You are probably familiar with the links between tobacco use and lung disease, cancer and heart disease. Tobacco use is also closely associated with the rate of bone loss in patients that have periodontitis. If you have periodontitis and smoke pack of cigarettes daily, the rate of bone loss will increase 8 times. In 80% of the patients with periodontitis, the bone loss process does not start until the mid 30's, but can begin up to 10 years sooner in patients that smoke. When tobacco is used on a regular basis, it is much more difficult to stop the bone loss process and loss of teeth in patients. Individuals that smoke are far more likely to experience oral cancer than patients that do not smoke.
Smoking dramatically reduces the success of reconstructive surgical procedures. Soft tissue and bone grafts fail and implants are less successful in patients that smoke. There is little to no bone loss around implants in patients that do not smoke, but we commonly see progressive bone loss around implants in patients that smoke.
Uncontrolled diabetes effects oral health in a manner that is different, but comparable to smoking. Uncontrolled diabetes makes it much more difficult to control periodontitis, and having uncontrolled periodontitis makes it more difficult to control diabetes. Uncontrolled diabetes dramatically reduces the success of any oral surgery including implant placement, bone grafting and soft tissue grafting. In patients that present with uncontrolled diabetes, we work with the patient and their doctor to bring their diabetes under control before performing surgery. Patients with well controlled diabetes do as well as patients without diabetes, and experience excellent results with all types of surgery.