Dental Implants, Dental Work

Dental Implants and Autoimmune Disease: Are Implants Safe?

October 26, 2026

Having an autoimmune disease does not automatically mean you cannot have dental implants.

Current clinical evidence suggests that many patients with autoimmune conditions can achieve successful implant treatment when:

the disease is appropriately controlled;
oral inflammation is managed;
medications are reviewed;
bone and soft-tissue conditions are suitable;
and long-term implant maintenance is carefully planned.

This includes patients living with conditions such as:

rheumatoid arthritis;
Sjögren’s syndrome;
systemic lupus erythematosus;
systemic sclerosis;
oral lichen planus;
Crohn’s disease;
and other immune-mediated conditions.

However, autoimmune diseases are not all the same.

A patient with stable rheumatoid arthritis taking one medication may have a very different surgical risk profile from someone with:

active systemic lupus;
high-dose corticosteroid therapy;
multiple immunosuppressive medications;
severe Sjögren’s-related dry mouth;
osteoporosis treatment;
or poorly controlled oral inflammation.

For that reason, the question is usually not:

“Do autoimmune diseases reject dental implants?”

The better question is:

“Is this patient’s autoimmune disease, medication profile and oral condition compatible with predictable implant healing and long-term maintenance?”

This guide explains what current research tells us about dental implants and autoimmune disease, including rheumatoid arthritis, lupus and Sjögren’s syndrome, as well as immunosuppressants, biologic drugs, corticosteroids, bone medications and the factors dentists evaluate before implant surgery.

This article provides general educational information. Patients with autoimmune disease should not stop or modify prescribed medication for dental implant surgery without guidance from the clinician who manages that medication.

Quick Answer: Can You Get Dental Implants With an Autoimmune Disease?

Often, yes.

A 2025 review of implant treatment in patients with autoimmune diseases found generally high mid-term implant survival despite many patients receiving immunosuppressive medications.

However, the authors also emphasized that much of the available evidence consists of:

case reports;
case series;
retrospective studies;
and relatively small patient groups.

Therefore, autoimmune disease should usually be considered a risk-modifying factor rather than an automatic contraindication.

The implant team should evaluate:

which autoimmune disease you have;
whether it is active or stable;
which medications you use;
whether your immune system is significantly suppressed;
your bone health;
your periodontal health;
whether you have dry mouth;
and whether you can maintain the implants long term.

Do Autoimmune Diseases Make the Body Reject Dental Implants?

Not in the same way the body can reject a transplanted organ.

A dental implant is not living donor tissue.

Most conventional implants are made from titanium or titanium alloys and are designed to become mechanically and biologically integrated with the surrounding jawbone.

This process is called:

osseointegration.

The immune system participates in:

wound healing;
bone remodeling;
inflammatory regulation;
and tissue repair.

Autoimmune disease or its treatment may potentially modify some of those processes.

But there is no evidence that patients with autoimmune disease routinely “reject” titanium implants simply because their immune system is abnormal.

What Is Osseointegration?

Osseointegration describes the direct functional relationship between a dental implant surface and living bone.

After implant placement:

a blood clot initially forms around the implant;
inflammatory and immune cells participate in early healing;
new bone is produced;
the bone remodels;
and the implant gradually achieves biological stability.

This process occurs over weeks and months.

An autoimmune disorder may theoretically influence:

inflammation;
bone metabolism;
immune response;
and wound healing.

But the clinical importance varies enormously between diseases and patients.

What Does the Research Say About Autoimmune Disease and Dental Implants?

The overall evidence is cautiously reassuring.

A 2022 systematic critical review analyzed 55 studies involving nine autoimmune diseases.

Despite considerable variation between studies, implant survival was generally comparable with outcomes reported in patients without autoimmune disease.

A larger 2025 scoping review included 87 studies.

It reported implant survival ranging from approximately:

85.3% to 100%

across the autoimmune populations represented.

However, that review also found that much of the scientific evidence was relatively low level.

Many studies were:

small;
retrospective;
or individual case reports.

So the current evidence supports implant treatment in selected autoimmune patients without suggesting that every autoimmune condition carries exactly the same risk.

Autoimmune Disease vs Autoimmune Medication: Which Matters More?

Often, both matter.

Some patients have relatively mild disease but require medication that affects:

immune function;
inflammation;
bone metabolism;
or wound healing.

Others may have significant systemic disease while taking relatively limited medication.

This is why an implant dentist should know both:

your diagnosis and your complete medication list.

What Autoimmune Conditions Have Been Studied With Dental Implants?

Published studies include patients with:

rheumatoid arthritis;
Sjögren’s syndrome;
systemic lupus erythematosus;
systemic sclerosis;
oral lichen planus;
Crohn’s disease;
type 1 diabetes;
pemphigus;
mucous membrane pemphigoid;
and other immune-mediated conditions.

The amount and quality of evidence are very different for each disease.

Therefore, survival percentages from one autoimmune condition should not automatically be applied to another.

Dental Implants and Rheumatoid Arthritis

Rheumatoid arthritis does not automatically prevent dental implant treatment.

Implants have been successfully used in patients with RA.

However, rheumatoid arthritis deserves additional attention because both:

the inflammatory disease;
and medications used to control it

can affect implant-related risk assessment.

Does Rheumatoid Arthritis Increase Implant Failure?

The evidence remains limited.

Recent reviews still report generally favorable implant survival in patients with autoimmune disorders.

