What Makes a Good Candidate?

Dental implants are a tried-and-tested way to replace missing teeth, but they are not a one-size-fits-all solution. Suitability comes down to whether your mouth can support the implant and heal predictably. Three factors matter most: the quality and quantity of your jawbone, the health of your gums, and your daily habits. Age alone is rarely a barrier — many patients in their 70s and 80s receive implants successfully. What matters is your overall health, your commitment to aftercare, and a thorough assessment by a dentist experienced in implant placement.

Bone Density and Jaw Structure

The implant needs a solid foundation. When you lose a tooth, the bone that once held it begins to shrink — a process called resorption. If too much bone has been lost, the implant may not have enough support. Your dentist will typically use a CBCT scan (a 3D X-ray) to measure bone height, width, and density. As a rough guide, a standard implant needs at least 6–8 mm of bone height and 5–6 mm of width. If you fall short, a bone graft or sinus lift can rebuild the area. Grafts may use your own bone, donor tissue, or synthetic materials. Healing can take three to six months before the implant is placed. Bone density also matters: softer bone in the upper jaw may require a wider implant or a different surgical approach.

Gum Health and Soft Tissues

Healthy gums are the seal around your implant. If you have active periodontal (gum) disease, the bacteria that cause inflammation can also attack the implant site, leading to infection and early failure. Your dentist will check for bleeding on probing, pocket depths, and mobility. Any gum disease must be treated and stabilised before surgery. This might involve deep cleaning (root surface debridement), antibiotics, or periodontal surgery. You may also need a gum graft if your gums are thin or receding. After treatment, you will need to keep up with regular hygiene visits — implants are not immune to gum disease. In fact, peri-implantitis (infection around the implant) is a leading cause of late failure.

Lifestyle Habits That Affect Healing

Your daily choices play a big role in whether implants succeed. Smoking is the biggest modifiable risk. Nicotine narrows blood vessels, reducing oxygen and nutrients to the healing tissues. Smokers have a significantly higher rate of implant failure. Ideally, stop smoking at least four to eight weeks before surgery and continue afterwards. Alcohol in excess can also impair healing and dry out the mouth. If you grind or clench your teeth (bruxism), the extra force can damage the implant or crown. A custom night guard protects your investment. Good oral hygiene at home — brushing twice daily and cleaning between teeth — is non-negotiable. Poor hygiene invites plaque and inflammation, which can undermine even a perfectly placed implant.

Medical Conditions and Medications

Certain health conditions need careful management. Diabetes: if your blood sugar is poorly controlled (HbA1c above 7% or 53 mmol/mol), healing is slower and infection risk rises. Your dentist may ask for a recent blood test. Osteoporosis: some medications, particularly bisphosphonates and denosumab, can increase the risk of medication-related osteonecrosis of the jaw (MRONJ). This does not automatically rule out implants, but it requires a risk assessment. Autoimmune conditions, bleeding disorders, and a history of head or neck radiation also need discussion. Some medications, such as steroids or immunosuppressants, can affect healing. Always share your full medical history and medication list with your dentist — it is the only way to get an accurate picture of your suitability.

When You're Not Ready — and How to Get There

If you are not immediately suitable, that is not a no. It is often a “not yet”. Your dentist can create a plan: treat gum disease, place a bone graft, quit smoking, improve diabetes control, or fit a night guard. In the meantime, a temporary denture or bridge can fill the gap. Some patients need a period of healing before implants can be placed. If implants remain unsuitable — for example, due to severe bone loss or uncontrolled health issues — alternatives include bridges, partial dentures, or adhesive bridges. A thorough assessment is the first step. Ask your dentist about their experience, success rates, and aftercare plan. With the right preparation, most healthy adults can enjoy a stable, natural-looking replacement for decades.