Dental Implants and Diabetes
Whether from tooth decay, an injury to the mouth, or simply genetics, there are numerous reasons why a person could lose a tooth during their lifetime. Historically, dental bridges or dentures have been used to replace missing teeth, but dental implants are rapidly growing in popularity as a restoration option.
Dental implants are typically suitable for people of any age but if the patient has underlying medical conditions, like diabetes, additional considerations must be made to determine if the treatment is suitable. This article will specifically focus on the issue of diabetes as it relates to a patient’s candidacy for dental implants. To start, let us first briefly examine what dental implants are.
Dental Implant Overview
Whereas dentures rest on the patient’s gums or dental bridges attach to adjacent teeth, both systems have issues with comfort, appearance, and functionality. In addition, irritation, inflammation, and infection are more common with these systems which increases the risk of periodontal disease developing.
Used in the United States since the 1960s, dental implants are a more modern alternative to traditional dentures or dental bridges that avoid these drawbacks. Because they are surgically embedded into the patient’s jawbone, dental implants offer a stronger and more sturdy foundation upon which restorative crowns can be mounted. The strength and stability of dental implants allow the patient talk and eat normally without the limitations that could be associated with dentures or bridges.
The process for getting dental implants takes several months from start to finish. This is because a period is needed to allow the dental implant and jawbone to fuse together through a process called osseointegration. This fusion is critical to the implant’s success and will look a little different for every patient based on how well they heal.
Are Dental Implants Safe for Diabetics?
Patients with Type 1 or Type 2 diabetes that are considering dental implants are commonly concerned whether the device will positively or negatively impact their health. While the disease does not make it impossible to undergo the procedure, the success of the treatment ultimately hinges on how well the patient’s diabetes is controlled and how well pre- and post-implant care instructions are followed. In general, people with uncontrolled diabetes are not candidates for dental implants but those for whom the disease is well controlled, can do well.
Dental implants are more likely to fail when diabetes is uncontrolled because it affects the time required for the implants to heal and can put the patient at higher risk of infection. Most commonly, infections develop in the gums which can further exacerbate the potential for implant failure or other complications.
Considerations for Diabetics
- Type 1 or Type 2 Diabetes: It can be more difficult to control Type 1 diabetes compared to Type 2. As such, the risk of complication and implant failure is slightly higher for patients with Type 1 diabetes compared to those with Type 2. Patients with Type 1 are not necessarily unable to have dental implants but their oral surgeon will be even more thorough in assessing their overall health, reviewing dental and medical records, discussing infection history, and evaluating the patient’s past history of healing.
- Length of Disease: Age is generally not a factor when considering dental implants but for diabetics, age is more of an issue than usual. The longer a person has diabetes, the more prone they are to infections and the longer it takes them to heal. As such, patients with diabetes that are considering dental implants should act sooner rather than later.
- Is Diabetes Well Controlled: Several studies have shown that patients with controlled diabetes have the same risk of implant failure or complications as non-diabetic patients. The same data indicates that patients with uncontrolled diabetes have higher rate of implant failure and post-op infection. As mentioned, dental implants rely on the body’s healing process to fuse with the jawbone, heal the gums, and rebuild bone tissue. Because diabetes slows down the healing process, those with uncontrolled disease will have more difficulty healing.
- Overall Health: Patients often believe their age prohibits them from getting dental implants when in fact, it is their health that qualifies them as a candidate for dental implants. Should any of the following issues be present, an oral surgeon likely will not schedule dental implant surgery:
- Existing periodontal (gum) disease.
- Have insufficient jawbone density – could be addressed with a bone grafting procedure prior to implant surgery.
- Inability or unwillingness to diligently navigate the post-implant period that requires special attention to what is eaten or put in the mouth to allow the implants to completely heal.
- Are a smoker – smoking not only makes it harder to heal, but the sucking action of smoking can also compromise healing and implant success. Typically, smokers must commit to quitting throughout the process which could be several months.
- Have a past history of taking bisphosphate medications or oral cancer treatments.
- Have a disease or condition that compromises healing ability.
Types of Dental Implant Procedures: Best Choice for Diabetics
There are a variety of dental implant procedures available and which is chosen for a diabetic patient is based on the patient’s control of the disease and oral hygiene routine.
- All-on-Four: The most popular implant system for patients with diabetes that utilizes four dental implants in the jaw. Should a full set of lower or upper teeth be needed, the procedure maximizes existing bone without requiring additional bone grafting. Of the dental implant options available, this is typically the most suitable for diabetic patients.
- Mini Dental Implants: Ideal for replacing a single lost tooth, mini implants are not permanent solutions and require ongoing repair and replacement. As such, they are generally not recommended when diabetes is uncontrolled as the gums will be at a higher risk of developing an infection.
- One-Day Process: There are procedures available to replace teeth in one day. Again, because diabetics frequently need more healing time between operations, these treatments are typically not ideal for patients with the disease.
- Single Tooth Replacement: These employ a bride technique and offer good short-term results for replacing a single tooth. One drawback is that these procedures expose the adjacent teeth to tooth decay which could lead to additional dental work down the road.