However, a 2025 systematic review and meta-analysis found that the RA studies included showed greater marginal bone loss around implants than their comparison groups.

The estimated mean difference was approximately:

1.6 mm of additional marginal bone loss.

This finding should be interpreted cautiously because:

the available RA studies are limited;
medications vary substantially;
disease severity differs;
follow-up periods vary;
and confounding factors can influence bone loss.

It does not mean that every patient with rheumatoid arthritis will lose significant implant bone.

What Makes Rheumatoid Arthritis Relevant to Implant Treatment?

The implant dentist may consider:

current disease activity;
long-term corticosteroid exposure;
methotrexate use;
biologic or targeted immune therapy;
osteoporosis;
antiresorptive medication;
smoking;
manual dexterity;
and periodontal disease.

Why Does Manual Dexterity Matter in Rheumatoid Arthritis?

RA can affect the:

hands;
wrists;
and finger joints.

This can make:

toothbrushing;
flossing;
interdental cleaning;
and cleaning beneath implant bridges

more difficult.

This becomes particularly important with:

All-on-4;
All-on-6;
or another fixed full-arch implant bridge.

The prosthesis should therefore be designed so the patient can realistically maintain it.

Can Rheumatoid Arthritis Affect Bone?

Yes.

Rheumatoid arthritis can be associated with reduced bone mineral density.

This may be influenced by:

systemic inflammation;
age;
reduced physical activity;
menopause;
and long-term glucocorticoid treatment.

Low bone density itself does not automatically rule out dental implants.

Read more about dental implants and osteoporosis.

Dental Implants and Sjögren’s Syndrome

Sjögren’s syndrome is one of the better-studied autoimmune conditions in implant dentistry.

Sjögren’s can cause significant reduction in salivary flow.

This produces xerostomia, or chronic dry mouth.

As a result, patients can experience:

rapid dental decay;
difficulty wearing removable dentures;
burning mouth;
oral discomfort;
difficulty swallowing dry food;
and increased need for dental restoration.

Are Dental Implants Successful in Sjögren’s Syndrome?

Available evidence is generally favorable.

A 2021 umbrella review summarized 722 implants placed in 189 patients with Sjögren’s syndrome and reported an overall success rate of approximately:

95.2%.

However, the authors emphasized that the systematic reviews available were of low or critically low methodological quality.

A 2024 systematic review reported approximately:

95.8% survival

for 316 implants placed in 111 Sjögren’s patients.

Again, this does not mean every patient has a 95.8% personal probability of success.

It simply indicates that Sjögren’s syndrome has not emerged as an automatic implant contraindication in the available literature.

Why Can Implants Be Especially Useful in Sjögren’s Syndrome?

Patients with severe dry mouth can struggle with removable dentures.

Saliva contributes to:

lubrication;
comfort;
adhesion;
and denture function.

A dry mouth can therefore make a removable denture:

less comfortable;
more irritating;
and more difficult to retain.

Implant-supported restorations may improve stability and function for selected patients.

Does Dry Mouth Cause Implant Failure?

Not directly in the same way that it dramatically increases natural-tooth decay risk.

Dental implants cannot develop dental caries.

However, dry mouth can still influence the oral environment.

Patients may experience:

mucosal irritation;
plaque accumulation;
oral discomfort;
difficulty cleaning;
and infections such as oral candidiasis.

Therefore, xerostomia still needs active management.

Do Patients With Sjögren’s Need More Frequent Implant Maintenance?

Often, a more individualized recall program is sensible.

Some studies have found:

greater marginal bone loss;
or more peri-implant mucosal inflammation

in certain Sjögren’s populations, particularly secondary Sjögren’s.

Regular monitoring allows the team to identify:

plaque accumulation;
bleeding;
bone changes;
and prosthetic cleaning difficulties

early.

Dental Implants and Lupus

Systemic lupus erythematosus does not automatically rule out dental implants, but the scientific evidence is much more limited than for Sjögren’s syndrome.

Published reports include successful implant treatment in patients with lupus.

However, the number of patients studied remains small.

A 2024 systematic review identified only:

12 implants in five patients with lupus erythematosus

within the studies meeting its inclusion criteria.

Those implants had 100% survival after one year of function, but the sample is far too small and the follow-up too limited to claim that lupus carries no additional risk.

Why Is Lupus More Complicated to Assess?

SLE can affect multiple organ systems, including:

joints;
skin;
kidneys;
blood cells;
blood vessels;
heart;
lungs;
and nervous system.

The dental implant risk assessment therefore depends heavily on:

disease severity;
current disease activity;
organ involvement;
immune suppression;
blood abnormalities;
and medication.

Can You Have Implants During a Lupus Flare?

Elective implant surgery is generally best planned when systemic disease is medically stable rather than during a significant active flare.

A flare may involve:

increased systemic inflammation;
changes in medication;
fatigue;
organ involvement;
or increased immunosuppression.

If disease activity is significant, the implant procedure may be postponed until the patient’s medical condition is more stable.

Should the Implant Dentist Speak With Your Rheumatologist?

For some patients, yes.

Medical coordination is particularly useful when:

disease activity is unclear;
multiple immunosuppressants are being used;
biologic therapy is involved;
high-dose corticosteroids are used;
kidney or blood abnormalities are present;
major grafting is planned;
or the medical history is complex.

What About Systemic Sclerosis?

