Chapter 05 âą Question 6
Can Diabetics Get Dental Implants?
đș 9:00 videođ 14 min read
Reviewed by Dr Tim Fleming
BDS â Dental Surgeon (GDC Reg: 83324)
Yes, diabetics can get dental implants, but success depends critically on how well the diabetes is controlled. Diabetics with well-controlled blood sugar (HbA1c below 7%) have success rates of 90-95%, only slightly lower than non-diabetics, while those with poor control (HbA1c above 9%) face significantly higher failure rates.
Blood Sugar Control: The Critical Factor
HbA1c Levels and Implant Success
- Excellent control (HbA1c <6.5%): 93-96% success rate, minimal increased risk vs non-diabetics
- Good control (HbA1c 6.5-7%): 90-93% success, slightly increased risk, good candidate
- Acceptable control (HbA1c 7-7.5%): 85-90% success, moderate increased risk, acceptable with precautions
- Poor control (HbA1c 7.5-9%): 70-80% success, significant risk, many dentists refuse or require improvement first
- Very poor control (HbA1c >9%): 50-70% success, unacceptably high failure rate, generally contraindicated
How Diabetes Affects Implants
Impact on Healing
- High blood sugar slows healing at cellular level
- White blood cells less effectiveâhigher infection risk
- Microvascular complicationsâreduced blood flow to gums and bone
- Collagen metabolism affectedâweaker soft tissue healing
Osseointegration Challenges
- Bone integration slowerâtakes longer for bone to attach to implant
- May require 4-6 months vs 3-4 months in non-diabetics
- Process may be incomplete if sugar poorly controlled
- Bone quality compromised by chronic high sugar
Requirements for Diabetic Patients
Pre-Treatment Assessment
- Medical clearance: GP or endocrinologist consultation, verify current HbA1c, review medications
- Recent HbA1c test: Within 3 months of implant surgery, demonstrates current control
- Medication review: Current diabetes medications, compliance with regimen, coordination with prescribing doctor
- Complication assessment: Neuropathy, nephropathy, retinopathy, cardiovascular disease indicate poorly controlled diabetes history
Type 1 vs Type 2 Diabetes
Both Can Be Good Candidates When Controlled
Type 1 (Insulin-Dependent): Excellent candidates if well-controlled, require close coordination with endocrinologist, may need insulin adjustment around surgery
Type 2 (Non-Insulin Dependent): Good candidates when controlled, majority of diabetic implant patients, may be easier to stabilize than Type 1
Long-Term Maintenance
More Frequent Monitoring
- Professional cleanings: Every 3 months recommended (more frequent than standard 6 months)
- Home care: Impeccable oral hygieneâbrush twice daily minimum, floss or interdental brushes daily
- Blood sugar control: Continue excellent diabetes management, HbA1c checks every 3 months
- Coordination of care: Keep dentist informed of diabetes status, keep GP informed of dental issues
đĄ Key Takeaways
- Diabetics with well-controlled blood sugar (HbA1c below 7%) can successfully get dental implants with 90-95% success rates, only slightly lower than non-diabetics
- HbA1c level is the critical factorâpoor control (above 9%) creates unacceptably high failure rates and most dentists will refuse treatment
- Diabetes impairs healing by reducing immune function, slowing wound closure, and affecting bone integration with the implant
- Type 1 and Type 2 diabetics can both be good candidates when diabetes is well-managed and stable for several months
- Pre-treatment assessment includes recent HbA1c test (within 3 months), medical clearance from GP/endocrinologist, and medication review
- Healing typically takes 1-2 months longer for diabeticsâosseointegration period often extended to 4-6 months versus 3-4 months
- Diabetics face 2-3 times higher risk of peri-implantitis (implant gum disease) and require professional cleanings every 3 months versus 6 months
- Blood sugar should be monitored more frequently during treatment period with targets of 4-7 mmol/L fasting and under 10 mmol/L post-meal
- Some dentists prescribe preventive antibiotics for diabetic patients, especially if HbA1c above 7.5% or other risk factors present
- Diabetics who improve their control to get implants often experience broader health benefitsâusing implants as motivation to manage diabetes better
- If control is currently poor, work with medical team for 3-6 months to improve HbA1c before proceeding with implant treatment