Ask an Expert: Implants and Nicotine Replacement Therapy

Crowns, Bridges, Dentures, Implants

Implants and Nicotine Replacement Therapy
03/19/2007

Question:

I understand that people who want to have a tooth implant procedure should not smoke because smoking affects the bone healing. Is this also the case for a former smoker who still uses nicotine replacement therapy? Will an oral surgeon refuse to place tooth implants in a patient who still uses nicotine replacement therapy?

Answer:

Nicotine has been shown to reduce blood flow to the oral cavity in smokers, and the result is a doubled failure rate for dental implants to "take". Non-smokers will have a success rate of 95-98%, while smokers have around 90% initial success. They also have a higher long-term complication rate attributed to smoking.

As far as NRT, some studies have looked at injecting nicotine (replacement, if you will) into rabbits and this had no effect on implant success at all. But since the most widely-used NRt is gum that delivers nicotine to the oral tissues, practitioners feel that cessation of nicotine products for 4 weeks prior to implant placement is probably the safest bet.

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Response by:

Julie A Holloway, DDS, MS, FACP
Associate Professor of Restorative and Prosthetic Dentistry
College of Dentistry
The Ohio State University