Who is a good candidate for implants?

Reviewed by Dr. Samar Fadavi, DDS

Short answer: A good candidate for a dental implant is an adult whose jaw has finished growing, who has healthy gums or gum disease under control, enough bone or the option of a graft, general health that allows minor surgery and healing, and the ability to clean around the implant every day. Smoking, uncontrolled diabetes and some medicines need extra planning but do not always rule implants out.

Why candidacy matters

Dental implants have a strong track record when they are placed in the right conditions. Most problems with implants trace back to factors that could have been spotted before surgery: gum disease that was not treated, bone that was too thin, heavy smoking, or a health condition that slowed healing. That is why the first visit for an implant is mostly about questions, an exam and imaging, not surgery.

This guide walks through the main things a dentist looks at when deciding whether an implant is suitable, what can be done if you are not a candidate yet, and what to ask at your consultation. It is general information for patients in Scarborough, the Danforth and East Toronto. Only an exam can tell you whether an implant suits your mouth. Our dental implants page explains treatment at our clinic.

Quick self-check

You may be a good candidate if most of these are true:

• You are missing one or more teeth, or have a tooth that cannot be saved.
• You are an adult and your jaw has finished growing.
• Your gums do not bleed much and you do not have loose teeth from gum disease.
• You do not smoke, or you are willing to stop around the time of surgery.
• Any ongoing health conditions are well managed.
• You can brush and clean between your teeth every day.
• You can attend several visits over a few months.

If some of these are not true, implants may still be possible with extra steps. The sections below explain each factor.

Factor 1: age and jaw growth

There is no upper age limit for implants. Many people in their seventies and eighties have implants placed successfully. What matters more is general health and the ability to care for them. There is a lower limit, though. Implants do not move with growing bone, so they are usually delayed until jaw growth finishes, often in the late teens for girls and early twenties for boys. Until then, other temporary options fill the gap.

Factor 2: gum health

Healthy gums are essential. Gum disease is caused by bacteria that inflame the gums and, over time, destroy the bone that holds teeth. The same process can affect implants, a condition called peri-implantitis. If you have gum disease, it must be treated and brought under control before implant surgery. Signs include gums that bleed when brushing, swollen or red gums, bad breath that does not go away, gums pulling back from the teeth and loose teeth. Our guide on bleeding gums explains early signs.

Factor 3: bone quantity and quality

An implant needs enough bone around it to hold firmly. After a tooth is lost, the bone in that area shrinks, quickly in the first months and more slowly after that. People who have worn dentures for many years often have less bone. The dentist checks:

• Height: is there enough bone above the nerve in the lower jaw or below the sinus in the upper jaw?
• Width: is the ridge thick enough to surround the implant?
• Density: is the bone firm enough for the implant to be stable when placed?

CBCT 3D imaging, which our clinic offers, shows bone in three dimensions. If bone is lacking, a bone graft or sinus lift can often rebuild it. Shorter or narrower implants are another option in some cases.

Factor 4: general health

Implant surgery is minor surgery, and healing depends on your overall health. Conditions that need extra planning include:

• Diabetes. Well-controlled diabetes usually allows implants. Poorly controlled blood sugar slows healing and raises infection risk.
• Heart conditions. Many heart patients can have implants. Some need advice from their doctor first, especially about blood thinners. Our guide on heart conditions and dental care explains why.
• Osteoporosis. The condition itself rarely stops implants, but some medicines used to treat it need careful planning.
• Autoimmune conditions and medicines that suppress the immune system can affect healing.
• Radiation to the head and neck. Past radiation therapy can affect the jawbone and needs careful assessment.
• Pregnancy. Elective surgery such as implants is usually delayed until after pregnancy.

Bring a complete list of your medicines, including vitamins and supplements, to your consultation.

Factor 5: medicines

Some medicines affect bleeding, healing or bone. These include blood thinners, certain osteoporosis drugs taken by mouth or injection, steroids, some cancer medicines and drugs that suppress the immune system. Never stop a prescribed medicine on your own before dental surgery. The dentist may contact your doctor to plan treatment safely.

Factor 6: smoking and vaping

Smoking narrows blood vessels and slows healing. Smokers have a higher rate of implant problems both early on and over the years. Vaping and cannabis smoking may also affect gum health. If you smoke, the dentist may suggest stopping for a period before and after surgery, and ideally for good. Your family doctor or pharmacist can help with quit-smoking support.

Factor 7: grinding and bite

Heavy grinding or clenching puts extra force on implants and the crowns on top. It does not rule implants out, but it may change the plan. The dentist may suggest a wider implant, more implants to share the load, a stronger crown material or a night guard. Our night guards and TMJ page explains guards.

Factor 8: daily cleaning

An implant cannot decay, but the gum and bone around it need daily cleaning, just like natural teeth. People who find it hard to clean their teeth, for example because of arthritis or limited hand movement, may need a design that is easier to clean, such as an implant-held denture that comes out. Electric toothbrushes and water flossers can also help.

