Getting an implant to start out stable is a mechanical problem. We wrote about the guideline we use for that in the five-thread rule.
What happens next is biology. Over the next few months, bone has to grow onto the implant, and then hold it while you chew, every day, for decades. That’s a significant ask of the body: heal, and then carry sustained load. So one of the first things we think about is a simple question: are you a good healer?
An implant asks your body to do two hard things: heal around it, and then carry load for decades.
What affects healing
Your health is part of the plan, not a footnote to it:
- Smoking. It’s one of the clearest risk factors. A 2021 review of more than 150,000 implants found that implants in smokers were about twice as likely to fail, with more bone loss around them. We don’t place implants for active smokers, because we don’t think it’s in your best interest.
- Diabetes. Well-controlled diabetes isn’t a reason to rule out an implant: in a 2022 review, success rates under good control were similar to those of healthy patients. Poorly controlled blood sugar is different. It was linked to more inflammation in the gum and bone around implants, and to more implants lost over time.
- Vitamin D. Your body uses it to build and remodel bone. Some studies have linked low levels to early implant failures, but a 2022 review called the evidence inconsistent, so it’s one piece of the picture, not the whole story. If a doctor has told you your levels are low, tell us.
- Diet. Healing takes raw materials. Eating well, with enough protein, gives your body what it needs to build bone around the implant.
- Your overall health and medications. Some conditions and medicines, including certain bone medications and radiation to the head and neck, change how bone heals.
- Your track record. If you’ve healed slowly after past procedures, that’s worth telling us.
Apart from smoking, most of these don’t rule an implant out on their own. They change the plan, the timing, and sometimes the order of things.
How we help
We can’t change your biology, but we can do a lot to give it the best chance.
- We start with your health history. Before we plan anything, we go through your conditions, medications and habits, because they shape what we recommend and when.
- We plan for the bone you have. A 3D scan shows whether there’s enough bone for a stable start. When there isn’t, we rebuild the site with a bone graft first and give it time to heal.
- Amoxicillin before surgery. Before implant placement, we have patients take amoxicillin, an antibiotic. This step has real evidence behind it: a Cochrane review of six randomized trials, with more than 1,100 patients, found that a single dose taken about an hour before surgery reduced early implant failures, with roughly one early failure avoided for every 25 patients treated. If you’re allergic to penicillin, tell us and we’ll plan around it.
- StellaLife for recovery. After surgery we use StellaLife, a line of oral recovery products made for the mouth as it heals, with ingredients that include calendula, arnica and echinacea. We don’t prescribe chlorhexidine, the classic post-surgery rinse: it can stain teeth, and in lab studies it’s harder on the cells that heal a wound. In those lab studies, StellaLife was gentler on them.
- We measure before we load. An instrument reads how firmly the implant is held, so it takes a tooth when your healing says it’s ready, not when the calendar does.
An honest note on StellaLife.
It’s a homeopathic product, and the research on it is early. A small pilot study of 34 bone-graft patients found lower average pain scores in the group using it than in a group given routine opioids, and one office’s records showed far fewer opioid prescriptions after it started using it. There are no large controlled trials yet, so we use it for comfort, alongside a solid plan, not in place of one.
What you can do
- Tell us everything about your health, including medications and supplements.
- If you smoke, quitting comes first.
- If you have diabetes, work on keeping it well controlled, and tell us how it’s going.
- Eat well while you heal, and follow the aftercare instructions we give you.
- Tell us early if something doesn’t feel right. We would much rather see you sooner than later.
So
An implant is a partnership between good engineering and good healing. We handle the plan, the parts and the precautions, and your body does the healing. The diagnosis makes the treatment plan, and your health is part of the diagnosis.