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Smoking, diabetes and implant results

Smokers have about twice the implant failure rate of non-smokers in pooled studies. People with diabetes had failure rates similar to people without it, with slightly more bone loss; control of the disease matters.

Smoking

A 2015 meta-analysis by Chrcanovic and colleagues pooled 107 studies comparing implants in smokers and non-smokers.1 The search ran to September 2014 and screened 1,432 publications.1

GroupImplantsFailuresFailure rate
Smokers19,8361,2596.35 percent
Non-smokers60,4641,9233.18 percent

Smoking also increased the risk of infection after surgery and the amount of bone loss around implants.1 The authors advised caution because the included studies had uncontrolled confounding factors.1

The FDA states that smoking may affect healing and decrease long-term success.2 The ADA states that tobacco use can slow healing.3 The AAP lists smoking as a risk factor for peri-implant disease.4

Diabetes

A 2016 meta-analysis by Moraschini and colleagues pooled 14 studies, published from 2000 to 2015, comparing people with and without diabetes.5 The authors rated all included studies as high quality.5

  • The number of implant failures did not differ between people with and without diabetes.5
  • Failures did not differ between type 1 and type 2 diabetes.5
  • Bone loss around implants was greater in people with diabetes.5

The FDA lists infection-related implant failure as a risk, particularly with uncontrolled diabetes.2 The ADA states that chronic illnesses such as diabetes may interfere with healing after surgery.3 The AAP lists diabetes as a risk factor for peri-implant disease.4

What this means for planning

The ADA notes that a physician evaluation may be needed before surgery.3

Questions to ask

  • How smoking or vaping changes the plan and the healing time.
  • Whether recent blood sugar results (such as HbA1c) are needed before surgery.
  • How often maintenance visits should be scheduled.

General information about dental implants. Treatment decisions are made with a licensed dentist.

Sources

  1. Chrcanovic BR et al. Smoking and dental implants: systematic review and meta-analysis. J Dent 2015. pubmed.ncbi.nlm.nih.gov
  2. U.S. FDA: Dental Implants, What You Should Know. fda.gov
  3. American Dental Association (MouthHealthy): Implants. mouthhealthy.org
  4. American Academy of Periodontology: Peri-Implant Diseases. perio.org
  5. Moraschini V et al. The impact of diabetes on dental implant failure: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2016. pubmed.ncbi.nlm.nih.gov

Evidence

Sourced facts

Each line links to the study or the specialty body it comes from.

  1. A meta-analysis of 107 studies found 6.35 percent failure in 19,836 implants in smokers versus 3.18 percent in 60,464 implants in non-smokers.

    Chrcanovic BR et al. Smoking and dental implants: systematic review and meta-analysis. J Dent 2015 · checked October 2, 2026

  2. Smoking also increased postoperative infection risk and marginal bone loss; the authors noted uncontrolled confounding factors.

    Chrcanovic BR et al. Smoking and dental implants: systematic review and meta-analysis. J Dent 2015 · checked October 2, 2026

  3. A meta-analysis of 14 studies found no difference in implant failures between people with and without type 1 or type 2 diabetes.

    Moraschini V et al. The impact of diabetes on dental implant failure: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2016 · checked October 2, 2026

  5. The FDA states that smoking may affect healing and decrease long-term success, and that infection-related failure is a risk with uncontrolled diabetes.

    U.S. FDA: Dental Implants, What You Should Know · checked October 2, 2026

  6. The ADA states that tobacco can slow healing and that chronic illnesses such as diabetes may interfere with healing.

    American Dental Association (MouthHealthy): Implants · checked October 2, 2026

  7. The AAP lists smoking and diabetes as risk factors for peri-implant disease.

    American Academy of Periodontology: Peri-Implant Diseases · checked October 2, 2026

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Dr. Michael Pawlus
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Dr. Michael Pawlus

Periodontist · Sarasota

ICOI Fellow, ICOI Diplomate · AAP member

Doctor page(941) 923-2288
Featured doctorDr. Michael Pawlus · Sarasota