If you smoke or vape and you are thinking about dental implants, you probably have one big question: will it still work for me? A 2025 research review looked closely at that question. It compared people who smoked cigarettes, people who used a waterpipe, people who used e-cigarettes, and people who did not smoke at all, and it measured what was happening around their dental implants. The results give Folsom patients a clearer picture than a simple yes or no.
What the Researchers Did
This was not a single small study. It was a systematic review and meta-analysis, which means the researchers gathered earlier studies, checked them against strict rules, and combined their results. They searched the MEDLINE database for studies published from October 2015 through October 2025, looking only at adults who had dental implants. By pooling the evidence this way, they could compare smoking habits side by side using the same measures: plaque buildup, bone loss around the implant, bleeding when the gum was probed, and markers of inflammation in the fluid around the implant.
More Plaque Around Implants
One of the clearest findings was about plaque, the sticky film of bacteria that builds up on teeth and implants. Compared with non-smokers, plaque index scores were higher in every smoking group. Cigarette smokers averaged 5.22 units higher, waterpipe users averaged 6.31 units higher, and e-cigarette users averaged 1.61 units higher. In plain terms, more plaque was collecting around the implants of people who smoked or vaped. That matters because plaque is the starting point for gum inflammation, and around an implant, inflammation can damage the tissues that hold the implant steady.
More Bone Loss Over Time
The review also measured marginal bone loss, which is the gradual loss of bone around the top of the implant. Again, every smoking group fared worse than non-smokers. Cigarette smokers averaged 2.16 mm more bone loss, waterpipe users averaged 1.9 mm more, and e-cigarette users averaged 0.83 mm more. Even small amounts of bone loss matter, because the bone is what anchors the implant. The pattern here matched the plaque results: cigarettes showed the largest difference, followed by waterpipe, then e-cigarettes, with non-smokers in the best position.
Higher Inflammation Markers
The researchers also looked at inflammation signals in the fluid around implants. Cigarette smokers had the highest levels of interleukin-1 beta, a marker of inflammation, with a mean difference of 239.63 pg/mL compared with non-smokers. E-cigarette users also showed elevated inflammation, with interleukin-1 beta higher by 170 pg/mL and tumor necrosis factor-alpha higher by 17.6 pg/mL. These laboratory measures tell the same story as the plaque and bone findings.
A Surprising Finding About Bleeding
There was one result that might surprise you. The review found a paradoxical reduction in bleeding on probing among smokers. Bleeding when the gum is gently probed is normally a warning sign of gum disease, so less bleeding might sound like good news. In smokers, though, it is misleading. Smoking narrows blood vessels in the gums, which can hide bleeding even while inflammation and bone loss are getting worse. That means a smoker’s gums can look calmer than they really are, which is one more reason regular professional checkups matter: a trained eye and proper measurements catch problems that bleeding alone would miss.
The Risk Gradient in Plain Language
Put together, the review points to a clear risk gradient: cigarette smoking carried the highest risk, followed by waterpipe use, then e-cigarette use, with non-smokers at the lowest risk. Vaping looked less harmful than cigarettes or waterpipe on these measures, but it was still worse than not smoking at all. The researchers also noted that evidence on waterpipe use and vaping remains limited, so these comparisons should be read as the best current picture, not the final word. Future studies may sharpen the numbers as more long-term data on vaping becomes available.
What This Means for Folsom Patients
If you live in Folsom and you smoke or vape, this review does not automatically rule out dental implants. It does mean your plan should be more careful. Your dentist may recommend quitting or cutting back before and after implant surgery, extra attention to daily cleaning, and more frequent checkups so plaque and bone levels can be tracked. People who keep smoking can still receive implants, but they should go in with open eyes: the odds of plaque buildup, bone loss, and inflammation are higher, and long-term maintenance becomes even more important.
At Expert Dental Group, Dr. Leila Nikpour is a prosthodontist with more than 15 years of dentistry experience, and the practice has placed 2,500+ dental implants. Planning includes in-house 3D CBCT imaging, which gives a detailed three-dimensional view of your bone before any implant is placed. If you are considering dental implants, a consultation with a prosthodontist in Roseville can help you understand your options, your risks, and the steps that give your implants the best chance to last.
References
Bangiev L, et al. J Oral Maxillofac Res. 2025;16(4):e1. DOI: https://doi.org/10.5037/jomr.2025.16401. PubMed: https://pubmed.ncbi.nlm.nih.gov/41756536/
Frequently Asked Questions
Does smoking mean I cannot get dental implants?
No, smoking does not automatically rule out dental implants, but it does raise the risk of plaque buildup, bone loss, and inflammation around implants. Your dentist will weigh your overall health, your bone, and your smoking habits, and may recommend quitting or cutting back before treatment to improve your chances of long-term success.
Is vaping safer than smoking cigarettes for dental implants?
In this 2025 review, e-cigarette users showed smaller differences from non-smokers than cigarette or waterpipe users did, but their plaque, bone loss, and inflammation markers were still worse than those of non-smokers. Vaping is not risk-free for implants, even if it appears less harmful than cigarettes on these measures.
Why do smokers sometimes bleed less around their gums?
Smoking narrows the blood vessels in the gums, which can reduce visible bleeding even when inflammation is present. This can hide early warning signs, so smokers should not rely on bleeding alone to judge gum health and should keep up with professional examinations and measurements.
Can quitting smoking help my implants last longer?
Quitting or cutting back reduces the factors linked to implant problems in this review, including plaque and inflammation. Many dentists recommend stopping before implant surgery and staying smoke-free during healing, and a consultation can help you plan the best timing for your treatment.
How often should smokers with implants have checkups?
Smokers and vapers with implants generally benefit from more frequent professional checkups than non-smokers, so plaque, bone levels, and gum health can be monitored closely. Your dentist will suggest a schedule based on your individual risk and how your implants are responding.
Visit Expert Dental Group
Expert Dental Group is located at 5070 Foothills Blvd, Suite 2, Roseville, CA 95747. Call (916) 888-1646 to schedule a consultation. Office hours are Mon–Fri 9–6, Sat 9–1.