Part of the Dental Implants guide
Most adults who are missing teeth can have dental implants eventually, but not always straight away. This guide explains what a periodontist checks before recommending an implant, and how common obstacles are handled.
01
The three things an implant needs
The American Academy of Periodontology describes the ideal implant candidate as someone who:
- Is in good general and oral health
- Has adequate bone in the jaw to support the implant
- Has healthy gum tissue that is free of periodontal disease
“Ideal” is the key word. Many patients who do not meet all three at first become good candidates once the underlying issue is treated. The sections below explain each factor and what can be done about it.
02
General health
Placing an implant is a minor surgical procedure, and the bone must then heal around it. Conditions and medications that affect healing, bone metabolism, or the immune system are reviewed carefully. Sterling's implant guidance notes that certain conditions, such as active gum disease, uncontrolled diabetes, and current chemotherapy, may need to be addressed before implants are placed.
Diabetes
Well-controlled diabetes does not rule out implants, but blood sugar control matters for healing and for gum health. According to the CDC, about 60% of U.S. adults aged 30 or older living with diabetes had periodontitis in 2009–2014, so the gums are checked closely before implant planning.
Smoking
Smoking impairs healing and is a major risk factor for gum disease: about 62% of U.S. adults aged 30 or older who smoked had periodontitis in 2009–2014, according to the CDC. Your periodontist will discuss how smoking affects your implant plan.
03
Bone volume
After a tooth is lost, the jawbone in that area gradually shrinks, and gum disease may already have reduced it. Imaging shows whether there is enough height and width of bone to hold an implant securely. In the upper back jaw, the sinus can also limit the space available.
Not having enough bone is one of the most common reasons an implant cannot be placed straight away, and also one of the most solvable. Bone grafting or a sinus lift can rebuild the site, sometimes at the same visit as the implant and sometimes as a separate stage. For some patients with limited bone, mini implants or an All-on-4 design that uses existing bone may be options. See dental bone graft cost and All-on-4 vs. individual implants.
04
Gum health
Active periodontitis should be treated before implants are placed. The same inflammatory process that destroys bone around teeth can affect the bone around implants, a condition called peri-implantitis. The AAP notes that implants need the same conscientious home care and regular dental visits as natural teeth to prevent peri-implant disease.
A history of gum disease does not prevent implants, but it does make maintenance more important. That is one reason many patients have implants placed by a periodontist, who treats both. Learn more in the periodontal disease guide.
Age
There is no upper age limit for implants. What matters is health, bone, and the ability to care for them. Implants are generally placed only after the jaw has finished growing.
05
How candidacy is decided
A consultation combines your health history, an examination of the gums and remaining teeth, your bite, and imaging. Three-dimensional imaging helps assess bone volume and plan implant position. The result is a written plan that sets out whether implants are suitable, what preparation is needed, alternatives such as a bridge or denture, and the cost of each stage.
“Your first visit is a conversation, not a procedure. We send your plan in writing after, so you can think it over at home.”
Read the complete dental implants guide or the implant timeline. To book an evaluation with Dr. Mohamed Khaled in Beverly Hills, call (310) 278-3666 or request a consultation.
06
Frequently Asked Questions
Can I get implants if I have bone loss?
Often, yes. Bone grafting or a sinus lift can rebuild the site, and some full-arch designs make use of the bone that remains. Imaging at your consultation shows what is possible.
Am I too old for dental implants?
There is no upper age limit. Suitability depends on general health, bone, gum health, and the ability to care for the implants.
Can I have implants if I have diabetes?
Many people with well-controlled diabetes have implants. Blood sugar control affects healing and gum health, so your periodontist will discuss it with you and, where appropriate, your physician.
I had gum disease. Can I still get implants?
Yes, once active disease is treated. A history of periodontitis makes regular maintenance especially important to protect the implants.
Does smoking prevent dental implants?
It does not automatically rule them out, but smoking impairs healing and raises the risk of gum disease. Your periodontist will explain how it affects your plan.
Sources
- American Academy of Periodontology: Dental implant procedures www.perio.org/for-patients/periodontal-treatments-and-procedures/dental-implant-procedures/
- American Academy of Periodontology: Peri-implant diseases www.perio.org/for-patients/periodontal-treatments-and-procedures/dental-implant-procedures/peri-implant-diseases/
- CDC: About Periodontal (Gum) Disease www.cdc.gov/oral-health/about/gum-periodontal-disease.html
This article is general education and does not replace a diagnosis or individualized treatment advice.
