4th March 2020
The impact of smoking on dental implant procedures
It is well documented that smoking impairs the healing process of a dental implant procedure. Rapid repair is the best outcome for patients and for implantologists who have a duty of care to ensure each patient is guided safely through the ‘risk of infection’ period. Those who insist on smoking are at greater risk of infection due to the delay it causes in wound healing. In fact, smokers heal at a third of the rate of non-smokers and therefore have three times as many infections. This could affect the success rate of the implant as well as putting additional pressure on dental professionals to be vigilant with the aftercare of their patient. Here are some of the reasons smoking is discouraged when it comes to dental implant procedures.
Reduced blood flow
The carbon monoxide that is inhaled when smoking restricts the blood supply to the body’s tissue, preventing adequate amounts of oxygen from reaching the wound. Oxygen is critical to the healing process and if restricted, can impair its progress. This leaves the patient open to infection for a longer period of time, putting them at a higher risk following a dental implant procedure. If an infected implant is not treated right away, it can lead to peri-implantitis and the implant may fail.
Nicotine causes increased inflammation throughout the body. This is because it activates the white blood cells called neutrophils, usually released when an infection is detected. Smoking has been shown to elevate your neutrophil count without an underlying reason, leading to excessive inflammation. Whilst inflammation is essential to the repairing of damaged tissue, the release of these extra neutrophils causes your body to fight unnecessarily, putting it under additional stress. This can delay wound healing and tissue regeneration following a dental implant, which could potentially lead to complications.
Inhibited fibroblast function
Fibroblasts are critical to wound healing; their role being to secrete ECM proteins which reduces the size of the wound through tissue repair, eventually closing it. Cigarette smoke has been shown to impair the fibroblasts’ ability to move into the wounded area, causing them to bunch around the edge of the wound, significantly delaying the healing process as well as increasing chances of scarring.
What should I do if I have an implant patient that smokes?
If a smoker comes to you for implant treatment, it is critical that they understand the risks involved ahead of the procedure and the likelihood that the implant could fail. If they would still like to go ahead with the treatment, they must be willing to accept the increased risks and take on the responsibility of exceptional oral health care following the procedure. Even better, your patient could choose to give up smoking for a better chance of success.