Who Can Get Dental Implants? Smoking, Diabetes, Bone and Age

This page is general information and does not replace an examination.

Who can get dental implants? The candidacy checklist

A dental implant needs three things: enough healthy bone to hold it, healthy gums around it, and a body that heals well. Most of the questions on this page come down to one of those three. Very few conditions rule implants out completely; many only mean that something has to be treated or brought under control first.

Sources as cited per cell; “What we do” = Ulubey Dental Clinic protocol. You may cite this table with a link to this page.

Can smokers get dental implants?

Smoking does not automatically rule out implants, but it is one of the clearest risks. A meta-analysis of 107 studies found implant failure in 6.35% of implants placed in smokers versus 3.18% in non-smokers, with more postoperative infections and more bone loss around the implant^[1]. A 2026 systematic review of 44 studies again found lower implant survival and 0.64 mm more bone loss in cigarette smokers. It concluded that smoking is not an absolute contraindication, but that help to stop smoking should always be part of the treatment plan^[2].

• Before surgery: stop as early as possible, ideally at least 4 weeks before. In general surgery, stopping at least 3–4 weeks before reduced wound-healing complications^[3].
• If you cannot stop: cut down as much as possible; we ask for no more than 6–8 cigarettes a day. This is a fallback, not a safe level.
• After surgery: no smoking for at least 1 week, until the wound has closed; for implants and bone grafts, longer is better.

The 2026 review found too little data on smoke-free products to judge their risk^[2]. What to expect after surgery is covered in our dental implant aftercare guide.

Can you get implants with diabetes? Our HbA1c rules

People with diabetes can have implants, as long as blood sugar is well controlled. A systematic review of 22 clinical studies concluded that patients with poorly controlled diabetes have impaired osseointegration, a higher risk of peri-implantitis and more implant failures, while implant procedures in well-controlled diabetes are safe and predictable, with a complication rate similar to healthy patients^[4].

The test that shows control is HbA1c. Our rules are strict:

• Preferred: HbA1c below 6.8% (about 51 mmol/mol).
• If it is higher: we treat a diabetic patient after HbA1c has been brought down to about 6.4% (about 46 mmol/mol) and followed for 3 months, together with your physician and with rules for the treatment period.
• Never above 7.0% (about 53 mmol/mol): we do not place implants above this value.

We test HbA1c before every implant patient, not only those who know they have diabetes. These routine tests have often revealed a high HbA1c the patient did not know about. If you know you have diabetes, bring your latest HbA1c result and your medicine list when you send your X-ray. The link between diabetes and gum health is explained in our guide to oral health and medical conditions.

Gum disease and dental implants

Gum disease and implants are closely linked. The 2017 World Workshop review on peri-implantitis found strong evidence that a history of chronic periodontitis, poor plaque control and no regular maintenance after implant therapy increase the risk of peri-implantitis, the inflammation and bone loss that can affect implants^[5].

That does not mean people who lost teeth to gum disease cannot have implants. It means the gum disease has to be treated and under control first, and that cleaning at home and regular check-ups are part of the plan from day one. The dentist decides at the examination what treatment is needed before implant surgery. After the implant has healed, we recommend a water flosser, interdental brushes or floss, and your toothbrush, and we show you how to use them on your own implants.

Our professional teeth cleaning page describes the cleaning we provide.

Not enough bone? Grafting, sinus lift and other options

After a tooth is lost, the jawbone in that area shrinks over time. Bone loss is one of the most common reasons people are told they “cannot have implants”, but in many cases it can be managed.

• Bone grafting: bone graft material is added where the bone is too thin; when needed, a block graft is also done. Non-porcine graft and membrane options are available on request, chosen by the dentist.
• Socket preservation: when a tooth is extracted and an implant is planned later, a graft can be placed in the socket at the same visit.
• Sinus lift: in the upper back jaw, a closed or open sinus lift creates room for the implant. See sinus lift in Antalya.
• Mini implants: used rarely, only when needed, for example in older patients with thin bone where advanced surgery should be avoided.

Grafting adds time: healing before the final crown takes about 3 months for a standard implant and about 6 months on average with bone grafting or an open sinus lift. Whether you need a graft is decided from the X-rays and, when needed, a CBCT scan.

