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Implants · single question

A 54-year-old female heavy smoker with multiple missing teeth wants dental implants. What should be the FIRST best management step?

  1. Prophylaxis
  2. Chlorhexidine rinse
  3. Start smoking cessation
Show answer and explanation

Correct answer: C. Start smoking cessation

Before ANY implant therapy is initiated for a heavy smoker, SMOKING CESSATION must be addressed first. Nicotine directly impairs blood flow, healing, and osseointegration — smoking is the most significant modifiable risk factor for implant failure. Without smoking cessation, implant therapy carries significantly higher failure rates. The standard of care is to counsel the patient on smoking cessation and ideally have them quit for at least 6-8 weeks before implant placement.
  • A. INCORRECT. Prophylaxis (cleaning) is part of initial periodontal therapy and is important, but it is not the single most important first step when facing a heavy smoker seeking implants.
  • B. INCORRECT. Chlorhexidine rinse is an antimicrobial adjunct used perioperatively — it is not the FIRST management step in a heavy smoker seeking implants.
  • C. CORRECT. SMOKING CESSATION is the first and most critical step before implant therapy in a heavy smoker. It addresses the highest-risk modifiable factor for implant failure. Without cessation, the prognosis for implants is significantly compromised.

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