Implant surgery is predictable when the body can heal bone around titanium. Three things interfere with that more than anything else, and any honest clinic will screen for all three before it quotes you. None of them is an automatic no. All of them change the plan.
Smoking and vaping
Nicotine constricts blood vessels and smoke impairs the cells that build bone. Reviews of implant outcomes consistently find failure rates in smokers roughly double those in non-smokers, with the effect strongest in the upper jaw and around grafts. Most surgeons ask for a stop of at least two weeks before surgery and eight weeks after; longer is better. Vaping is less studied but nicotine is nicotine, and most clinics treat it the same way. If you cannot stop, you can usually still get implants, but expect a more conservative plan: no immediate load, possibly more implants, and a frank note about risk on your consent form.
Diabetes
High blood sugar slows healing and raises infection risk. What matters is control, not the diagnosis. Clinics commonly use HbA1c as the gate: under 7 percent is treated like anyone else, 7 to 8 percent is usually acceptable with closer follow-up, and above 8 percent most surgeons will ask you to work with your physician before surgery. Bring recent bloodwork. Well-controlled diabetics have implant survival close to the general population in most studies.
Bisphosphonates and denosumab
Drugs for osteoporosis and some cancers (alendronate, risedronate, zoledronic acid, denosumab) suppress bone turnover, and in rare cases jaw surgery in people taking them triggers medication-related osteonecrosis of the jaw, or MRONJ. The risk is low with oral bisphosphonates for osteoporosis and higher with intravenous doses for cancer. Clinics will ask which drug, what dose, how long, and whether it was oral or IV, and may request a letter from your physician. Long-term oral users often proceed with informed consent; IV users for oncology are usually advised against elective implants.
Other things worth mentioning
- Radiotherapy to the head and neck: significantly changes bone healing, needs specialist planning.
- Blood thinners: not a barrier, but the clinic needs to know to manage bleeding.
- Uncontrolled gum disease: implants placed in a mouth with active periodontitis fail more often. Treat the gums first.
- Heavy grinding: not a healing issue, a load issue. Expect a night guard in the plan.
The point of all this is not to scare you out of implants. It is that a clinic that asks these questions is a clinic that is planning for your success rather than its schedule. Related: implant success rates and questions to ask any clinic.
Reputable Colombian clinics apply the same medical clearance rules. If a clinic anywhere does not ask about smoking, HbA1c and bone medication before quoting implants, that is the warning sign. See the vetted clinics at colombiadentist.co, full-mouth cases at fullmouthrestoration.co, or start at the network hub, colombiamedical.co.
Frequently asked
Can smokers get dental implants?
Yes, but with roughly double the failure rate. Most surgeons require stopping for at least two weeks before and eight weeks after surgery, and may avoid immediate loading.
What HbA1c do I need for implants?
Most clinics are comfortable under 7 percent, cautious between 7 and 8, and will ask you to improve control above 8 before elective implant surgery.
I take alendronate for osteoporosis. Can I still get implants?
Often yes. Oral bisphosphonates for osteoporosis carry a low risk of jaw osteonecrosis. Your surgeon will want the drug name, dose and duration, and may coordinate with your physician.
All prices are typical 2026 ranges drawn from published US self-pay data and Colombian clinic price lists, not quotes. USD/COP moved from roughly 3,805 to 3,070 during 2026, so dollar figures for Colombia have risen versus older articles. Only a clinic that has reviewed your scan can give you a real number. This is educational content, not medical advice.