Is there an age limit for dental implants?

There is no upper age limit for implants. A systematic review of 60 studies on implants in geriatric patients found a pooled post-loading implant survival of 97.3% after 1 year (96.1% after 5 years) in patients aged 75 and over, and concluded that implant prostheses in older people are a predictable treatment with a very high rate of implant survival^[6]. The same review found that implant survival may be similar or higher in patients with cardiovascular disease, and high in patients with type 2 diabetes or Parkinson’s disease^[6].

What changes with age is usually the medicine list and general health, not the bone’s ability to heal. That is why we look at the whole medical history. For young people, implants are placed only after the dentist has checked that jaw growth has finished^[11].

Medicines and medical conditions that affect implants

Bone-strengthening medicines (bisphosphonates, denosumab)

These medicines treat osteoporosis and some cancers. They carry a rare risk of medication-related osteonecrosis of the jaw (MRONJ), in which jawbone becomes exposed. For osteoporosis, SDCEP puts the risk between 1 in 1,000 and 1 in 10,000; the risk rises when treatment affects bone, such as an extraction or implants, but is still considered low^[7]. For anti-resorptive drugs taken for cancer, the risk is typically less than 1 in 20^[8]. The geriatric review likewise found high implant survival with low-dose therapy for osteoporosis, but a high risk of complications after implant surgery with high-dose therapy for bone metastases^[6].

Our rule: patients taking bisphosphonates are referred to their own physician first. If the bisphosphonate was given by injection (intravenously), we do no oral surgery for up to 5 years. Do not stop a bone medicine on your own; SDCEP advises continuing it, because the benefits usually far outweigh the risks^[7].

Blood thinners

Anticoagulant and antiplatelet medicines help prevent dangerous clots but make you bleed more easily^[9]. Do not change them for dental treatment unless told to by your doctor or dentist^[9]. Before surgery we consult the physician who prescribed the medicine and act after their approval; the physician permits the surgery or adjusts the medication if needed.

Heart conditions

The American Heart Association recommends antibiotic cover before certain dental procedures only for the patients at highest risk of infective endocarditis^[10]. If you are one of them, tell us: patients who need prophylaxis receive a preventive antibiotic before the procedure.

Cancer treatment and radiotherapy

The geriatric review found that implant survival is negatively affected in patients with cancer, mainly by radiotherapy^[6]. If you have had radiotherapy to the head or neck, or are on cancer medicines, tell us: the dentist decides together with your treating physician whether implant surgery is appropriate, and implants may not be the right choice.

Pregnancy

During pregnancy we only do urgent work, in the second trimester, approved by your physician. Definitive treatment, including implants, is postponed until after the birth.

When implants are not the right choice

An honest assessment sometimes ends with “not now” or “not implants”. At our clinic, implants are not the right choice, or not yet, when:

• HbA1c is above 7.0%: diabetes control comes first;
• you had intravenous bisphosphonates within the last 5 years;
• you are pregnant: implants wait until after the birth;
• active gum disease has not yet been treated;
• your physician does not approve the surgery, for example because of blood-thinner or heart treatment;
• head and neck radiotherapy or cancer treatment makes the risk too high, as decided with your treating physician;
• you smoke heavily and cannot cut down: implants remain possible, but the risk is higher^[1][2], and we explain it before you decide.

Other ways to replace teeth exist. Our guides implant vs bridge and implants vs dentures compare them. A Maryland (adhesive) bridge is used only when really necessary and suits patients who live nearby, because it can come loose.

How we assess candidacy at Ulubey Dental Clinic

• Both doctors, no rotating dentists: Dr. Ali Cem Ulubey and Dr. Surur Ulubey examine and treat patients themselves.
• X-rays: a panoramic X-ray for every patient; a CBCT scan when the case needs a 3D view of the bone.
• Routine blood tests before every implant patient: complete blood count, biochemistry, HbA1c, fasting glucose, vitamin D and calcium.
• Medical history: medicines, allergies, heart conditions, bone medicines and blood thinners; we contact your physician when needed.
• Written plan: send your X-ray and photos on WhatsApp; a written quote usually follows within 24 hours. The final plan is confirmed after the examination.

For implant options, brands and costs, see dental implants in Antalya and the single implant cost calculator.

Frequently asked questions