Smoking, Vaping and Their Effect on Dental Implants: What You Need to Know

Dental implants have become a reliable and long-lasting solution for replacing missing teeth. They restore function, protect surrounding bone, and improve confidence in everyday life. However, lifestyle choices—particularly smoking and vaping—can significantly affect how well implants heal and how long they last. At our practice in Worthing, we often receive questions from patients about whether smoking or e-cigarette use impacts implant treatment outcomes.

In this article, we will review how both smoking and vaping affect oral health, explain the risks for implant patients, and outline steps you can take to improve success rates.

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How Dental Implants Heal

A dental implant is a small titanium post surgically placed into the jawbone. Over a period of several months, the bone fuses with the implant surface in a process called osseointegration. For this to succeed, healthy blood flow, bone quality, and gum healing are crucial.

Any factor that reduces oxygen supply, slows healing, or increases the risk of infection can jeopardise implant success. Smoking—and, increasingly, vaping—are two such risk factors.

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Smoking and Dental Implant Failure

Cigarette smoke contains thousands of harmful chemicals, including nicotine, carbon monoxide, and tar. These affect implant healing in several ways:

• Reduced blood flow: Nicotine causes blood vessels to constrict, limiting oxygen delivery to the tissues around the implant. This slows down osseointegration (Bain & Moy, 1993).
• Increased risk of infection: Smoking impairs immune function, making gum tissues more vulnerable to peri-implantitis, a destructive inflammation around implants (Heitz-Mayfield, 2008).
• Bone loss: Long-term smoking is linked to greater marginal bone loss around implants, compromising stability (Hinode et al., 2006).

Studies consistently show that implant failure rates are higher in smokers compared with non-smokers. For example, one review found that smokers are nearly twice as likely to experience implant failure (Chrcanovic et al., 2015).

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What About Vaping?

Vaping is often marketed as a “safer” alternative to smoking. While e-cigarettes contain fewer carcinogens than tobacco, they still deliver nicotine and other substances that may affect implant healing.

• Nicotine in e-liquids: Just like smoking, vaping restricts blood flow to gum tissues. This can delay wound healing after implant surgery.
• Heat and chemicals: Vapourised propylene glycol and glycerine can cause dry mouth, reducing saliva’s protective effect against bacteria (Fraser et al., 2020).
• Inflammatory response: Emerging studies show vaping increases oxidative stress and inflammation in gum tissues, similar to smoking (Cichońska et al., 2019).

Although long-term research is limited, early evidence suggests vaping may still increase the risk of implant complications—though possibly to a lesser degree than smoking.

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Peri-Implantitis: A Major Concern

One of the most significant complications related to smoking and vaping is peri-implantitis. This condition involves inflammation of the gums and bone around the implant, leading to progressive bone loss and potential implant failure.

Both smoking and vaping appear to increase susceptibility by altering the oral microbiome, reducing healing capacity, and impairing the body’s natural defence against bacteria (Heitz-Mayfield & Salvi, 2018). Once peri-implantitis develops, treatment becomes complex and outcomes are less predictable.

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Improving Success Rates

If you are considering dental implants and you smoke or vape, it is important not to lose hope. Many patients in Worthing, Brighton, and across Sussex who smoke still benefit from implants—provided they take certain steps:

1. Quit if possible: Stopping smoking (or vaping) before surgery significantly improves outcomes. Even short-term cessation of 1–2 weeks pre-surgery and up to 8 weeks post-surgery reduces complications (Clarke et al., 2012).
2. Cut down gradually: If quitting altogether is difficult, reducing daily use can help improve blood flow and healing.
3. Optimise oral hygiene: Regular brushing, flossing, and professional cleaning reduce bacterial load around implants.
4. Attend maintenance visits: Implants require regular check-ups and hygiene visits to monitor gum health and prevent peri-implantitis.
5. Consider nicotine replacement: Patches or gum may support healing better than smoking or vaping, as they avoid heat and toxic by-products.

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Our Practice Approach

At the Clinic for Implant & Orthodontic Dentistry in Worthing, we take a personalised approach. Before recommending implants, we carefully review your medical history, smoking or vaping habits, and oral health status.

For patients who smoke or vape, we provide tailored advice on risk reduction, work closely with hygienists to support gum health, and offer regular monitoring after implant placement. With careful planning and maintenance, many patients still achieve excellent long-term outcomes.

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Conclusion

Smoking and vaping both negatively impact dental implant success, mainly by reducing healing capacity and increasing the risk of peri-implantitis. While vaping may be less harmful than traditional smoking, it is not risk-free.

If you are considering implants, the best step you can take is to quit smoking or vaping entirely. If that is not possible, reducing use and committing to excellent oral hygiene and regular check-ups can still improve outcomes.

At our Worthing practice, we are here to help guide you through every step of your implant journey and support you in achieving a healthy, confident smile.

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References

• Bain, C.A. & Moy, P.K. (1993). The association between the failure of dental implants and cigarette smoking. International Journal of Oral and Maxillofacial Implants, 8(6), 609–615.
• Chrcanovic, B.R., Albrektsson, T. & Wennerberg, A. (2015). Smoking and dental implants: A systematic review and meta-analysis. Journal of Dentistry, 43(5), 487–498.
• Cichońska, D. et al. (2019). The impact of e-cigarettes on oral health – a narrative review. Oral Health and Dental Management, 18(1), 1–8.
• Clarke, N.G. et al. (2012). Influence of smoking on oral wound healing: A review. Journal of Dental Research, 91(2), 119–123.
• Fraser, T., McCullough, M. & Gordon, C. (2020). E-cigarettes and oral health: A scoping review. Tobacco Induced Diseases, 18, 89.
• Heitz-Mayfield, L.J.A. (2008). Peri-implant diseases: Diagnosis and risk indicators. Journal of Clinical Periodontology, 35(Suppl 8), 292–304.
• Heitz-Mayfield, L.J.A. & Salvi, G.E. (2018). Peri-implant mucositis and peri-implantitis: A current understanding of their diagnoses and clinical implications. Journal of Periodontology, 89(Suppl 1), S257–S262.
• Hinode, D., Tanabe, S., Yokoyama, M. & Fujisawa, K. (2006). Influence of smoking on osseointegrated implant failure. International Journal of Oral and Maxillofacial Implants, 21(2), 294–299.