break. You can’t really feel cavities until they’re huge.
Hi, dear Dr.Amin,
I recently underwent dental implant surgery and have been prescribed methylphenidate (Ritalin). Could you please provide me with information on whether taking this medication could impact the healing process and success of my dental implant?
This is a great question. This particular medication is very unlikely to cause you any problems with the dental implant procedures. It can dry out your mouth which can lead to problems with your regular teeth, but it’s never been an issue in my practice.
Hi dear Dr.Amin,
I recently underwent dental implant surgery and have been prescribed methylphenidate (Ritalin). Could you please provide me with information on whether taking this medication could impact the healing process and success of my dental implant?
Hi Dr. Amin,
I wanted to ask you about the potential effects of methylphenidate (Ritalin) on implant surgery. There have been some studies on rats regarding this stimulant, and I have been prescribed this medication. I recently had a dental implant done about two weeks ago, and I mentioned this to my doctor, but he did not provide any guidance. I would appreciate it if you could advise me on this matter.
Sincerely,
Reza Hamidian
I’m 2 weeks into having all on X implants put in. Doing a little research on my own due to concerns and ran across your information. I’m still experiencing numbness and tingling above my mouth and cheeks. The Dr didnt seem concerned, but has me coming back more frequently to monitor the situation. He only performed a 2 point discrimination test and asked if the feeling had improved since surgery (not much).
I was honest with him with my daily marijuana use and nothing was mentioned that it would be a problem. I smoked up till the day of my surgery. Would have this contributed to my ongoing numbness/tingling? Do I have nerve damage and its not being addressed? He hasn’t prescribed anything other than one steroid pack directly after surgery. I’m concerned and he is not addressing my concerns. Any thoughts on this?
I’m also trying to find some studies on continuing marijuana use with implants. He stated after 2 weeks I would be ok going back to it. I’m not planning on it after reading some studies, but I would like to see some research on why I shouldnt.
Any advise would be appreciated.
The numbness and tingling you’re experiencing above your mouth and cheeks following all-on-X dental implant surgery could be related to several factors, but it’s unlikely to be directly caused by your marijuana use. Here’s why:
Surgical Factors: Numbness and tingling after oral surgery, especially a procedure as involved as all-on-X implants, can be due to swelling, inflammation, or nerve disturbance caused by the surgery itself. It’s not uncommon for these symptoms to persist for a few weeks as the body heals.
Nerve Damage: In some cases, dental surgery can lead to nerve damage, which might cause numbness or tingling. This is something that your surgeon should monitor closely, as they seem to be doing with the frequent check-ups and 2-point discrimination tests. Often these resolve in a few weeks!
Marijuana Use: While marijuana use can have various effects on the body, there’s no strong evidence suggesting that it directly causes or exacerbates post-surgical numbness or tingling in the context of dental implant surgery. However, marijuana can have effects on pain perception and might interact with other medications.
Im having all of my teeth taken out and implants in, I have smoked for years and I am quitting for this procedure. I was told I could not wear a nicotine patch even years down the line after I am healed, I have smoked for 35 years and I am concerned. Also I use THC gummies occasionally to help me sleep at nigh and am also concerned if I can still have them.
As of my last update in April 2023, the literature suggests that smoking is a significant risk factor for both the failure of dental implants and the incidence of post-operative complications. This is due to several reasons, including the negative impact of smoking on bone healing and regeneration, increased risk of infection, and impaired blood flow.
When it comes to using nicotine patches as an alternative to smoking for those undergoing dental implant procedures, the situation is a bit nuanced:
Reduced Risk Factors: Shifting from smoking to nicotine replacement therapy (NRT), such as nicotine patches, can potentially reduce the risks associated with smoking. Unlike cigarette smoke, nicotine patches do not expose the oral cavity and lungs to harmful smoke and tar, which can negatively impact wound healing and increase the risk of implant failure.
Nicotine’s Impact: However, it’s important to note that nicotine itself can have some negative effects. Nicotine can constrict blood vessels and reduce blood flow, which is crucial for healing after implant surgery. Therefore, while nicotine patches are likely less harmful than smoking in the context of dental implants, they are not completely risk-free.
Encouraging Smoking Cessation: Ideally, for the best dental implant outcomes, complete cessation of smoking and nicotine is recommended. This advice stems from the goal of optimizing blood flow and tissue oxygenation for healing. Many dental professionals encourage patients to quit smoking entirely before undergoing implant surgery.
Clinical Evidence: Clinical studies and reviews have likely evaluated the outcomes of dental implants in patients using various forms of nicotine replacement therapy, including patches. Such studies would provide more specific insights into how nicotine patches compare with smoking regarding implant success rates.
Overall Health Benefits: Switching from smoking to a nicotine patch is generally beneficial for overall health. This switch can lead to improvements in cardiovascular and lung health, which can indirectly support better surgical outcomes and overall wellness.
In summary, while nicotine patches are likely a better alternative to smoking regarding dental implant success, the best approach for implant success and overall health is the complete cessation of nicotine and tobacco products. Patients considering dental implants should discuss their smoking and nicotine usage with their healthcare providers to understand the best approach for their specific circumstances and to receive support for smoking cessation if needed.
Hi I quit vaping before having a bone graft in advance of implants and I want to know how long after the procedure I can vape again because its very difficult for me to quit completely.
Thanks!
Reduce greatly or eliminate for 2 weeks before and 6 weeks after. You are adding a lot of risk.
If I occasionally consume marihuana edibles for recreational purpose, will it impact my dental implant? I plan to have one in next month on my upper molar.
how long shall i wait after my procedure for edibles? I dont vape or smoke regularly. but if i do ‘occasionally’ (like some puffs in few months) will it be okay?