Dental implants have also been reported successfully in patients with systemic sclerosis or scleroderma.

A systematic review published in 2023 identified:

37 patients;
and 153 implants.

Implant survival in the case series was approximately 89.2%, while the individual case reports generally reported 100% survival.

The authors did not identify a clear effect of systemic sclerosis alone on implant survival but emphasized careful medical risk assessment.

Why Can Systemic Sclerosis Make Dental Treatment Difficult?

Patients may develop:

reduced mouth opening;
tight facial tissues;
dry mouth;
difficulty cleaning teeth;
and altered oral anatomy.

This can make both:

implant surgery;
and long-term maintenance

more technically challenging.

What About Oral Lichen Planus?

Oral lichen planus is an immune-mediated inflammatory condition affecting the oral mucosa.

Current evidence suggests that stable, well-controlled oral lichen planus does not necessarily compromise dental implant survival.

A 2024 systematic review and meta-analysis found no significant increase in peri-implant mucositis or peri-implantitis compared with control patients.

However, implant or prosthetic treatment is generally avoided during an active erosive flare.

Long-term oral surveillance is particularly important because oral lichen planus requires ongoing monitoring independently of implant treatment.

Why Does Disease Activity Matter?

Autoimmune disease is not simply:

“present” or “absent.”

A patient can be:

in remission;
clinically stable;
mildly active;
or experiencing a significant flare.

Disease activity can influence:

systemic inflammation;
medication requirements;
immune function;
energy and ability to maintain oral hygiene;
and general surgical risk.

For elective implant surgery, stable disease generally provides a more favorable situation than uncontrolled active disease.

Does Immunosuppression Prevent Osseointegration?

Not automatically.

Patients receiving immunosuppressive medication have successfully undergone implant treatment.

A systematic review and meta-analysis involving immunocompromised patients did not identify a statistically significant overall effect of immunocompromised status on implant survival.

However, the amount of evidence for individual medications is limited.

The 2025 autoimmune implant scoping review similarly reported generally high implant survival despite widespread use of immunosuppressants.

But it also emphasized that evidence regarding specific medication effects remains incomplete.

Which Autoimmune Medications Matter Before Implant Surgery?

The dentist should know if you take:

corticosteroids;
methotrexate;
hydroxychloroquine;
azathioprine;
mycophenolate;
cyclosporine;
tacrolimus;
TNF inhibitors;
interleukin inhibitors;
JAK inhibitors;
rituximab;
or another immunomodulating medication.

The relevance depends on:

dose;
duration;
combination therapy;
disease being treated;
infection history;
blood counts;
and the extent of the planned implant surgery.

Should You Stop Methotrexate Before Dental Implants?

Do not stop methotrexate yourself.

The decision to continue, modify or temporarily interrupt medication should be made by the clinician who manages your autoimmune disease in coordination with the dental surgical team when necessary.

Stopping an effective autoimmune medication can cause:

a disease flare;
increased inflammation;
and potentially greater overall medical risk.

A dental surgeon should therefore not casually instruct patients to stop systemic treatment without considering the consequences.

What About Biologic Drugs?

Biologic medications target specific immune pathways.

Examples include medications directed against:

TNF;
interleukins;
B cells;
and other immune targets.

These drugs may affect infection risk and perioperative planning.

However, high-quality evidence specifically determining the optimal management of biologics for dental implant surgery remains limited.

The treatment plan may depend on:

the medication;
dosing interval;
type of implant surgery;
grafting requirements;
infection history;
and underlying disease activity.

Should Biologic Medication Be Stopped for Dental Implant Surgery?

Not automatically.

There is no safe universal instruction that applies to every biologic drug and every autoimmune patient.

The implant surgeon may coordinate with the:

rheumatologist;
immunologist;
gastroenterologist;
dermatologist;
or other prescribing specialist

when major implant surgery is planned.

Do Corticosteroids Affect Dental Implants?

Long-term systemic corticosteroid use deserves consideration because it can influence:

immune response;
bone metabolism;
glucose regulation;
and wound healing.

However, existing implant studies have not established that corticosteroid use automatically causes implant failure.

The clinical importance depends on:

dose;
duration;
other medications;
bone health;
and the patient’s systemic condition.

Should Steroids Be Stopped Before Implant Surgery?

No patient should abruptly discontinue prescribed systemic corticosteroids because of dental surgery without medical guidance.

Sudden withdrawal after prolonged steroid use can be medically dangerous.

Your implant surgeon should know:

which steroid you use;
the daily dose;
how long you have taken it;
and the condition being treated.

Can Immunosuppressants Increase Infection Risk?

They can alter immune defense and may increase infection susceptibility in certain patients.

A 2025 scoping review of invasive dental procedures in patients receiving:

biologic DMARDs;
conventional DMARDs;
and glucocorticoids

reported local infection, delayed healing and medication-related osteonecrosis in the literature.

However, much of the evidence came from:

case reports;
case series;
and tooth-extraction cases

rather than controlled implant studies.

This means the risk needs to be individualized rather than assumed.

Do Autoimmune Patients Need Preventive Antibiotics for Implants?

Not simply because they have an autoimmune diagnosis.

Antibiotic decisions should consider:

the planned surgery;
immune status;
medications;
history of infection;
medical comorbidities;
and current clinical guidelines.

Long or repeated antibiotic courses should not be prescribed automatically without clinical indication.

