The impact of gum disease on dental implants: Enamel Dentistry’s Review in 2026

Active gum disease lowers the success rates of dental implants by eroding the jawbone that anchors the tooth. This can significantly increase the risk of peri-implantitis. While an untreated infection can prevent patients from undergoing immediate surgery, successfully treating the gum disease restores candidacy and ensures long-term implant stability.  More often than not, bone grafts are required before the implant is placed. However, with proper periodontal therapy, gum disease patients can achieve high implant success rates. Here at Enamel Dentistry near Pilot Knob, we often discuss with our patients the reason why gum disease can impact their smile.

Dentist showing woman what the dentla implant would look like

Gum disease can reduce bone density and cause the gums to recede. For instance, if a titanium post is planted into an unsuitable bone, it cannot fuse properly –  a process called osseointegration. Without this solid binding, the implant will simply loosen and fall out. In healthy mouths, dental implant survival rates are about 78% for 20 years after implantation [1] (Kupka et al., 2024). However, in patients with gum disease, failure rates can significantly increase due to the poor bone structure.

This is a common misconception in dentistry. Gum disease is a bacterial infection or a longstanding inflammation of the gums and surrounding teeth.  If the teeth are extracted without adequate removal of particular bacteria,  native bacteria will continue to multiply and colonize the implant. This can lead to a condition that is harder to treat than gum disease.

If you have a history of periodontitis, you may be at higher risk for developing peri-implantitis. Peri-implantitis is gum disease of the implants. This disease causes inflammation in the gums and progressive bone loss [2] (Mayfield et al., 2024). Since an implant does not have a blood supply or nerves leading to it, you will not feel the pain until bone loss has already occurred. Some symptoms to watch for include: 

  1. Redness or tenderness around the implant. 
  2. Bleeding often while brushing 
  3. Slight wobbling of the implant indicates that it is loose. 

Below is a table that compares implants to other options available. 

Feature

Implants

Dentures 

Dental Bridge 

Durability 

20+ years 

5-8 years

10-15 years 

Bone health 

Preserves the bone 

Accelerates the loss 

Neutral 

Risk of gum disease 

Risk of peri-implantitis 

Gum irritation

High 

Stability 

Fixed 

Removable 

Fixed 

Pain 

Low 

Moderate 

Low 

 

We know your schedule is packed, whether you’re commuting to Oracle Corporation or catching a flight out of Austin-Bergstrom International Airport for a business trip. But when it comes to dental implants, patience truly pays off. To protect your investment and ensure it lasts for years to come, we take the time to carefully prepare a strong, healthy foundation first.

  1. Comprehensive therapy: Here at Enamel Dentistry near Pilot Knob, we may perform scaling and root planing to remove the tartar and bacteria that are stuck deep in the gum pockets. 
  2. Bone grafting: If the gum disease has eroded the bone underneath the gums, we can add bone material so that the jaw’s density can be rebuilt. 
  3. Smoking cessation: Absolutely do not smoke while undertaking any of these procedures, since it can slow healing. 
  4. By ensuring that your gums remain stable and show no sign of infection for a few months before scheduled implant surgery, we can determine if your “foundation” is suitable for an implant.

If you smoke and have a history of gum disease, you greatly increase the risk of implant failure. Nicotine is a vasoconstrictor, meaning that it shrinks the blood vessels. Blood flow is essential to bring oxygen and nutrients to the jaw to help with the fusion of the bone to the implant. According to recent research, implants that are placed in smokers present with a 140% higher risk of failure than implants placed in non-smokers [3] (Mustapha et al., 2021). We highly advise you to stop smoking at least 4 weeks before and after the procedure to give your body adequate healing time.  Something worth noting is that the cost of an implant is roughly 3,000 to 6,000 dollars, depending on whether a bone graft is necessary. Smoking ultimately compromises both prevention and healing when it comes to oral health and implants.

1. Can I get implants if my gums are receding?

Yes, but you will likely need a gum graft first before the implants can be placed.

2. How long should I expect to wait after gum treatment to get implants?

We recommend you wait 3-6 months. This allows the tissue to heal and ensures the infection is eradicated before the titanium post is placed.

3. Can peri-implantitis be treated?

Yes, but it must be detected early. Treatment involves cleaning the implant surface, antibiotics, and even minor surgery.

Dr. Ravin Chodavadia, DDS, provides comprehensive general and cosmetic dentistry at Enamel Dentistry in Austin, TX. He brings extensive experience in Invisalign, implant care, and cosmetic treatments. Known for his light-hearted, positive energy, he is committed to delivering thoughtful, evidence-based care that keeps patients comfortable and confident at every step.

[1] Kupka, J. R., König, J., Al-Nawas, B., Sagheb, K., & Schiegnitz, E. (2024). How far can we go? A 20-year meta-analysis of dental implant survival rates. Clinical oral investigations, 28(10), 541.

[2] Heitz-Mayfield, L. Peri-implant mucositis and peri-implantitis: key features and differences. Br Dent J 236, 791–794 (2024). 

[3] Mustapha, A. D., Salame, Z., & Chrcanovic, B. R. (2021). Smoking and Dental Implants: A Systematic Review and Meta-Analysis. Medicina (Kaunas, Lithuania), 58(1), 39. 

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