Who Is Not a Candidate for Implants?

When dental implants may not be appropriate

Implants usually have to wait, or may not be possible, when there's active gum disease or infection, not enough bone and no workable way to rebuild it, a health condition that interferes with healing, or a jaw that's still growing. Many of these can be treated or managed, so "not now" is more common than "never". For the basics, see what dental implants are and how they work.

For the other side of the question, read who is a good candidate for dental implants. Everything here is general; a dentist's examination is what settles it for you.

Active oral health issues

An implant needs a stable mouth to heal in. Active problems raise the risk of complications and normally get treated first:

• Untreated gum disease (periodontal disease). Active infection can damage the bone and soft tissue an implant depends on.
• Active infections. Infection at or near the planned site has to clear before surgery.
• Extensive untreated decay. Badly decayed teeth elsewhere in the mouth are usually dealt with as part of the overall plan before implants go in.

Once these are treated, many people become candidates later on.

Insufficient bone without viable corrective options

An implant has to be anchored in bone. Years without a tooth, gum disease or other causes can leave too little bone to hold one.

Bone grafting or a sinus lift can often rebuild it. Implants stop being realistic when the loss is too extensive, or when your health makes those extra procedures unsafe.

Medical conditions affecting healing

Implant treatment relies on normal healing after surgery. Some conditions, especially when poorly controlled, get in the way:

• Poorly controlled diabetes, which can delay wound healing and raise infection risk
• Conditions treated with immunosuppressive drugs, which can reduce the body's ability to heal
• Some blood disorders that affect clotting or healing
• Active cancer treatment, particularly radiation therapy to the head and neck
• Medications that affect bone metabolism, such as certain bisphosphonates

A condition on this list doesn't always mean no. When it's well managed, treatment can often be planned around it, with your dentist and physician working together.

Ongoing lifestyle factors

Some habits may need to change before treatment goes ahead:

• Heavy smoking. Smoking reduces blood flow to the tissues and slows healing, and systematic reviews report higher implant failure rates in smokers. Heavy smokers may be advised to quit or cut down significantly first.
• Unmanaged teeth grinding (bruxism). Constant grinding or clenching puts heavy force on implants and the teeth on them, which raises the risk of something breaking or loosening.
• Inconsistent oral hygiene. Someone who can't or won't keep the area clean faces a higher risk of peri-implant disease and implant failure over time.

Incomplete jaw development

Implants generally aren't placed in children or teenagers whose jaws are still growing. An implant doesn't move with the bone the way a natural tooth does, so as the jaw keeps changing, it can end up out of position.

The age when growth is finished varies. A dentist can assess skeletal maturity to decide when placement makes sense.

Misaligned patient expectations

Implants take time, appointments and money. If you're hoping for a quick fix and aren't ready for months of healing, follow-ups and long-term upkeep, another option may suit you better.

The healing and recovery timeline shows what the months after surgery involve. Going in, it helps to accept that:

• Treatment happens in stages, over months
• Implants need daily care, much like natural teeth
• Complications can happen and may need more treatment
• Outcomes differ from person to person, depending on bone, health and habits

Alternatives and next steps

If implants aren't suitable, bridges and partial or full dentures are the usual alternatives. Our comparison of implants, bridges, and dentures sets out what each one asks of you.

A dentist can tell you which of these fit and what would have to change for implants to become possible. Our sister site explains what the dentist examines at the assessment, and the Ontario Dental Association offers guidance on finding a dentist. Even if implants aren't right now, treating the underlying issue may make them an option later.