Dental Implants and Diabetes
Be it from an injury to the mouth, tooth decay, genetics, or old age, there are a variety of ways a person could experience tooth loss during their life. Dental bridges or dentures have historically been used to replace lost teeth but thanks to advancements in modern dental technology, dental implants are rapidly becoming a popular restoration option patients are turning to.
Age is not an issue in determining a person’s candidacy for dental implants, but should the person have underlying medical conditions, like diabetes, other factors must be considered to determine if the procedure is appropriate. The focus of this article will be on how diabetes impacts a person’s candidacy for dental implants. First, we will start with a brief overview of what dental implants are.
What Are Dental Implants?
Edentulous patients have long turned to dental bridges or dentures to replace missing teeth. However, because dental bridges attach to other teeth and dentures simply rest on the gums, both options are prone to appearance, functionality, and comfort issues. Additionally, patients employing these systems often report irritation, inflammation, and are at higher risk of developing infections or periodontal disease.
A modern alternative to dental bridges and dentures that avoids many of their pitfalls, dental implants have been used since the 1960s in the United States to replace lost teeth. By surgically placing dental implants directly into the jawbone, the small metal posts create a stronger, sturdier foundation for mounting restorative crowns. Unlike dental bridges or dentures that often inhibit the wearer from talking and eating normally, the stability and strength of dental implants allow the patient to live life without limitation.
Because the procedure for obtaining dental implants is surgical in nature, may require multiple visits to the dentist or oral surgeon, and takes time to heal, the process takes several months from start to completion. The majority of this time will be spent healing during which, the dental implant and jawbone fuse together. This fusion process is called osseointegration and is vital to the stability and success of the implant. Everyone heals differently so the time required will vary person to person.
Can Diabetics Safely Get Dental Implants?
Those with Type 1 or Type 2 diabetes that are considering getting dental implants are often concerned whether the system will have a positive or negative effect on their health. Although the disease does not outright exclude someone from undergoing the procedure, how well their diabetes is controlled and how well they adhere to pre- and post-surgery instructions will impact the success of the treatment. As a general rule of thumb, patients whose diabetes is uncontrolled are not suitable candidates for dental implants but for those with well controlled diabetes, the treatment is suitable.
When diabetes is uncontrolled, dental implants have a higher likelihood of failure because the time needed for the implants to properly heal is affected and can increase the patient’s risk of developing an infection. Most often, periodontal (gum) infections develop which can further increase the risk of other complications or implant failure.
Considerations for Diabetics Evaluating Dental Implants
There are several things that diabetics should be consider when determining if dental implants are suitable:
- Type 1 vs. Type 2 Diabetes: Type 1 diabetes tends to be more difficult to control compared to Type 2. Because of this, patients with Type 1 diabetes have a higher risk of complication and implant failure. While Type 1 patients are not automatically excluded from dental implant candidacy, their oral surgeon will conduct a more thorough assessment of the patient’s overall health, review medical, dental, and infection records, and discuss the patient’s previous history related to healing/recovery.
- How Long with Disease: While age is typically not prohibitive when considering dental implants, for diabetics it is more of a factor than usual. The longer someone has diabetes, the longer it will take for them to heal and they will have a higher their risk of developing an infection. Because of this, patients with diabetes that are thinking about dental implants, should act soon rather than delay treatment.
- If Diabetes is Well Controlled or Not: Multiple studies have indicated that patients with well-controlled diabetes have no higher risk of complication or implant failure than non-diabetic patients. The same studies also show that patients whose diabetes is uncontrolled are at increased risk of post-operative infection and implant failure. As noted, the success of dental implants is predicated on their successful fusion with the jawbone, healing the gums, and rebuilding bone tissue. Since the healing process is slowed down by diabetes, people with uncontrolled disease will have a more difficult time healing.
- Overall Health: It is a common misconception that age prohibits someone from getting dental implants when in fact, it is a person’s overall health that determines their candidacy for dental implants. If the patient has any of the following, the oral surgeon will likely decline scheduling dental implant surgery:
- Pre-existing periodontal (gum) disease.
- Lack sufficient jawbone density to support implants – in some cases, this can be corrected via a bone grafting procedure prior to implant surgery.
- An unwillingness or inability to diligently follow aftercare instructions necessary for the implants to properly heal – could include restrictions on what can be eaten as well as modifications to cleaning processes.
- Is a smoker – not only is smoke damaging and inhibits healing, the sucking action employed when smoking can also negatively impact healing and the implant’s success. To qualify for dental implants, patients must commit to abstaining from smoking throughout the duration of the months long process.
- Have a prior history of using biophosphate medications or oral cancer treatment.
- Have a condition or disease that inhibits their ability to heal.
Best Dental Implants for Diabetics
- All-on-Four: This system utilizes four dental implants in the jawbone and is the most popular, and most suitable, choice amongst diabetics. The restoration can replace full sets of upper or lower teeth and maximizes that existing bone without the need for bone grafts.
- Mini Dental Implants: While suitable for replacing a single missing tooth, these implants are not permanent and since they require ongoing repair and replacement, are typically not recommended for people with uncontrolled diabetes.