Most healthy adults who’ve lost a tooth are candidates for a dental implant. But “most” isn’t everyone, and the honest answer for you specifically only comes after a proper assessment. Before you book that consult — with us or anyone else — it’s worth running through six questions yourself. They’re the same ones I work through with every implant patient in my chair at Biltoft.
1. How healthy are your gums and jawbone right now?
An implant is a titanium post that fuses with your jawbone. If the bone isn’t there, or the gums around the site are inflamed and infected, the implant has nothing solid to anchor into.
Gum disease is the big one. Active, untreated periodontitis is the single most common reason I’ll pause an implant plan and treat something else first. We’ll get the gums stable, then reassess. It’s not a no — it’s a not yet.
Bone volume is the other half. If you’ve had the tooth missing for a while, the bone in that spot shrinks over time — it’s normal biology. A 3D scan tells us exactly how much bone is there. Sometimes there’s plenty. Sometimes we need a small graft placed at the same time as the implant. Occasionally we need a staged graft, where we build bone first, let it heal for a few months, then place the implant.
None of that is a deal-breaker. It just means the plan has a few more steps, and the quote we give you reflects what your mouth actually needs rather than a one-size-fits-all number.
The other thing worth flagging here: if the tooth you’re replacing came out recently, the bone is usually in good shape and the timing is on your side. If it’s been out for years, expect the plan to involve more groundwork.
2. Do you smoke?
This is the question most patients flinch at, so I’ll be direct. Smoking is consistently associated with higher dental implant failure rates in the research literature, and with more gum problems around implants after they’re placed. The evidence is strong enough that most systematic reviews and meta-analyses agree smokers face a measurable increase in risk compared with non-smokers.
We don’t refuse to place implants for smokers. That’s your choice, and you’re an adult. But I will have an honest chat about the extra risk, and I’ll strongly encourage you to cut back — or quit — at least around the surgery and the healing window. Even a few weeks off cigarettes around the procedure helps blood flow and healing.
If you’d like to dig into this specifically, we’ve written more about dental implants and smoking.
3. Are there medical conditions affecting how you heal?
Implants are surgery, and surgery asks your body to heal predictably. A few conditions make that harder:
- Uncontrolled diabetes — high blood sugar slows healing and raises infection risk. Well-controlled diabetes is usually fine. We’ll ask about recent HbA1c.
- Immunosuppression — whether from medication (organ transplant, some autoimmune treatments) or disease, this raises the risk of infection and poor healing.
- Active chemotherapy — usually means we wait until treatment finishes and recovery is underway.
- Head or neck radiation therapy — past or planned radiation to the jaw area is a significant consideration because it affects bone healing for years afterward. We’d coordinate closely with your oncology team.
- Heavy alcohol use — impairs healing and increases complications.
None of these automatically disqualify you. They just mean the conversation is longer, the planning is more careful, and sometimes we loop in your GP or specialist before we go ahead.
4. Are you committed to looking after it?
An implant replaces the tooth, but it doesn’t replace the oral hygiene habit. Without brushing and flossing properly around the implant, you can develop peri-implantitis — gum inflammation around the implant that, if it keeps going, eats away the supporting bone. That’s the number-one cause of late implant failure I see in general practice.
Honest test: if you’re not flossing your natural teeth now, you’re not going to start flossing around an implant. That’s not a lecture — it’s just a practical reality. We’d rather help you get your hygiene routine sorted first than place an expensive implant into a mouth that’s going to struggle to maintain it.
Part of the commitment is also showing up for check-ups and cleans afterward. Implants benefit from the same kind of regular monitoring we do for natural teeth — a hygienist appointment every six to twelve months, x-rays when we need them, and a quick look at the gum tissue around the implant to catch any early inflammation. Done properly, a well-placed implant in a well-maintained mouth can last decades.
If you’re considering whether an implant fits your budget, our 2026 dental implant cost guide walks through what’s actually included in the $5,000–$6,000 per-tooth range we and most Australian general practices charge.
If you’re not sure whether now is the right time for implants, a 20-minute consult with me at Biltoft will give you an honest answer — not a sales pitch.
5. What medications are you on?
The biggest category worth flagging is bisphosphonates and related antiresorptive drugs (alendronate, risedronate, zoledronic acid, denosumab, and others). They’re commonly prescribed for osteoporosis, and in higher doses for some cancers.
These drugs are associated with a rare but real condition called medication-related osteonecrosis of the jaw — where an area of jawbone fails to heal after a dental procedure. The risk is low with standard oral osteoporosis doses and higher with long-term or IV cancer-dose use.
It’s not a flat no. It’s a “tell me everything and let me check before we plan anything.” We’ll look at:
- The specific drug
- Oral vs IV
- How long you’ve been taking it
- The underlying reason you’re on it
For most patients on low-dose oral bisphosphonates for osteoporosis, implants are still a reasonable option after a careful risk conversation. For some, they aren’t, and we’ll tell you that honestly.
