Does a dentist have the right to refuse treatment to a patient just because they’re a smoker? To me that seems like discrimination. I’ve lost several teeth because of gum disease. I went through all the extra treatments to get the gum disease dealt with, while putting up with my dentist lecturing me about smoking and oral health. Now that I’ve gotten rid of the gum disease I want to replace the teeth with dental implants, but my high and mighty dentist refuses to give them to me because I smoke. Can he do that?

Bruce J.

Dear Bruce,

While a dentist cannot refuse anyone dental treatment because of their race or religion, etc., they can refuse any service for legitimate medical reasons. There is a medical reason to refuse dental implants to smokers. I don’t know if you’re aware, though with the lectures you mentioned I can’t imagine you aren’t, smoking is horrible for your gums. I wouldn’t be surprised if it was not one of the main factors which led to you having gum disease to begin with.

Smoking and Dental Implants

While dental implant success is very high for those in the general population, that percentage goes down drastically if you only look at smokers. Smoking is one of the leading factors in dental implant failure for two main reasons:

• The toxic ingredients in cigarettes actually restrict the blood flow in your gums. This diminishes your chances of healing after surgery, leading to dental implant failure.
• Smoking damages your salivary glands. Saliva is a huge factor in protecting you from decay and gum disease. There are bacteria fighting minerals in our saliva. Without enough saliva, you increase your risk of decay, infection, and gum disease. All of which can lead to dental implant failure.

Your dentist doesn’t want to give you an expensive and invasive procedure, putting you through surgery, when in all likelihood it will fail. To me, it sounds like your dentist is being honest and considerate of you. He could, if he wanted, just give you the implants and collect the money knowing full well it’s unlikely to last. I’m grateful he’s a dentist with integrity.

Your Options

You have options. First, you could quit smoking and get dental implants. I know that isn’t easy. Addictions are awful and hard to deal with. But, if dental implants are important to you it will be worth it. There are groups that help with addiction and medications your doctor can prescribe to make the withdrawal symptoms easier to deal with.

Another choice is to find a dentist with less integrity who’s willing to give you dental implants even while you smoke.

Thirdly, you can try an alternative to dental implants such as a removable partial denture or possibly a dental bridge (a false tooth suspended between two dental crowns).

This blog is brought to you by Dr. Bonnie Rothwell.