You know the drill — avoiding tobacco and nicotine is one of the key factors for good gum health. But how do these substances affect prosthetics like dental implants, and will lifestyle habits like smoking result in implant failure?
Let’s find out.
What are dental implants?
Dental implants are a type of dental prosthesis that can help to replace a missing tooth. The process requires surgery and implantation of a titanium screw that will act as a replacement for the root of the missing tooth. Dental implant surgery is usually not uncomfortable as there will be local anaesthesia. Dental implants are permanent and made to match your natural teeth.
How long should dental implants last?
A dental implant should last you a lifetime, given that you care for it properly by regularly brushing, flossing and going for follow-up dental appointments with your dentist.
What causes dental implant failure?
The success rate of dental implants is up to 98%. Very rarely, things can go wrong.
Peri-implantitis
Peri-implantitis is an inflammation of the gums or bones around the dental implant due to bacteria and poor dental hygiene. Out of the rare complications that could occur from dental implant surgery, peri-implantitis is the most common. There will typically be swelling or pus near the implant site, causing bone loss and implant failure. Smokers are at higher risk of getting infections around the dental implant.
Failed osseointegration
There could also be failed osseointegration where the dental implant becomes loose and falls out of place. Osseointegration is the process of forming a fusion between the bone and the titanium implant; this process is integral for your implants to work. Osseointegration takes place over several months after your procedure. Sometimes, the jawbone may fail to fuse with the implant, causing implant failure. This may happen if you do not have enough jawbone volume or density.
Overloading
There are also instances where dental implants become overloaded by excessive pressure. Such forces may cause the failure of the implant to osseointegrate. If you tend to grind your teeth, you may find yourself with such a problem — consider getting a mouthguard from your dentist!
Nerve and tissue damage
This is a rare problem where the implant is placed too close to the nerves, causing chronic pain, numbness and tingling at the implant site. The nerve damage may be permanent or temporary, and the implant may need to be replaced.
Sinus inflammation or infection
Sinus inflammation may occur in those who use dental implants to replace teeth from the upper jaw. When the implant protrudes into the sinus cavity, the area can become inflamed or infected.
What happens if you smoke with dental implants?
Time and again, the literature shows that tobacco use is associated with increased implant failure. A 2012 study revealed that smoking increases the incidence of peri-implantitis, and heavy smokers (>14 cigarettes a day) experience the greatest marginal bone loss around their implants.
Why is this so?
Cigarette smoke can damage or block salivary glands in the mouth, leading to dryness which can result in tooth decay and gum disease. This weakens the bones and gums supporting the implants.
Nicotine in cigarettes also restricts the flow of blood and oxygen to the bones and oral tissues, impeding the healing process. All these impacts the osseointegration process, which as earlier mentioned is crucial in dental implant success.
Why can’t you drink alcohol after dental surgery?
Dental implants are most vulnerable within the first 72 hours after implantation surgery. This is because the body needs to rebuild tissue, bone cells and blood vessels for osseointegration. Alcohol may very well disrupt this healing process, thereby delaying recovery or worse – causing dental implant failure.
Alcohol also has a dehydrating effect on the body, and dehydration of the oral cavity will impede proper healing of the oral tissues, and lead to increased sensitivity.
Moreover, alcohol may cause vessels and capillaries in the gums to dilate, increasing the amount of pain and tenderness experienced.
Something even more terrifying is that alcohol increases fat content in the blood, which can cause the formation of clots in the jaw and complicate surgery.
After the initial healing phase, you may be able to have an occasional glass or two but remember that excessive alcohol consumption disrupts blood supply and can cause dental implant failure. So, be sure not to take too many of those shots. We’re not saying you can’t; the idea is to do it in moderation.
What should I do or not do to prevent dental implant failure?
Dos
- Eat soft foods
- Yoghurt
- Milkshake
- Smoothies
- Ice cream
- Pudding
- Mashed potatoes
- Soup
- Drink more water
- Apply ice if there is swelling in the first 24 hours
- Visit the dentist every 6 months
Don'ts
- Don’t drink alcohol excessively
After the dental implant procedure, do not drink alcohol for the next 72 hours while the body is healing and recovering. You may drink in moderation thereafter.
- Don’t smoke
It is recommended to quit smoking at least one to two weeks before the dental implant procedure. After the procedure, it is advisable not to smoke within 72 hours to prevent blood clots from loosening, causing a painful condition known as dry socket. And, it is best to wait 2 - 3 months before smoking regularly again. This is so that osseointegration is allowed to take place.
- Don’t rinse your mouth on the day of surgery
You may rinse your mouth gently with saltwater 48 hours after surgery.
- Don’t brush your implant on the day of surgery
You may brush around the implant first, avoiding the surgical site. After a few days, you may begin to carefully clean the area with a toothbrush.
- Don’t eat hard or sticky foods
- Don’t use straws
How do I know if my dental implant has failed?
The first sign of a dental implant failure would be mobility. If the bone around the implant doesn’t grow properly, the dental implant may start to loosen and move around, especially when chewing or talking. Other signs of dental implant failure include pain, swelling or infection, though they don’t happen in all cases.
What can be done if my dental implant fails?
A failed dental implant can be easily removed with local anaesthesia. The dentist will take out the implant and clean the area. If the bone around the implant site is intact, a bone graft will not be necessary. If there is bone loss, there may be a new bone graft to improve the site for replacement of the implant. Healing from the bone graft may take several months before it is ready for a new implant.
You may wish to talk to your dentist about why the first implant failed, and how to prevent the failure of this replacement implant.
Conclusion
Dental implants are a big commitment. You have to be really careful with it if you want the healing and osseointegration process to be successful. If you are not sure how you can take care of your implant, your dentist will provide you with detailed instructions on proper dental care techniques. The best way to avoid failure of your dental implants is to listen to the advice of your dentist, drink plenty of water and avoid smoking or drinking – at least during the recommend stipulated time! If anything feels amiss, contact your dentist immediately. Your dentist will always be there to help you, regardless of whether your dental implant has failed.
References
- Twito, D., & Sade, P. (2014). The effect of cigarette smoking habits on the outcome of dental implant treatment. PeerJ, 2, e546.
- Alissa, R., & Oliver, R. J. (2012). Influence of prognostic risk indicators on osseointegrated dental implant failure: a matched case-control analysis. Journal of Oral Implantology, 38(1), 51-61.
- Annibali, S., Ripari, M., LA Monaca, G., Tonoli, F., & Cristalli, M. P. (2008). Local complications in dental implant surgery: prevention and treatment. ORAL & implantology, 1(1), 21–33.