Can You Have Dental Implants With Gum Disease?
Why gum disease must be controlled before implants, the usual treatment sequence and the warning signs to watch for.
Checked by our editors. A dentist review of this article is planned but has not happened yet.
Can you have dental implants with gum disease? Not while it is active. Gum disease needs to be treated and under control first, and you then need to keep your gums healthy, because a history of gum disease raises the risk of problems around an implant later.
That does not mean people who have had gum disease are ruled out. It means the order of treatment matters, and so does what you do in the years after the implant is fitted. This article sets out why, what the sequence usually looks like, and the warning signs to watch for.
If you are weighing up treatment abroad, start with our planning guide to dental implants in Türkiye, which covers assessment, timelines, risks and aftercare back home.
Why does active gum disease rule out an implant?
An implant depends on healthy bone and gum around it. Gum disease is caused by a build-up of plaque, and the NHS says that left untreated it can lead to shrinking gums, loose teeth and abscesses. Bacteria can also build up around an implant, as the specialist guidance below explains.
The European Federation of Periodontology (EFP), a body of gum specialists, states that a patient must be free of periodontitis (advanced gum disease) before an implant can be placed. Cleveland Clinic similarly lists active or untreated gum disease among the reasons someone may not be a good candidate for implants.
Does a past history of gum disease matter?
Yes. The EFP lists poor oral hygiene, a history of periodontitis and smoking as the most common causes of implant failure. It reports that in patients with periodontitis, around 22% of implants develop peri-implantitis, an inflammation that causes bone loss around the implant.
The EFP also explains that disease around implants can damage tissue and bone more quickly than gum disease around natural teeth, and is usually much more difficult to treat. That is why your dentist will want evidence that your gums are stable before going ahead, and why aftercare is not optional.
What does the treatment sequence usually look like?
- Diagnosis. Your dentist checks your gums and bone and explains how advanced any gum disease is.
- Gum treatment. The NHS says early gum disease is managed with cleaning advice, stopping smoking and possibly a hygienist appointment, while more serious cases may need deep cleaning under the gums, antibiotics, removal of teeth or gum surgery.
- A period of stability. Your dentist will want to see that the gums stay healthy with your home care before planning implants.
- Implant assessment. Bone levels are checked. Cleveland Clinic notes that if there is not enough jawbone, a bone graft may be needed.
- Placement and healing. The implant is placed and left to fuse with the bone, which Cleveland Clinic says takes three to nine months.
- Long-term maintenance. Regular check-ups and hygiene visits, as advised by the EFP.
What else can increase the risk?
| Factor | What sources say |
|---|---|
| Smoking | Listed by the EFP as a common cause of implant failure; the NHS advises stopping as part of treating gum disease |
| Poor oral hygiene | Listed by the EFP as a common cause of implant failure |
| Uncontrolled diabetes | The FDA says it may raise the risk of infection and implant looseness |
| Missed check-ups | The EFP says regular check-ups with a dentist, periodontist or hygienist are essential |
What are the warning signs of a problem around an implant?
The EFP lists these signs of peri-implant disease. If you notice any of them, contact your dentist rather than waiting for your next routine visit:
- gums that bleed more easily when you brush or clean between your teeth
- swollen gums around the implant
- bad breath or a bad taste in your mouth
- an implant, bridge or denture that feels loose
The EFP describes two stages. In the earlier one, peri-implant mucositis, bacteria build up on the implant surface and inflame the surrounding gum. If that is not treated it can progress to peri-implantitis, where there is greater inflammation and bone around the implant is lost. Catching it at the first stage is the aim.
Questions to ask your dentist
- Is my gum disease currently active or stable?
- How long do you want my gums to be stable before planning an implant?
- Will I need a bone graft?
- How often should I see a hygienist after the implant is fitted?
- Which cleaning tools should I use around the implant at home?
For background on the condition itself, see our guide to what gum disease is and how it is treated. If you want to understand longer-term outcomes, our article do dental implants fail over time? looks at what can go wrong and why.
What does gum treatment cost on the NHS in England?
If you are treated as an NHS patient in England, gum care is charged through the band system. According to the NHS, scaling that your dental professional says is clinically needed is usually included in Band 1 (£27.90), but extensive treatment, or treatment for complex gum problems, may be charged as Band 2 (£76.60). If scaling is not clinically necessary, you pay for it privately. These are NHS England charges, checked in October 2026; Scotland, Wales and Northern Ireland set their own.
Some people pay nothing, including under-18s, under-19s in full-time education, people who are pregnant or have had a baby in the past 12 months, and people on certain benefits. Dental implants, by contrast, are usually private treatment, so the gum care and the implant may be charged on different bases even at the same practice. Ask for both in writing before you start.
Keeping your gums stable at home
The NHS advice for preventing gum disease is the routine your dentist will expect to see before and after an implant: brush with fluoride toothpaste at least twice a day and spit rather than rinse, clean between your teeth every day with floss or interdental brushes, do not use mouthwash straight after brushing, do not smoke, and keep up regular check-ups with a dentist and hygienist, especially if you are pregnant or have type 2 diabetes.
Sources
- European Federation of Periodontology, Peri-implant diseases
- NHS, Gum disease
- Cleveland Clinic, Dental Implants
- US Food and Drug Administration, Dental Implants: What You Should Know
- NHS, How much NHS dental treatment costs
This article is general information and is not a substitute for advice from your own dentist.
