Dr. Tamara Rojas, DMD  |  Tooth Fairy Workshop  |  Updated June 2026  |  6 min read

Dental implants are considered the gold standard for replacing missing teeth — but not every patient is a candidate on day one. The good news: most people who aren’t immediately eligible can become candidates with the right preparatory treatment.

Dr. Tamara Rojas, periodontist and dental implant specialist at Tooth Fairy Workshop in Hollywood, FL, walks through the key factors that determine implant candidacy and what to expect from the evaluation process.

What Makes a Good Implant Candidate?

Successful implant placement depends on several biological and health factors. The ideal candidate has:

• Adequate jawbone volume and density — enough bone to anchor the implant post securely
• Healthy gums — no active periodontal disease or untreated infection
• Good general health — conditions that impair healing (uncontrolled diabetes, certain medications) require evaluation
• Fully developed jaw — implants are generally not placed in patients under 18
• Non-smoker or committed to quitting — tobacco significantly impairs osseointegration
• Good oral hygiene habits — implants require the same home care as natural teeth

Meeting all of these criteria perfectly is not required. Many patients have one or two limiting factors that can be addressed before or during treatment.

Factors That Can Affect Candidacy

Bone Loss

After a tooth is extracted, the surrounding jawbone begins to resorb (shrink). In as little as 6 months, significant bone volume can be lost. Without sufficient bone, an implant post has nothing stable to integrate with.

Bone loss is the most common barrier to immediate implant placement — but it’s rarely a permanent barrier. Bone grafting procedures can rebuild the ridge before implant placement.

Active Gum Disease

Placing an implant in a mouth with active periodontal disease almost guarantees failure. Bacteria from infected tissue colonize the implant surface and cause peri-implantitis — an infection that destroys bone around the implant.

Dr. Rojas will not place implants until gum disease is fully controlled. As a periodontist, she treats the gum disease herself before referring or proceeding with implant placement — no extra appointments at a separate office.

Diabetes

Uncontrolled diabetes impairs wound healing and immune response, increasing implant failure risk. However, patients with well-controlled diabetes (HbA1c under 7%) achieve success rates comparable to non-diabetic patients. Blood sugar management in the weeks before and after surgery is critical.

Osteoporosis and Bone Medications

Patients taking bisphosphonates (used for osteoporosis) require careful evaluation. These medications affect bone turnover and healing. A drug holiday (temporary pause of medication) may be recommended before surgery — coordinated with your prescribing physician.

Smoking

Smokers have approximately 2x the implant failure rate of non-smokers. Nicotine restricts blood flow to healing tissue and impairs the immune system’s ability to integrate the implant post. We strongly encourage smoking cessation before implant placement.

What If You’re Not a Candidate Yet?

Being told you’re “not a candidate” today doesn’t mean never. Common preparatory treatments include:

Bone Grafting

Ridge augmentation or socket preservation grafts rebuild lost bone using bone material (from your own body, a donor source, or synthetic material). After 3–6 months of healing, sufficient bone volume is typically present for implant placement.

Sinus Lift

When upper back teeth are missing and the sinus cavity has dropped down, there may not be enough vertical bone for implants. A sinus lift procedure elevates the sinus membrane and adds bone below it, creating space for the implant.

Periodontal Treatment

For patients with active gum disease, scaling and root planing (and in some cases LANAP® laser therapy) is completed first. Once gum health is restored and stable, implant placement can proceed safely.

The Candidacy Evaluation Process

At Tooth Fairy Workshop, candidacy is determined through a comprehensive evaluation — not a quick visual exam.

Step 1: Medical and dental history review. Dr. Rojas reviews your medications, health conditions, and history of tooth loss to identify any factors that need to be addressed before proceeding.

Step 2: Periodontal exam. Pocket depths, bleeding points, and gum tissue quality are evaluated. Any active gum disease must be treated before implant placement.

Step 3: 3D cone beam CT scan (CBCT). This provides precise measurements of bone height, width, and density at every potential implant site. It also identifies the location of critical anatomy (nerves, sinus cavities) to ensure safe placement.

Step 4: Treatment plan and timeline. You leave with a clear written plan that includes what preparatory treatment (if any) is needed, the implant placement timeline, and a detailed cost estimate.

Next Steps After Approval

Once Dr. Rojas confirms you’re a candidate, the implant process follows three main phases:

1. Implant placement — the titanium post is surgically inserted into the jawbone under local anesthesia. Most patients return to work the next day.
2. Osseointegration (healing) — over 3–6 months, the implant fuses with the surrounding bone. A temporary restoration is worn during this phase.
3. Crown placement — once integration is confirmed, a custom porcelain crown is attached. The result looks, feels, and functions like a natural tooth.

Frequently Asked Questions

Can I get implants if I’ve had bone loss?

Yes, in most cases. Bone grafting rebuilds lost bone before implant placement. The amount of bone loss and time since extraction determine how much grafting is needed and how long the preparatory phase will take.

How long does the implant process take from start to finish?

For straightforward cases (adequate bone, healthy gums), the process takes 4–6 months from placement to final crown. Cases requiring bone grafting or periodontal treatment first may take 9–18 months total.

Are dental implants painful?

Placement is performed under local anesthesia. Most patients report being surprised at how little discomfort they felt. Post-surgical soreness is typically managed with ibuprofen and resolves within a few days.

What’s the success rate of dental implants?

In healthy patients with adequate bone, implant success rates exceed 95% over 10 years. Success rates are slightly lower in smokers, diabetics, and patients with a history of periodontal disease — all factors that Dr. Rojas addresses proactively before placement.

Is the consultation free?

Call (954) 963-4700 to ask about current consultation promotions. We want you to have all the information you need before committing to treatment.