Other medications worth mentioning at your consult: blood thinners (we can usually work around these), long-term steroids, and any immunosuppressants.
6. Are your expectations realistic?
An implant is the closest thing dentistry has to a replacement tooth. It looks natural. It chews like a tooth. It doesn’t come out. Most patients, once they’ve had one for a few months, genuinely forget it’s there.
But it’s not your original tooth. A natural tooth has a tiny ligament around the root that acts as a shock absorber and sensory feedback system. An implant fuses directly to bone, so the feel is a fraction firmer. For almost everyone, that difference is barely noticeable — but if you’re expecting something indistinguishable from what you were born with, it’s worth knowing.
Implants also aren’t instant. From first consult to final crown is typically a few months for a straightforward case, and longer if grafting is needed. The bone needs time to fuse with the titanium — you can’t rush biology.
Individual results vary, and a proper consult is the only way to get specifics for your mouth.
What a proper implant assessment actually looks like
When you come in for an implant consult at Biltoft, this is what happens. It’s not a sales pitch — it’s a workup.
- Full medical and medication history — including everything above
- Clinical exam — gum health, tooth condition, bite, soft tissue
- OPG x-ray, and a 3D CBCT scan where we need detailed bone volume and nerve positioning
- Site-specific assessment — bone width, height, density at the planned implant site
- Honest discussion — what’s possible, what it’ll cost, how long it’ll take, what the risks are for you specifically
- A written treatment plan you can take home and think about
We work under local anaesthetic only. Biltoft doesn’t offer in-house IV sedation or general anaesthetic — if you need that, we’ll refer you to a specialist oral surgeon and stay involved in the broader plan. That’s deliberate. We’d rather do the work we do well than stretch into things that sit better with someone else.
For the full picture of how we approach implants end-to-end, have a read of our dental implants guide.
The honest bottom line
Most healthy adults with reasonable gum health, stable medical conditions, and realistic expectations are candidates for dental implants. A handful of specific issues — untreated gum disease, uncontrolled diabetes, active radiation, long-term high-dose bisphosphonates — need careful consideration and sometimes mean waiting or choosing a different solution.
You don’t need to self-diagnose. Run through the six questions above, note what’s relevant to you, and book a consult. We’ll give you the honest answer for your mouth — even if that answer is “let’s sort this out first” or “an implant isn’t the right fit for you.”
If you’re ready to find out, book an appointment with me at Biltoft Dental via corepractice.is/practices/biltoftdental or call us on (02) 6672 1980. We’re in Murwillumbah, serving the Tweed and Northern Rivers. For general information on dental care, Healthdirect Australia is a solid starting point, and the Australian Dental Association has patient guidance on implant treatment worth reading before any consult.
Frequently asked questions
Can you still get a dental implant if you've lost bone in your jaw? +
Often, yes — but you may need a bone graft first, or at the same time as the implant. How much bone you have, and where, is something we can only tell properly from a 3D scan (OPG or CBCT) and a clinical exam. Some people need no graft at all. Others need a small one. A few need a larger staged graft before we can place the implant. It's not a deal-breaker — it just changes the treatment plan.
Do I have to quit smoking to get a dental implant? +
We don't refuse to treat smokers, but we will have an honest conversation about the increased risk of implant failure and gum problems around the implant. The research consistently shows smokers have higher failure rates than non-smokers. If you can cut down or quit, even just around the surgery and healing window, it genuinely helps the implant bed in properly.
I have diabetes — can I still get implants? +
If your diabetes is well controlled, you're usually a reasonable candidate. Poorly controlled diabetes — high HbA1c, frequent infections, slow healing — is where the risk goes up, because implants rely on your body healing bone tightly around the post. We'll ask about your recent HbA1c and talk to your GP if there's any doubt.
I'm on bisphosphonates for osteoporosis. Does that rule me out? +
Not automatically, but it's a serious conversation. Bisphosphonates (and related drugs) are linked to a rare but real jawbone complication called medication-related osteonecrosis of the jaw. The risk depends on the drug, the dose, the route (oral versus IV), and how long you've been on it. We'll review your full medication history and often coordinate with your GP or specialist before deciding.
How old is too old for a dental implant? +
There's no upper age limit. I've placed implants for patients well into their 70s and 80s who healed beautifully. What matters is your general health and healing capacity, not the number on your driver's licence. At the other end, we wait until jaw growth is complete — usually late teens or early 20s — before placing implants in younger patients.
Will an implant feel exactly like my natural tooth? +
Honest answer: very close, but not identical. Most patients tell us they forget it's there within a few months. You chew normally, it looks natural, and it doesn't come in and out. What's different is the lack of a periodontal ligament — the tiny cushion natural teeth have — so the feedback is slightly firmer. For almost everyone, that difference is barely noticeable.