Smoking after tooth removal can be harmful. It increases the risk of problems and pain.
For regular smokers, the act of NOT smoking for a few days can be uncomfortable and upsetting. The risk of agonizing pain or poor healing caused by smoking is very serious though.
When you have a tooth removed it can take a few days for the healing process to kick into gear. Lifestyle factors like diet, overall health, and nutrition can slow down or modify healing.
Smoking anything (even vaping) can slow down tooth healing and increase the pain felt.
In an ideal world, you would abstain from smoking for five full days after tooth removal. For many, this is not realistic. The first 24 hours are critical for the process of healing. So at the minimum aim for 24 full hours after the extraction.
The take-home message? For as long as possible following tooth extraction do not smoke.
Why smoking after tooth extraction matters
As a dental surgeon, I see better results from patients who don’t smoke after having a tooth out. They tend to heal faster and with less pain.
The main reason for the better healing is likely the effect that cigarette smoke has on the blood clot.
Smoke can disrupt the process of a blood clot forming. If the blood clot is lost or of poor quality – the whole healing process suffers. Expect more pain and a longer healing time.
This happens because smoking contains some chemicals which can impact how well the initial blood clot forms. It also affects blood flow.
This is where it gets interesting – smoking reduces the blood flow to the healing area. We are relying on this blood flow to help manage inflammation and promote fast easy healing!
The other possible contributing factors are that the physical act of smoking and exhaling can knock the blood clot, and also the reduction in saliva and heat of the smoke itself might dry out the clot. This can make the clot fragile. Some dentists think this is the biggest reason that smokers have issues like pain, prolonged healing, or dry socket.
Should I vape after a tooth extraction instead of smoking?
Vaping and e-cigarettes carry much of the same risk to a healing extraction site as regular smoking.
In my patients, I see similar issues of delayed healing and dry sockets. So I typically recommend avoiding vapes and e-cigs for the same amount of time. Treat them the same as smoking.
If you are a smoker – there is no strong evidence to suggest that switching from smoking to vaping will give a better outcome after tooth extraction. That said, more research needs to be done as many people now use e-cigarettes.
The main reason you should not smoke after extraction is smoker’s dry socket
A dry socket is a condition that can develop after an extraction. It is a painful and serious complication that should be avoided at all costs.
A dry socket occurs when the clot doesn’t form or falls out. A failed blood clot means a massive delay to healing. This makes a few days of discomfort turn into a week or two. Ouch!
Tobacco smoke has been shown to hasten the development of a dry socket, as smoke damages the blood clot around the tooth’s socket. Smoking tobacco cigarettes or e-cigarettes also contributes to dry socket, as smoke also reduces saliva production, which is essential for creating a healthy blood clot.
Smoking post-extraction can lead to delayed healing and an increased risk of developing dry sockets. The duration of smoking cessation needs to last at least five days following tooth removal – even though this may not be possible for many.
If you think you have a dry socket, your first call is to the surgeon or dentist who took the tooth out. We can’t really fix the problem, but there are things we can do to make it feel better while it slowly heals.
Let the body heal
There are several additional factors to take into account while waiting for an extraction to heal. Follow these basic extraction healing steps (along with not smoking) and your extraction site will heal quickly.
This will also help prevent infections, prevent dry socket, and lower the risk of the wound from being reinjured.
The first few days
- Hot drinks like tea and coffee are fine BUT only at warm temperatures. Extreme temperatures in the first 24 hours can affect the blood clot
- Your dentist will tell you to avoid heavy physical activity (I always tell people to skip the gym that day or even better do a light session a few hours before the appointment)
- DO brush the teeth, DON’T brush the extraction site. Because – it will hurt. Simple!
- Skip the straw – you don’t want any suction to disrupt the delicate blood clot. Just drink from a cup.
- And alcohol is best avoided as it slows down healing and can hurt the clot.
- Crunch foods and hard food are usually best avoided. Not worth the risk of damaging the clot and early skin healing.
- Use plenty of salt water rinses (make it yourself) to keep the area clean and healthy
So hot nachos with a margarita through a straw after lifting weights? A really bad idea.
Following and extraction you would expect some bad tastes and sometimes even temporary bad breath.
Some extractions are at a higher risk of post-operative complications than others. So if your tooth extraction with an emergency tooth extraction, or wisdom tooth removal – be extra cautious and it is even MORE important to avoid smoking after.