Why Is Bone Health Important?

Autoimmune patients may have additional risk factors for reduced bone density.

These include:

systemic inflammation;
age;
menopause;
reduced mobility;
vitamin D deficiency;
and long-term corticosteroid therapy.

This can lead to:

osteopenia;
or osteoporosis.

Neither condition automatically prevents dental implant treatment.

Does Osteoporosis Mean Implants Will Not Integrate?

No.

Implants can successfully osseointegrate in many patients with osteoporosis.

The dentist should consider:

local jawbone anatomy;
implant stability;
medication;
fracture history;
and overall bone health.

Read our detailed guide to dental implants and osteoporosis.

Why Are Bisphosphonates Important?

Some autoimmune patients develop osteoporosis and receive antiresorptive medication such as:

alendronate;
risedronate;
zoledronic acid;
or another bisphosphonate.

These medications are relevant because they are associated with a rare complication called:

medication-related osteonecrosis of the jaw, or MRONJ.

The risk varies greatly according to:

why the medication is prescribed;
drug type;
dose;
route;
duration;
cancer history;
and other medical risk factors.

Can You Have Dental Implants While Taking Bisphosphonates?

The answer depends heavily on the medication context.

AAOMS guidance distinguishes between:

patients taking antiresorptive medication for osteoporosis;
and oncology patients receiving higher-dose parenteral antiresorptive or antiangiogenic therapy.

Elective implant placement is generally approached much more cautiously in the oncology setting.

If you use a bisphosphonate, the implant surgeon needs to know:

the exact drug;
why you take it;
how long you have taken it;
and whether it is oral or intravenous.

Read more about bisphosphonates and dental implants.

What About Denosumab?

Denosumab is another antiresorptive medication used in:

osteoporosis;
and certain cancer-related conditions.

It also requires specific implant and oral-surgery risk assessment.

Patients should not alter denosumab timing themselves because interruption can have important systemic consequences, particularly in osteoporosis treatment.

Coordination with the prescribing doctor may therefore be required.

Can Autoimmune Disease Cause Poor Wound Healing?

Some autoimmune diseases and medications can influence healing.

But this does not occur uniformly in every autoimmune patient.

Important additional factors include:

smoking;
diabetes;
malnutrition;
steroid exposure;
active infection;
vascular disease;
and the extent of surgery.

A small single implant procedure creates a very different surgical burden from:

multiple extractions;
extensive bone grafting;
bilateral sinus lifting;
or full-mouth implant reconstruction.

Does Autoimmune Disease Increase the Risk of Peri-Implantitis?

The answer is not yet clear for autoimmune disease as one broad category.

Some individual conditions may influence:

inflammation;
plaque control;
soft tissues;
or marginal bone behavior.

But current evidence does not justify assuming that every autoimmune patient will develop peri-implantitis.

The most important established long-term considerations remain factors such as:

plaque control;
history of periodontitis;
smoking;
prosthetic cleansability;
and regular maintenance.

What Is Peri-Implantitis?

Peri-implantitis is an inflammatory condition involving:

the tissues surrounding an implant;
and progressive loss of supporting bone.

Possible signs include:

bleeding;
suppuration;
deepening peri-implant pockets;
recession;
radiographic bone loss;
and, in advanced disease, implant mobility.

Autoimmune patients receiving implants should therefore have structured maintenance rather than waiting until symptoms develop.

Why Is Periodontal Disease Important Before Implant Placement?

If you have active gum disease around natural teeth, it should be treated before elective implant rehabilitation.

Patients with a history of periodontitis can still receive implants.

But they may have a higher risk of future peri-implant disease.

This becomes particularly relevant when autoimmune disease is combined with:

smoking;
dry mouth;
limited manual dexterity;
or immunosuppressive therapy.

Should All Natural Teeth Be Removed Because You Have Autoimmune Disease?

No.

An autoimmune diagnosis is not a reason to extract maintainable teeth.

Each tooth should be evaluated according to:

periodontal support;
decay;
fracture;
endodontic condition;
restorability;
and strategic value.

Dental implants are a replacement for teeth that cannot or should not be retained — not automatically a replacement for healthy natural teeth.

Can Autoimmune Patients Have All-on-4?

Potentially, yes.

There is no universal rule preventing All-on-4 solely because the patient has an autoimmune disorder.

However, full-arch treatment creates additional considerations because it can involve:

multiple extractions;
four or more implants;
immediate loading;
greater surgical exposure;
and a large fixed prosthesis requiring meticulous hygiene.

Patient selection should therefore consider:

medical stability;
medication;
bone anatomy;
implant stability;
oral hygiene ability;
and follow-up access.

Does Autoimmune Disease Prevent Immediate Loading?

Not automatically.

Immediate loading depends primarily on:

implant primary stability;
bone anatomy;
implant distribution;
prosthetic design;
bite forces;
and overall patient risk.

However, if a patient has:

poor healing capacity;
active systemic disease;
significant immunosuppression;
or other major risk factors,

the surgeon may choose a more conservative loading protocol.

Can Autoimmune Patients Have Bone Grafts?

Potentially.

But bone grafting increases treatment complexity and healing requirements.

The implant surgeon may need to consider:

disease activity;
bone metabolism;
steroid use;
antiresorptive medication;
immune suppression;
and the size of the graft.

A small simultaneous graft around an implant is very different from a major staged reconstruction.

Does Autoimmune Disease Mean You Need More Implants?

