Smoking and Dental Implants: Why Smokers Are at Higher Risk

By Leading Health Centers GmbH · Published on 07.09.2026 · Last updated on 08.09.2026

Overview of this article

Why Smoking Impairs Healing

After a dental implant is placed, a process known as osseointegration begins. During this process, the implant fuses firmly with the jawbone, forming the foundation for a permanently stable dental restoration. This process takes several weeks to months and is crucial for the long-term success of the treatment.

Smoking can impair this process in various ways. Nicotine constricts blood vessels, reducing blood flow to the tissue. At the same time, less oxygen reaches the wound, and the supply of essential nutrients is restricted. This can delay wound healing.

In addition, components of tobacco smoke affect the immune system. This makes it easier for pathogens to multiply and promotes inflammation. The risk that an implant will not fully integrate is significantly higher for heavy smokers than for nonsmokers.

The following factors can further complicate the healing process:

reduced blood flow to the gums
reduced oxygen supply to the tissue
slowed bone healing
increased susceptibility to infections
delayed wound healing after the procedure

Increased risk of peri-implantitis

Even after successful healing, smoking remains a risk factor. Of particular concern is so-called peri-implantitis—a bacterial inflammation of the tissue surrounding the implant. It is similar to periodontitis but affects the implant rather than the natural tooth.

If peri-implantitis goes untreated, it can lead to bone loss in the jaw. In advanced stages, the implant loses its stability and may need to be removed.

The risk increases further when additional factors are present, such as:

poor oral hygiene
untreated periodontitis
irregular checkups
poorly controlled diabetes mellitus
heavy tobacco use

This is precisely why regular follow-up examinations and professional dental cleanings are especially important after implant surgery.

What Studies Show

Numerous scientific studies show that smoking can negatively affect the success of implant treatment. Compared to nonsmokers, smokers are more likely to experience healing complications, inflammation of the implant site, and implant loss. The risk increases with the number of cigarettes smoked per day.

Nevertheless, smoking does not necessarily mean that a dental implant will fail. Many implants function successfully in smokers for many years.

Key factors include:

the number of cigarettes smoked per day
overall health
thorough oral hygiene
regular checkups
consistent follow-up care

Recommendations Regarding the Procedure

Quitting smoking completely significantly improves the chances of healing. However, if this is not possible, you should at least take a break from smoking around the time of the procedure.

It is particularly advisable to:

• to quit smoking or significantly reduce your consumption, ideally several weeks before the implant procedure

• to refrain from smoking during the first few days and, if possible, throughout the entire healing phase

• practicing oral hygiene with extra care

• Attend all scheduled follow-up appointments

• To have any warning signs—such as pain, swelling, or bleeding gums—checked by a dentist as soon as possible

Every cigarette you avoid can have a positive effect on wound healing and reduce the risk of complications.

Alternatives and Precautions

Not every patient is equally suitable for implant treatment. In cases of very heavy tobacco use or additional risk factors, it may be advisable to treat existing gum disease first. Quitting smoking before implant placement can also significantly improve the chances of success.

The most important precautions include:

a thorough preliminary examination and individualized risk assessment
Treatment of existing periodontitis prior to implantation
Consistent oral hygiene at home
regular professional dental cleanings
close follow-up care after the procedure

Conclusion for smokers considering dental implants

Smoking increases the risk of complications related to dental implants, but does not necessarily preclude implant treatment. Proper preparation, careful oral hygiene, and regular follow-up care contribute significantly to the long-term success of treatment. Those who reduce their tobacco use before and after implantation—or quit smoking entirely—improve the conditions for successful healing and can significantly lower the risk of peri-implantitis and implant loss.

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