Occasional is fine
Is smoking THC the main cause of complications or is it the chemical THC itself. More specifically are Marijuana edibles safer than smoking, or will it still cause bone density to decrease either way?
It is dependent on how much you use.
Hi i quit smoking right before my procedure and im wondering if its okay for me to smoke any time after the implant and how long i should wait to smoke again or if i just cant ever smoke again ?
Best to quit or you will just have long term problems of bone and gum loss. Sorry!
Can I smoke weed every now and then after getting bone and imlants? Because it difficult to completely stop.
Yes
As a healthcare provider, I must advise that smoking – whether it’s tobacco or cannabis – can have negative effects on dental health, particularly when it comes to healing after procedures like bone grafts and the placement of dental implants. Smoking can impair blood flow and healing, increasing the risk of complications such as infection and implant failure.
It’s strongly recommended to avoid smoking following such procedures, at least until your dentist says your mouth has healed completely. This typically takes several weeks to months. After healing, smoking still poses risks for the long-term success of the implants due to its impact on oral health and bone integrity.
If abstaining completely is difficult, it’s important to discuss this openly with your dentist. They can provide advice on harm reduction and support to help you reduce or quit smoking. Your health is paramount, and your dentist can work with you to find the best approach for your situation.
Hey Doc! I’m Matt, I just got implants for 2 molars, I’m a heavy weed user (medical treatment) and I would like to know how soon am I able to smoke again. The thing is that, I don’t smoke, I vape marijuana, so there’s no combustion happening there and also marijuana doesn’t have nicotine, so what do you think?
It softens your bones….forever. Try to reduce for the 1st 6 weeks!
Can you use a small nicotine pouch such as ON! after implants? or Can you wear a nicotine patch after the implants?
YES — this is a much better alternative than the smoke coming in the mouth!
If cannabis smoke the same as tobacco smoke which has nicotine and a very different chemical profile than tobacco–one that has no link to lung cancer. You seem to treat these very different chemical the same. Do you have studies of pot smokers or are you just assuming it’s the same? You warn of the “heat” cause by smoking. How does heat arrive at the site of the surgery? I don’t feel ANY heat from smoke. Please clarify and cite ONE study of cannabis smoking only. Is there one or is this just extrapolation between two VERY DIFFENENT substances. If the sucking action on cigarette or pipe contributory? Are there less harmful ways to smoke with less suction required–joint vs. pipe or bong? Thank you.
I have placed 17,000 implants over 20 years. I have seen a ton of correlation. Here is one study. Now that it is legal it will be easier to study since we can ask study participants to smoke it.
https://www.sciencedirect.com/science/article/abs/pii/B9780128007563000570
So how soon can I smoke weed I just got my implant done today?
Best to wait as it marijuana lowers the success of dental implants.
Hi,
I have smoked / vaped marijuana for years. I haven’t smoked it for several years however I have vaped regularly until 2 weeks ago. I am wanting to get a dental implant to replace a molar that has been removed. I am looking to have this procedure in the next 6 weeks or so, should I be concerned that my bone is like butter and it won’t take? I am not planning to vape marijuana before or after the procedure – I have finally given up!
Thank you
David
It should be ok. Especially if it is a lower molar. The bone density can be easily evaluated on your 3d x-ray. Just ask your DDS.
😉
I just completed the implant 6 months ago and had crown put on recently.I haven’t smoked Marijuana since the implant was done, is it safe to smoke occasionally now? I don’ want to cause damage to such a long process
Thanks, Maria
Yes no issues
No issues now? I asked My Dentist, after waiting 7 months. He replied ” You can smoke, but it will affect your teeth and the implant. I’m just an occassinal smoker, and I’m under alot of stress. but considering the cost for everything I don’t want to cause damage.
thnk you
Thnk you!!
So I was reading a lot of your blogs and such and I wanted to ask you about your statements about fixing failed implants. I am seeing this periodontist that took out three failed implant and I still have three left that he said are not good attached to a Prettau full arch which is currently hanging on. He has said that he could not fix them since bone does not osseointgrate onto metal only bone to bone. Is this true. I live in NY and I was wondering how to get to see you in my own mind since you are very knowledgeable or do you have a recommendation. It would be kind of hard unless you could do a guaranteed day or two procedure. There is no one on my radar that does pterygoid only a few zygomatic but I do not think I have any anterior bone. If you could get back to me as my time seems that it could be short before I am without teeth and fear a denture my periodontist said for a year with bone grafts and I am completely sick and depressed over this.
Oh gosh Trish. I am sorry about this. Yes what you were told is true. Bone does not attach to an implant that is losing bone by a true “bond” in many situations. If you need to see me, we can arrange a virtual consult followed by treatment. I do see a lot of out of state patients for complicated treatment. https://burbankdentalimplants.com/traveling-patients/
Oh my, Do You REALLY have an … AGNES ? That’s Funny.
Oh, Im so sorry Agnes!
I’m not trying to be mean to you.
Or Rude! Infact, Now I don’t even know WHY I found It funny.
UGGGG! 🤔
Yes and she is awesome
Dr. Amin~ would you be willing to do a virtual consult ? I am having issues and I think you can help based on another blog post I read about lip support.
I do some virtual consults. Please call the office and speak to Agnes ☺️ 818-846-3203
Aloha, I was curious about a small consultation as well.
Is this number above still the correct one/in service ?
Mahalos
Karly
Yes but we are out until 1/4/23 Happy New Year!