But Doc, I like to Smoke!
Q: I must be the world’s biggest procrastinator or maybe a good beginner but not a good “follower through”. When I’ve gone to see the dentist/hygienist I come away motivated but rarely does it last – the brushing and flossing that is. So, I always have lots of buildup on my teeth and what follows- decay.
I’ve lost many teeth and now I think it’s denture time. I’m afraid because I know lower dentures don’t work too well and I do like to eat.
When I saw the dentist, he said my teeth are done. He said I will be getting dentures. I asked about implants and he said, “Let’s see if you are healthy enough to haveimplants. Are you a smoker?” “Yes,” I said. “How many cigarettes a day,” he asked. “About a pack and a half,” I said. “Then you aren’t a candidate,” he said. “Why?” I asked.
“Smoking compromises your health,” he said. “So what?” I said. “So, healing after implants is unpredictable and the implants might not take,” he said. “If they fail, it’s expensive. If you can stop smoking for three to six months, the surgeon might say yes.” That was devastating. “I like to smoke,” I said, “Are you sure about this?” “I’m sure,” he said. “So, I’m hooped… wait, I have a friend who has implants and she smokes.” “Well, I’m telling you what’s recommended. Smoking is a no-no for implants.” Is he right?
A: Your dentist is right - smoking tobacco in quantity is a contraindication for implant surgery. Smoking can affect the body’s micro circulation which can make healing unpredictable. If there are other health concerns they may decrease the success even more dramatically.
I have a patient who enjoys smoking who had implants placed. The implants were placed because she did not want fixed bridges and committed to quit smoking. She weened herself to about three cigarettes a day for three weeks and stopped smoking until the surgery had healed.
It was not until the crown was placed did she confess to returning to her nearly one pack a day habit. An interesting side note is that one of her implants failed. Grafting was required and the same routine followed but more carefully the second time. She has three implants that appear successful. We talk about her smoking but her parting shot is always, “I’m not going to lie, I like to smoke!”
Be careful, it’s expensive to lose bone around an implant, to say nothing of the frustration for you and your implant surgeon. If you can quit for at least three weeks before surgery and through the next three months, you increase your chances of success dramatically.
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Based on actual patient cases
Calvin Ross Crapo