Most adults can be candidates for implant treatment, but “most” is not “all”, and candidacy depends on specific things that can be assessed. This guide sets out what those are, so you have a realistic sense of where you stand before you walk in.
The basic requirements
General health
- reasonable overall health and immune function
- the capacity to heal normally after surgery
- any chronic conditions well controlled rather than merely diagnosed
- non-smoking, or a genuine commitment to stopping through treatment
Oral health
- gum tissue free of active disease
- adequate bone density and volume, or a plan to create it
- sufficient space at the site for an implant and its restoration
- a real commitment to daily oral hygiene
Note the word “controlled” above. Diabetes does not disqualify you; poorly controlled diabetes materially affects healing and implant survival. The distinction is the whole point of the evaluation.
What a proper evaluation looks at
Medical history
Conditions we review: diabetes and how well managed it is, cardiovascular disease and its medications, autoimmune conditions, and any history of cancer treatment — particularly radiation to the head and neck.
Medications we ask about: anticoagulants and blood thinners; bisphosphonates and related drugs used for osteoporosis, which affect bone remodelling; steroids and immunosuppressants; and any history of radiation therapy.
Bring your actual medication list. This is not a formality — it changes plans.
Anatomy
Bone: 3D CBCT imaging to assess bone quality, density, available width and height, and the position of nerves and sinuses relative to where an implant would go.
Soft tissue: gum tissue quality and thickness, periodontal status, whether there is adequate attached tissue at the site, and any inflammation or infection present.
Considerations by circumstance
Younger patients
What we check: whether jaw growth is complete — placing an implant into a still-growing jaw creates problems later — and whether the long-term commitment is understood.
What is in your favor: excellent healing capacity, decades of benefit ahead, and preservation of bone that would otherwise be lost.
Older adults
What we check: medication interactions, healing capacity and bone density.
What is in your favor: the improvement in nutrition, comfort and confidence tends to be larger for patients who have been managing without teeth or with unstable dentures. Age alone is rarely what decides this — see dental implants for seniors.
Complex cases
Many patients who have been told they are not candidates can be treated with additional preparation:
- bone grafting where bone volume is insufficient
- sinus lifts for upper posterior placement
- full-arch approaches using angled implants to reach available bone
- smaller-diameter implants in narrow ridges, where indicated
What actually happens at a consultation
- Medical and dental history. A detailed review of your health, medications, previous dental treatment, and what you are hoping for.
- Clinical examination. Assessment of gum health, your bite, and a preliminary look at bone and site conditions.
- 3D imaging. A CBCT scan giving measured information about bone quality and quantity and the location of anatomical structures.
- Treatment planning discussion. Options, sequence, timeline, an itemized cost, and expected outcomes — including where the uncertainties are.
You should leave that appointment knowing what is realistic for you, whether or not the answer is what you hoped.
If you are not currently a candidate
That is frequently a temporary status rather than a permanent one.
Preparatory treatment: periodontal therapy for active gum disease; bone grafting; socket preservation at the time of an extraction, which prevents the problem rather than solving it later; orthodontic correction where alignment is the obstacle.
Changes you can make: stopping smoking, which has the largest single effect; getting diabetes properly controlled; establishing consistent oral hygiene; and addressing nutritional factors that affect healing.
Do not take one “no” as final
Advances in technique — angled placement, guided surgery, grafting protocols — have moved the boundary of what is treatable considerably. Patients told they were not candidates several years ago are often candidates now, and complex cases with significant bone loss are the core of this practice’s work.
The only way to know is an examination and a scan. That is a conversation worth having even if the answer turns out to be no.