Patients themselves can contribute to the success of an implant or bone graft surgery ahead. For instance, appropriately adjusted vitamin D and LDL cholesterol levels and quitting smoking can greatly contribute to the healing process.

Appropriate vitamin D levels can help the osseointegration of the implant. Adjusting vitamin D levels reduces oxidative stress, the presence of which adversely affects the healing process. Visit your general practitioner at least one month prior to the intervention and have them prescribe vitamin D to allow time for the adjustment of vitamin D levels.

The ideal vitamin D level for the surgery is >50 ng/mL with <10 ng/mL levels qualifying as extremely low. Normal levels could be achieved by basking in the sun for 15-30 minutes daily from March to September. What with our hectic lifestyles and today’s accelerated world these targets are difficult to meet. The substitution of vitamin D can be achieved through the appropriate regimen of medications prescribed by our treatment specialist. Calcium supplies will also be required during treatment. An adult’s recommended daily intake of vitamin a D3 is 1000 IU. In the event of vitamin D deficiency this daily intake increases to 2000 IU.

What factors may increase the risk of vitamin D deficiency?

  • diabetes
  • certain medicines such as epilepsy medications.
  • absorption disorders (e.g. inflammatory bowel diseases, coeliac disease, lactose intolerance, etc.)
  • granulomatous diseases (e.g. sarcoidosis, tuberculosis)
  • pancreatic disorders
  • parathyroid overactivity
  • age (frequent over 65 years)
  • previous vitamin D deficiency
  • chronic pulmonary disease
  • chronic kidney disease
  • lymphomas (cancerous diseases of the lymphatic system)
  • liver disease
  • rickets (osteomalacia)
  • osteoporosis
  • severe obesity
  • vegan diet
  • non-traumatic bone fractures
  • smoking
  • depression

(For further details see

The adjustment of LDL (low density lipoprotein) cholesterol levels

LDL cholesterols are also known as bad cholesterols since in excessive amounts in the blood they deposit on blood vessel walls. This deposit keeps increasing as a result of which blood vessel walls lose their flexibility and become vulnerable. Due to the deposit the diameter of the veins also shrinks and arteriosclerosis develops. If the proportion of LDL and HDL cholesterols is toppled it may lead to the formation of blood clots (thrombosis) at cracks in the inflexible blood vessel walls and cling on to the choroid. Both arteriosclerosis and thrombosis may have fatal consequences (heart attack, pulmonary embolism and stroke). From a dentist’s point of view high

LDL cholesterols levels cause the decay of osteoblast (bone forming) cells which play an important role in the osseointegration of implants. Lipid metabolism slows down and fat deposits in the bone, which in turn becomes unsuited for a dental implant surgery. Inappropriate nutrition, obesity and sedentary lifestyle increase the risk of arteriosclerosis. Cholesterol levels can be perfectly well contained by a balanced diet and regular, albeit moderate-intensity exercise (cycling, walk). A fibre-rich, low-fat diet is advocated. If your doctor prescribes a cholesterol lowering medication, make sure you abide by the dosage instructions. Drug therapy does not exempt us from changing our life styles, it only supplements it. LDL cholesterol levels may also be checked by a blood test.

Recommended food items in the event of high cholesterol levels:

  • broccoli
  • citrus fruits
  • green leafy vegetables
  • carrot
  • cereal flours
  • fish and fish oil
  • wholemeal flour bread
  • brown rice
  • fruits
  • vegetables
  • lean dairy products
  • fish
  • skinless poultry


Quitting smoking

A great deal can be achieved in the interest of the long-term success of implants through quitting smoking. This is rather a difficult task, since cigarette causes a strong addiction very similar to that of “hard” drugs. Once you have made up your mind to quit smoking you can avail of a slew of opportunities. You mustn’t give up; if one therapy fails you must try another. Everyone should find the method they lay store by and can best relate to.

As cigarette smoke pervades the oral cavity it sticks to the teeth, tongue and the mucosa. Absorbed from the mucosa the smoke enters the blood stream causing the constriction of blood vessels. All healing processes require ample blood supply and oxygen. Poor blood supply in smokers is evinced by colder fingertips as opposed to non-smokers.

Sadly the incidence of periodontal disease and periodontal issues in smokers increases 5-fold and smokers are therefore at an increased risk for tooth loss, not to mention other harmful effects of smoking on the body.

Taking medications containing bisphosphonates

Patients suffering from osteoporosis and certain tumour diseases often receive medications containing bisphosphonates. As an adverse effect severe jaw bone decay (necrosis) may arise and therefore all oral surgeries (tooth extraction, resection, dental implant surgery, bone graft, etc.) should be avoided when on a regimen containing bisphosphonates since there is a risk of infection.

Proper treatment of other diseases (such as diabetes, hypertension, osteoporosis, etc.), abidance by the doctor’s instructions and participation in regular screening tests are essential from the point of view of the healing process.

Important notice

Please inform your doctor about your illnesses and the medications you are taking at all times. Should any new disease arise between two dental treatments, or if you have received a new medication please always let your doctor know, since such information may influence the treatment.

Keywords: vitamin D, LDL cholesterol, medications containing bisphosphonates, periodontal disease, dental implant surgery, implant, bone graft surgery, sinus lift, HDL cholesterol, osteoporosis