No.

The number of implants should be determined by:

anatomy;
prosthetic requirements;
bone availability;
implant distribution;
and biomechanics.

There is no scientific rule that autoimmune patients automatically require extra implants.

What Tests Might Be Needed Before Implant Surgery?

Testing depends on the patient’s medical history.

A healthy, medically stable autoimmune patient may not require special blood tests simply because of the diagnosis.

In more complex cases, relevant information may include:

complete blood count;
platelet count;
renal function;
liver function;
glucose or HbA1c;
or other disease-specific laboratory tests.

These should be ordered only when they are clinically relevant.

Why Might a Complete Blood Count Be Important?

Some autoimmune diseases or medications can affect:

white blood cells;
red blood cells;
or platelets.

Significant abnormalities can influence:

infection risk;
healing;
oxygen delivery;
or bleeding.

The implant surgeon may therefore request recent results in selected medically complex patients.

Do You Need Medical Clearance?

Not every autoimmune patient requires formal medical clearance.

Coordination may be useful when:

the disease is unstable;
multiple immunosuppressants are used;
significant organ disease is present;
recent medication changes have occurred;
major implant surgery is planned;
or the surgeon needs advice about medication management.

What Information Should You Give the Implant Dentist?

Provide:

the exact autoimmune diagnosis;
when you were diagnosed;
whether the disease is currently stable;
recent flares;
all medications;
medication doses when known;
allergies;
previous infections;
osteoporosis treatment;
smoking history;
and relevant specialist contact information.

Should You Mention Medication You Took Years Ago?

Yes, particularly if it involved:

bisphosphonates;
denosumab;
cancer therapy;
long-term corticosteroids;
or significant immunosuppressive treatment.

Past medication exposure can remain relevant to oral-surgery risk assessment.

Do You Need a CBCT?

Autoimmune disease itself is not an indication for CBCT.

CBCT is used when three-dimensional information is needed for implant planning.

It can show:

bone height;
bone width;
ridge anatomy;
nerve location;
sinuses;
and possible grafting requirements.

Read more about CBCT for dental implants.

Does CBCT Tell the Dentist Whether Your Autoimmune Disease Is Controlled?

No.

A CBCT shows anatomy.

It does not show:

immune function;
disease activity;
infection susceptibility;
medication safety;
or systemic healing capacity.

Implant candidacy therefore requires both:

radiographic assessment and medical assessment.

Can Autoimmune Patients Smoke and Still Get Implants?

Smoking adds another significant risk factor.

In a patient already managing autoimmune disease, smoking can further affect:

wound healing;
peri-implant inflammation;
bone;
and long-term implant outcomes.

The combination of multiple risk factors matters more than evaluating each issue in isolation.

What About Diabetes Plus Autoimmune Disease?

Some patients have more than one systemic condition.

For example, an autoimmune patient may also have:

type 1 diabetes;
type 2 diabetes;
cardiovascular disease;
or osteoporosis.

Each additional condition needs to be included in the risk assessment.

Read our guide to dental implants and diabetes.

Can Stress From Surgery Trigger an Autoimmune Flare?

Major physical and psychological stress can affect some autoimmune conditions, but the relationship is highly individual.

Patients with a history of disease flares associated with:

procedures;
infection;
or medication interruption

should discuss this with their treating specialist.

The implant plan can sometimes be staged to reduce surgical burden.

Is a Single Implant Safer Than Full-Mouth Implant Surgery?

A single implant is generally a smaller procedure than full-mouth rehabilitation.

Full-arch treatment may involve:

multiple extractions;
multiple implants;
bone reduction;
grafting;
sedation;
and immediate prosthetic loading.

Therefore, the same patient may be a straightforward candidate for one implant but require greater medical planning for bilateral full-mouth surgery.

Can Implant Surgery Be Divided Into Stages?

Yes.

Staging may be considered when the team wants to:

reduce surgical burden;
observe healing;
allow graft maturation;
or avoid performing extensive surgery at one appointment.

Whether this is useful depends on the individual treatment plan.

Can You Get Dental Implants During Autoimmune Remission?

Stable remission can provide a favorable opportunity for elective treatment.

The implant team may prefer a period when:

symptoms are controlled;
medication is stable;
there is no active oral inflammatory disease;
and the patient’s general health is predictable.

However, a patient should not change effective systemic therapy simply to create an artificial medication-free period for implant surgery.

What if the Autoimmune Disease Is Newly Diagnosed?

If the diagnosis is recent and medical treatment is still being adjusted, it may be reasonable to establish medical stability before proceeding with elective complex implant surgery.

This allows the dental team to understand:

the disease course;
medication;
treatment response;
and any systemic complications.

What if Your Autoimmune Disease Is Uncontrolled?

Elective implant surgery may be postponed when the systemic disease creates an unacceptable surgical or healing risk.

The priority should be:

medical stabilization;
control of oral infection;
and prevention of further dental disease.

The implant plan can then be reconsidered later.

Can Dental Implants Trigger an Autoimmune Disease?

There is no good clinical evidence that conventional dental implants routinely trigger systemic autoimmune disease in otherwise healthy patients.

Claims that titanium implants commonly cause conditions such as:

rheumatoid arthritis;
lupus;
or Sjögren’s syndrome

are not supported by current clinical implant evidence.

What About Titanium Allergy or Sensitivity?

True clinically significant reactions to titanium implants appear to be uncommon.