Factor 9: time and visits

Implant treatment usually involves several visits over a few months: consultation and imaging, any preparation such as extraction or grafting, implant placement, healing checks and the final crown or denture. Being able to attend these visits matters.

If you are not a candidate yet

Being told you are not ready for an implant is not always the final word. Common next steps include:

1. Treating gum disease with deep cleaning and better home care, then reassessing.
2. Bone grafting to rebuild thin or short bone.
3. Getting health conditions under control, such as improving blood sugar.
4. Stopping smoking before and after surgery.
5. Waiting for growth to finish in younger patients.
6. Choosing another option, such as a bridge or denture, if implants are not suitable.

Our guide on implants, bridges or dentures explains the other options.

Seniors and implants

Many older adults in Scarborough and East York ask whether they are too old for implants. Age is rarely the deciding factor. What matters is general health, medicines, bone and the ability to clean around the implant. For many seniors, two implants holding a lower denture make eating far more comfortable. Our dental care for seniors page explains how we plan care for older patients, and our guide on aging and dental health covers common changes.

What happens at an implant consultation

1. The dentist reviews your medical history, medicines and habits.
2. Your teeth, gums, bite and the gap are examined.
3. X-rays and, where useful, CBCT 3D imaging are taken.
4. The dentist explains whether an implant is suitable now, what preparation is needed and what other options exist.
5. You receive a written estimate and, if you wish, a predetermination is sent to your insurer.

Our guide on what affects the cost of dental implants explains the factors behind an implant estimate.

Questions to ask at your consultation

• Is my bone thick and tall enough, or will I need a graft?
• Are my gums healthy enough right now?
• Do any of my medicines or health conditions change the plan?
• How long will the whole treatment take?
• What will I have in the gap while it heals?
• What are the risks for me, and how are they reduced?
• How should I clean around the implant?
• What other options would work for me?

What to avoid

• Do not hide smoking or medicines from the dentist. Honest information leads to safer planning.
• Do not skip treatment for gum disease before implant surgery.
• Do not stop prescribed medicines on your own.
• Do not assume you are too old for an implant without asking.
• Do not choose implants without understanding the daily care they need.

Risks the dentist will discuss

Every surgery has some risk, and a good candidacy check is how those risks are kept low. The dentist will explain the risks that apply to you, which may include:

• Infection around the implant during healing.
• The implant not bonding with the bone, which happens in a small number of cases and is more common in smokers and people with uncontrolled diabetes.
• Nerve irritation in the lower jaw, which can cause numbness or tingling in the lip or chin. Careful 3D planning helps avoid this.
• Sinus problems in the upper jaw if the implant sits too close to the sinus.
• Gum and bone loss around the implant over time if cleaning is poor or gum disease returns.

Our guide on risks with dental treatments explains how risks are reduced in general.

Preparing for implant surgery

1. Finish any gum treatment and keep up your home care.
2. Talk to your doctor if you take blood thinners or bone medicines, so the dentist can plan with them.
3. Stop smoking as early as you can before surgery.
4. Arrange soft foods such as soup, yogurt, eggs and smoothies for the first few days.
5. Plan a quiet day after surgery and avoid heavy exercise for a short time.
6. Ask about pain relief and any rinse or medicine to have ready at home.

Most people are surprised by how manageable recovery is. Mild swelling and tenderness usually settle within a few days.

When to see a dentist

Book a visit if:

• You have a missing tooth or a tooth that cannot be saved.
• You wear a denture that feels loose and want it more stable.
• You were told in the past you could not have implants and want to know if anything has changed.
• You have bleeding gums or loose teeth and want them treated before considering implants.

Questions about implant candidacy

Am I too old for dental implants?

There is no upper age limit. General health, bone, medicines and the ability to clean around the implant matter more than age.

Can I get implants if I have diabetes?

Often yes, if your blood sugar is well controlled. The dentist may ask about your recent readings and work with your doctor.

Can smokers get implants?

Smokers can sometimes have implants, but the risk of problems is higher. Stopping before and after surgery helps healing.

What if I do not have enough bone?

A bone graft or sinus lift can often rebuild bone. In some cases, shorter or narrower implants are used.

Can I have implants if I had gum disease?

Yes, once it is treated and under control. You will need good daily care and regular cleanings to keep it that way.

Does osteoporosis rule out implants?

Not usually, but some osteoporosis medicines need careful planning. Bring a full list of your medicines.

How do I find out for sure?

An exam and imaging are the only way to know. The dentist will explain your options and give you a written estimate.

Can I have implants if I wear a denture now?

Yes, many denture wearers are good candidates. Years without teeth can thin the bone, so imaging shows whether a graft is needed. Two implants holding a lower denture is a common and practical plan.

How long does healing take after the implant is placed?

Most implants need a few months to bond with the bone before the final tooth is attached. Grafted areas may need longer.