Does Zoloft or sertraline increase dental implant failure risk?

Review

A recent retrospective study by Pena et al. has shown that the consumption of SSRI has been associated with an increased risk of dental implant failure, and these drugs are associated with a 4.53 times higher rate of dental implant failure. It’s worth considering that the increased risk of dental implant failure might be more related to the patient's psychological condition than to SSRI intake. Depressive illnesses can adversely affect oral health, resulting in a lack of dental care and lower cooperation. As a result, peri-implant diseases are more common [78].

Dental Implant Placement in Medically Compromised Patients: A Literature Review. Copyright © 2024, Samara et al. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

Review

A comprehensive systematic review by D’Ambrosio et al. showed that there were more dental implant failures in people taking SSRIs. Based on Chappuis et al.'s review, SSRI users have a 7.5% higher failure rate than non-SSRI users. Similarly, Aghaloo et al.'s review revealed that dental implant survival rates ranged from 89.4% to 94.4% among people with SSRIs compared to 95.4% to 98.15 % among non-users of SSRIs. [51]. In a meta-analysis, implant survival was studied in patients with neuropsychiatric and neurodegenerative disorders, and seven studies were included in the systematic review. Analysis showed that patients without any disorders or taking medications for these disorders were significantly more likely to survive the implants and showed that patients who didn't take SSRIs had better implant survival than those who did. Also, it’s worth mentioning that any type of neuropsychiatric or neuromuscular disorder can limit proper oral hygiene and eventually contribute to early implant failure [77].

Dental Implant Placement in Medically Compromised Patients: A Literature Review. Copyright © 2024, Samara et al. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).

Effect of antidepressants on periodontal health and wound healing:

Clinical studies indicate that venlafaxine is associated with worsened periodontal parameters, including increased gingival index, probing depth, attachment loss and alveolar bone inflammation [15]. SSRIs such as fluoxetine may induce movement-related side effects, including bruxism, which increases mechanical stress on periodontal tissues [14]. Wound healing is a complex, multi-step process involving fibroblast proliferation, collagen deposition, angiogenesis and platelet aggregation. Serotonin contributes to collagen synthesis, fibroblast growth and angiogenesis [17]. SSRIs reduce serotonin uptake and impair platelet aggregation by altering intracellular calcium mobilization, which may compromise hemostasis and tissue repair [17]. Preclinical and clinical studies suggest that SSRIs, including sertraline, may inhibit craniofacial bone healing and alter bone remodeling dynamics, highlighting the importance of monitoring periodontal and surgical outcomes in patients receiving these medications [18, 19].

Oral health considerations in patients receiving antidepressant therapy: Clinical implications and management strategies. © 2026 Biomedical Informatics. Creative Commons Attribution 3.0 International (https://creativecommons.org/licenses/by/3.0/).

Scope and clinical significance:

Additional issues such as taste dysfunction and oral bleeding have also been reported [1]. The risk of oral bleeding with SSRIs appears minimal. A retrospective cohort study of 92 SSRI users undergoing 145 invasive dental procedures, including extractions, implant surgeries, periodontal interventions and biopsies, reported only one return visit and one phone consultation for postoperative bleeding, indicating that bleeding complications are rare and manageable. Among these complications, salivary gland hypofunction is particularly significant, representing one of the most consistent and clinically relevant side effects of antidepressant therapy [7]. Given its frequency and impact, salivary dysfunction is considered one of the most important oral complications of antidepressant use and is discussed next in detail.

Oral health considerations in patients receiving antidepressant therapy: Clinical implications and management strategies. © 2026 Biomedical Informatics. Creative Commons Attribution 3.0 International (https://creativecommons.org/licenses/by/3.0/).