Symptoms around an implant are much more commonly explained by factors such as:

plaque-related inflammation;
peri-implantitis;
cement;
prosthetic complications;
or another local condition.

A suspected material reaction should therefore be evaluated carefully rather than assumed.

Should Autoimmune Patients Choose Zirconia Implants Instead?

There is no established rule that autoimmune patients should receive zirconia implants instead of titanium.

Material choice should consider:

clinical evidence;
implant design;
bone anatomy;
prosthetic needs;
surgeon experience;
and patient-specific factors.

An autoimmune diagnosis by itself is not evidence that titanium implants are unsuitable.

How Important Is Oral Hygiene?

Extremely important.

Across systematic reviews of autoimmune implant patients, careful oral hygiene and long-term maintenance repeatedly emerge as important factors.

Patients should be able to clean:

around each implant crown;
between implants;
under fixed bridges;
and around natural teeth.

How Often Should Autoimmune Patients Have Implant Check-Ups?

There is no single interval for everyone.

Follow-up should be based on:

autoimmune disease;
medication;
history of periodontal disease;
dry mouth;
plaque control;
smoking;
implant number;
prosthetic design;
and previous complications.

Higher-risk patients may benefit from more frequent supportive implant care.

What Is Checked During Maintenance?

The dental team may assess:

plaque;
bleeding;
gum condition;
peri-implant probing;
recession;
prosthetic stability;
bite;
cleaning access;
and bone levels when radiographs are clinically indicated.

Why Is Maintenance Especially Important in Sjögren’s Syndrome?

Dry mouth can create a challenging oral environment.

In addition to implant monitoring, patients need prevention against:

rapid natural-tooth decay;
oral fungal infection;
mucosal trauma;
and oral discomfort.

Saving the remaining natural teeth is just as important as maintaining the implants.

Can Saliva Substitutes Help Sjögren’s Patients With Implants?

They may improve comfort in some patients.

Management of dry mouth can include:

frequent water intake;
saliva substitutes;
salivary stimulants when medically appropriate;
high-fluoride preventive strategies for natural teeth;
and management of oral candidiasis when present.

The exact xerostomia plan should be individualized.

What if You Already Have Implants and Are Later Diagnosed With an Autoimmune Disease?

You do not automatically need the implants removed.

Tell both:

your dentist;
and your medical specialist

about the diagnosis and medication.

Your implant maintenance program may need adjustment depending on:

the condition;
dry mouth;
immune suppression;
bone medications;
and oral symptoms.

What if You Start Immunosuppressive Medication After Getting Implants?

Again, existing implants do not automatically need removal.

Your dentist should know about the medication change.

Monitoring may focus on:

soft-tissue health;
infection;
bone levels;
and oral hygiene.

Can Existing Implant Infection Be More Important Than the Autoimmune Disease?

Yes.

An implant with active:

peri-implantitis;
suppuration;
progressive bone loss;
or mobility

requires treatment regardless of whether the patient has an autoimmune disease.

Do not attribute every implant problem to the systemic diagnosis.

Read more about dental implant infection.

What if an Implant Is Already Loose?

A truly mobile implant fixture usually indicates loss of osseointegration or severe supporting bone loss.

That is a local implant problem requiring assessment.

A loose crown or loose screw is different and may be repairable without removing the implant.

Can Autoimmune Patients Have Dental Implants Abroad?

Potentially, yes.

But medical documentation and continuity of care become particularly important.

Before travelling, send the clinic:

your autoimmune diagnosis;
complete medication list;
relevant recent medical reports;
recent dental X-rays;
CBCT if already available;
and information about previous surgery or implant treatment.

Should You Travel Without Telling the Clinic About Your Autoimmune Disease?

No.

Do not hide medical information because you are worried the clinic may refuse treatment.

The purpose of medical screening is to determine the safest treatment pathway.

Not disclosing:

immunosuppressants;
steroids;
blood-thinning medication;
antiresorptives;
or active systemic disease

can make surgical planning less safe.

Can the Implant Dentist Assess Your Case Online First?

Yes.

An online preliminary assessment may help determine:

whether implant treatment appears feasible;
which dental imaging is needed;
whether medical coordination may be required;
and what treatment options should be discussed.

However, medical candidacy cannot be confirmed from an X-ray alone.

Learn more about online dental implant consultations.

What Should You Send for an Online Assessment?

Useful information includes:

panoramic X-ray;
CBCT if available;
clear photographs;
your exact autoimmune diagnosis;
medication list;
recent medication changes;
other medical conditions;
smoking history;
and your treatment goals.

Who May Not Be Ready for Dental Implants Right Now?

Implant treatment may need to be postponed or reconsidered in patients with:

significantly uncontrolled systemic disease;
an active severe autoimmune flare;
uncontrolled oral infection;
severe untreated periodontal disease;
medical abnormalities making elective surgery unsafe;
certain high-risk antiresorptive or antiangiogenic oncology therapies;
or inability to maintain the planned implant restoration.

This does not always mean implants are impossible forever.

Some risk factors can be treated or stabilized first.

What Makes Someone a Better Implant Candidate?

Favorable factors include:

stable autoimmune disease;
stable medication;
good plaque control;
treated periodontal disease;
no active dental infection;
adequate bone or a realistic grafting plan;
non-smoking status;
and willingness to attend long-term maintenance.

