Smoking is the single largest modifiable risk factor in implant treatment, and the numbers are stark enough that it is worth stating them plainly rather than gently.
What the evidence shows
Implant failure rates in smokers are consistently reported at roughly double those in non-smokers. Peri-implantitis is substantially more common, and bone loss around implants progresses faster.
Complications after bone grafting and sinus elevation are also markedly more frequent, which matters because smokers more often need those procedures.
Why it happens
Nicotine reduces blood flow to the tissues, and the combustion products impair the immune response and the cells responsible for bone formation.
The effect is on healing rather than on the surgery itself. The implant goes in identically. What differs is what the body does with it over the following months.
What stopping actually achieves
Stopping before surgery and remaining off for the healing period improves outcomes measurably. The commonly used protocol is one week before and eight weeks after, and even that window makes a documented difference.
Long-term cessation is better still, but the point worth making is that a limited period of abstinence around the surgery is worthwhile in its own right.
How we handle it
We do not refuse to treat smokers, and we do not lecture. What we do is state the failure rates honestly, put them in the treatment plan, and discuss whether a design that is easier to maintain and clean makes sense.
Vaping is not an established safe substitute in this context. The evidence is thinner and what exists is not reassuring.
If you smoke, say so and discuss the timing rather than avoiding the subject. A planned period of abstinence around surgery is one of the few things that measurably shifts the odds in your favour.
Questions about your own case? Send us your photos and we will walk you through the options.