Questions to Ask Your Implant Dentist

Does my autoimmune disease change my implant risk?
Is my disease stable enough for elective surgery?
Do any of my medications affect healing or infection risk?
Do you need to contact my rheumatologist or specialist?
Should I have any recent blood tests?
Do I have enough jawbone?
Do I need bone grafting?
Can the surgery be performed in stages?
Is immediate loading appropriate?
How often will my implants need maintenance?
How will my dry mouth affect the restoration?
Can I realistically clean the planned implant bridge?

Questions to Ask Your Rheumatologist or Medical Specialist

Depending on your treatment, useful questions may include:

Is my autoimmune disease currently considered stable?
Are there any medical reasons to postpone elective implant surgery?
Does my medication create special surgical considerations?
Do I have blood abnormalities relevant to surgery?
Do I have osteoporosis or another bone condition?
Do I use antiresorptive medication?

The goal is coordinated care — not obtaining a simple “yes” or “no” permission letter without context.

Red Flags Before Autoimmune Patients Have Implant Surgery

Additional evaluation may be appropriate if you have:

a recent severe autoimmune flare;
fever or active infection;
significant unexplained weight loss;
very low white blood cell counts;
significant platelet abnormalities;
poorly controlled diabetes;
active oral ulceration at the surgical site;
severe untreated periodontal disease;
high-dose oncology antiresorptive therapy;
or recent major changes in immunosuppressive treatment.

Frequently Asked Questions About Dental Implants and Autoimmune Disease

Can you get dental implants if you have an autoimmune disease?

Often, yes. Autoimmune disease is not automatically a contraindication. Treatment depends on disease activity, medication, bone condition, oral health and overall surgical risk.

Do autoimmune diseases cause dental implants to fail?

Not necessarily. Current reviews report generally high implant survival in autoimmune patients, although evidence quality is limited and some diseases may have specific risks.

Can the immune system reject a titanium dental implant?

Implant failure is not generally considered equivalent to organ-transplant rejection. Dental implants integrate directly with bone through osseointegration.

Are dental implants safe with rheumatoid arthritis?

Many RA patients can receive implants successfully. Recent evidence suggests that marginal bone loss may deserve closer monitoring in RA, although the evidence remains limited.

Does rheumatoid arthritis cause implant failure?

A direct large increase in implant failure has not been conclusively established. Disease control, medication, osteoporosis, smoking, periodontal health and hygiene should all be considered.

Can you have implants while taking methotrexate?

Potentially, yes. Do not stop methotrexate yourself. Medication management should be individualized with the prescribing clinician when necessary.

Can you get dental implants while taking biologic medication?

Potentially. The decision depends on the specific drug, disease activity, infection risk and extent of surgery. Medical coordination may be appropriate.

Should biologics be stopped before implant surgery?

There is no universal rule for every drug and patient. Do not interrupt biologic therapy without guidance from the prescribing medical specialist.

Can steroid use cause dental implant failure?

Long-term steroids can influence bone and immune function, but current implant evidence does not show that steroid use automatically results in implant failure.

Should I stop prednisone before dental implants?

No medication change should be made without medical guidance. Abruptly stopping long-term systemic corticosteroids can be dangerous.

Can someone with lupus get dental implants?

Potentially, yes. Successful cases have been reported, but clinical evidence in lupus remains very limited. Disease activity, organ involvement and medication require careful assessment.

Are implants safe during a lupus flare?

Elective implant surgery is generally more appropriately considered when significant systemic disease is stable rather than during an active severe flare.

Can someone with Sjögren’s syndrome have implants?

Yes. Available reviews show generally favorable implant survival in patients with Sjögren’s syndrome.

Does dry mouth make implants fail?

Dry mouth does not cause dental decay in implants because implants cannot develop cavities, but xerostomia can make plaque control, mucosal comfort and long-term oral maintenance more challenging.

Are implants better than dentures for Sjögren’s syndrome?

They may provide significant advantages for selected patients because severe dry mouth can make removable dentures uncomfortable and difficult to retain.

Does Sjögren’s syndrome increase peri-implantitis?

Some studies suggest greater mucosal inflammation or marginal bone loss in certain Sjögren’s groups, but the evidence is not strong enough to claim that all Sjögren’s patients have a substantially higher peri-implantitis risk.

Can I get implants if I have scleroderma?

Potentially. Implant survival has been favorable in published systemic sclerosis studies, although limited mouth opening and oral hygiene difficulties can complicate treatment.

Can I have implants with oral lichen planus?

Stable oral lichen planus is not currently considered an absolute implant contraindication. Elective implant treatment is generally avoided during active erosive disease.

Can immunosuppressed patients have dental implants?

Many can. Current evidence does not establish immunosuppression as an automatic contraindication, but careful risk assessment and medical coordination may be needed.

Do immunosuppressants prevent osseointegration?

Not automatically. Successful osseointegration has been reported in patients receiving immunosuppressive medication, although evidence for individual medications remains limited.

Do autoimmune patients need antibiotics before implants?

Not simply because of the autoimmune diagnosis. Antibiotic decisions should be individualized according to surgery and medical risk.

Can I get All-on-4 with rheumatoid arthritis?

Potentially, yes. The dentist must evaluate disease stability, medication, bone, implant stability, hygiene ability and overall surgical risk.

Can I get All-on-4 if I have lupus?

Possibly, but full-arch surgery is more extensive than placement of a single implant and requires careful medical and dental assessment.

Can autoimmune patients have bone grafts?

Many can, but grafting increases healing demands. Medication, disease activity, bone health and the size of the graft should be considered.

Can you get implants with osteoporosis and autoimmune disease?

Potentially. Osteoporosis does not automatically prevent implant treatment, but antiresorptive medication and individual bone risk need evaluation.

Can you get implants while taking bisphosphonates?

It depends on why the medication is used, the dose, route and duration. Osteoporosis treatment and high-dose oncology treatment carry very different risk profiles.

Can you get implants while taking denosumab?

Potentially in selected osteoporosis patients, but individualized medical and surgical assessment is important. Do not alter denosumab treatment yourself.

Do autoimmune patients need more implant check-ups?

Some patients benefit from closer maintenance, particularly when dry mouth, periodontal history, smoking, oral mucosal disease or immunosuppression is present.

Can dental implants trigger autoimmune disease?

There is no good clinical evidence that conventional dental implants routinely cause systemic autoimmune diseases such as lupus or rheumatoid arthritis.

Should autoimmune patients use zirconia instead of titanium implants?

There is no established evidence-based rule requiring zirconia implants simply because a patient has an autoimmune disorder.

Can my dentist assess implant candidacy online?

A preliminary assessment can be performed using medical information, dental photographs and imaging, but final surgical candidacy may require clinical examination and medical coordination.

Dental Implants and Autoimmune Disease: The Bottom Line

Autoimmune disease alone is usually not enough to rule out dental implant treatment.

Current systematic and scoping reviews show that many patients with autoimmune disorders achieve high implant survival.

This includes published experience involving:

rheumatoid arthritis;
Sjögren’s syndrome;
lupus;
systemic sclerosis;
oral lichen planus;
and other immune-mediated conditions.

However, the scientific evidence is not equally strong for every disease.

For example:

Sjögren’s syndrome has relatively reassuring implant-survival data;
rheumatoid arthritis may warrant closer monitoring of marginal bone according to recent evidence;
lupus has encouraging published cases but very limited patient numbers;
and patients with active mucosal autoimmune disease may benefit from having the condition stabilized before implant treatment.

The most important clinical factors are often:

disease stability;
immunosuppressive medication;
corticosteroid exposure;
bone health;
antiresorptive medication;
dry mouth;
periodontal disease;
smoking;
oral hygiene;
and long-term maintenance.

Do not stop methotrexate, biologic medication, corticosteroids, denosumab or another systemic drug simply because implant surgery is planned.

Medication decisions should be coordinated with the doctor who manages the underlying condition when necessary.

A well-planned implant assessment should therefore combine:

medical history;
complete medication review;
dental examination;
periodontal assessment;
appropriate dental imaging;
and a realistic long-term maintenance strategy.

At SOTA Dental – Advanced Implantology Center, patients with medically complex histories can be evaluated according to their complete clinical picture rather than excluded solely because of an autoimmune diagnosis.

If you are considering treatment from abroad, send your:

panoramic X-ray;
CBCT if available;
medical diagnosis;
medication list;
and relevant recent medical information

for preliminary assessment before travelling.

Learn more about our dental implant treatments, dental implants and osteoporosis, bisphosphonates and dental implants, dental implants and diabetes, dental implant infection and online dental implant assessment.

Scientific References

Hyldahl E et al., 2025. Dental Implant Therapy in Patients With Autoimmune Diseases: A Scoping Review. Clin Oral Implants Res. PMID: 40181226.

Chitumalla RK et al., 2025. Success Rate of Dental Implants in Patients with Autoimmune Disorders: A Systematic Review and Meta-Analysis. PMID: 41244663.

Hyldahl E et al., 2024. Survival and Success of Dental Implants in Patients with Autoimmune Diseases: A Systematic Review. PMID: 38812949.

Sarafidou K et al., 2024. Implant Treatment in Patients With Autoimmune Diseases: A Systematic Review and Analysis of Studies. PMID: 39310633.

Duttenhoefer F et al., 2022. Dental implants in patients suffering from autoimmune diseases: A systematic critical review. PMID: 35033725.

Chrcanovic BR et al., 2019. Dental implants in patients with Sjögren’s syndrome: a case series and a systematic review. PMID: 30827571.

Albrecht K et al., 2021. Is Sjögren’s syndrome a risk factor/contraindication for dental implants? An umbrella review. PMID: 33987854.

Dental implants in patients with oral manifestations of autoimmune or muco-cutaneous diseases: A systematic review. PMID: 30818315.

Oral rehabilitation with dental implants in patients with systemic sclerosis: A systematic review. PMID: 36988245.

Stabilized oral lichen planus does not compromise dental implants survival: A systematic review and meta-analysis, 2024. PMID: 38735757.

Dental implants in immunocompromised patients: A systematic review and meta-analysis. PMID: 31776815.

Complications of invasive oral procedures in patients with immune-mediated inflammatory disorders treated with biologic/conventional DMARDs or glucocorticoids, 2025. PMID: 40148875.

American Association of Oral and Maxillofacial Surgeons. Medication-Related Osteonecrosis of the Jaw – 2022 Update.

Medical disclaimer: This article provides general educational information and does not replace individualized advice from an implant dentist, oral surgeon or the medical specialist managing your autoimmune disease. Do not stop or modify prescribed autoimmune, steroid, biologic or bone medication without medical guidance.