Why Should You Avoid Smoking after Tooth Extraction?

Tooth extraction is typically an invasive dental procedure that takes time to heal. Many complications can occur if the aftercare is not followed correctly. One of the key points that one must be mindful of during the healing process is to avoid any activity that may dislodge the blood clot from the empty socket.

Smoking is one such contributing factor that has the potential to cause severe complications after tooth extraction. It damages the surrounding oral tissues at the same time, dislodges the healing blood clot. Moreover, smoking after tooth extraction can significantly increase the risk of dry socket.


Therefore, it is advised to avoid smoking for at least the first three days to allow proper healing of the extraction site. Within this period, the gums try to close the socket and reduce the risk of post-extraction complications.

Today’s article will highlight the reasons for avoiding smoking after tooth extraction. Furthermore, we will discuss the answer to some frequently asked questions about smoking after tooth extraction.

What is the purpose of tooth extraction?

Tooth extraction is a surgical, dental procedure that involves the complete removal of the tooth from the gums and alveolar bone. Typically, tooth extraction procedures are performed for teeth that are beyond repair. Moreover, it may also be used as a preventive therapy to avoid damage to the adjacent tooth or to limit the spread of oral infection from a tooth. (1)

There are many reasons why a tooth is extracted. Some of them may include –

  • Wisdom tooth removal
  • Orthodontic tooth removal in case of excessive crowding
  • A grossly decayed tooth that cannot be repaired by tooth filling or endodontic therapy
  • Pericoronitis
  • Tooth fracture
  • Advanced periodontal disease

A dentist may carefully analyze each dental condition and plan treatment for its removal.

How does healing occur after tooth extraction?

Typically, the healing process after tooth extraction occurs in four stages –

  • Stage 1 – within 24 hours of tooth extraction, the blood clot starts to form in the bony socket. The dentist may place a pack of gauze to stop bleeding.
  • Stage 2 – 24-48 hours after a tooth extraction is witnessed by the formation of white or yellow granulation tissue in the bony socket. The patient may feel some pain or discomfort. However, it can be taken care of by using prescribed medicines. (2)
  • Stage 3 – 48-72 hours after a tooth extraction is when the gums start to close the space in the bony socket.
  • Stage 4 – 7-10 days after a tooth extraction is when the gums completely close and cover the space. Moreover, the patient can resume their physical activities during this period.

When can you smoke after tooth extraction?

It is best to avoid smoking for as long as possible after tooth extraction to ensure proper healing. All healing times may vary and depend on the body’s response to smoking. Moreover, it will also depend on the amount of surgery performed. Therefore, do not allow a cigarette to elongate the healing process. (3)

However, most avid smokers may want to know the safest time before having the first cigarette after surgery. In such cases, it is best to smoke at least 72 hours or three days after tooth extraction. This is because it allows the blood clot to form correctly and start the healing process without unnecessary interference.

If you feel like smoking after tooth extraction, it is best to first talk to your oral surgeon or dentist about the best timing. This time duration may vary, especially if you’ve had multiple surgical extractions. Therefore, it is best to follow your dentist’s recommendations to ensure the rapid healing process.

Why should you avoid smoking immediately after tooth extraction?

Cigarette smoke usually contains several deadly chemical toxins that can delay the healing process after tooth extraction. Moreover, it can cause damage to the surrounding gums and oral tissues. Smoking, especially after tooth extraction, can also lead to severe complications such as the following –

dislodgment of a blood clot

one of the most common complications of smoking after tooth extraction occurs due to inhaling and exhaling air while smoking, creating issues with the newly formed blot clot. The formation of blood clots in the first and most crucial step in the healing process. (4)

Failure of the formation of a blood clot or even its dislodgment from the bony socket can end up leading to a dry socket. Usually, the blood clot serves as a protective layer that covers the exposed bone and never endings in the bony socket. The clot is also the foundation of growth for new granulation tissue and new bone in the extraction socket.

Therefore, smoking should be avoided to allow proper healing of the extraction site.

Dry socket

As mentioned earlier, the dislodgement of blood clots can lead to a dry socket. Dry socket is a relatively complicated and painful dental condition that occurs due to the exposure of underlying bone and nerves in the extracted bony socket. It is typically identified by bad breath and severe pain, which gradually spreads from the tooth socket to the face’s entire jaw and side.

Over time, the socket may become red, tender, swollen, and inflamed. Dry sockets typically develop within the first 1-3 days after the tooth extraction. Professional dental treatment is usually required to treat dry socket. In such situations, the dentist may place an antiseptic and pain-relieving dressing to provide proper healing and comfort. (5)

Smoking should strictly be avoided during this time, as it can further complicate the condition and lead to jaw necrosis.

What are the general effects of smoking on oral hygiene after tooth extraction?

While smoking may be dangerous after tooth extraction, there are several other complications that smoking can cause to the patient’s oral hygiene. Some of them may include-

  • Increased buildup of plaque and tartar on the teeth
  • Bad breath
  • Inflammation of the salivary gland openings on the roof of the mouth
  • Tooth discoloration
  • Increased risk of precancerous conditions like leukoplakia or white patches in the mouth
  • The lower success rate of dental implant procedures
  • Increased loss of bone within the jaw(6)
  • Increased risk of developing gum disease, a leading cause of tooth loss
  • Increased risk of developing oral cancer

FAQ about smoking after tooth extraction

When is a tooth removed in a smoker?

One of the most common reasons for tooth extraction in smokers is periodontal diseases, such as gingivitis or advanced bone loss and attachment loss. One of the common effects of smoking cigarettes on oral health is inflammation of the gums. Additionally, it leads to increased production of cytokines that have the potential to worsen periodontal diseases.

Another reason for tooth extraction in smokers is Wisdom tooth removal. Wisdom teeth, especially those that are tilted or impacted, act as a host for bacterial growth because such areas are difficult to brush properly. Smoking will lead to significant poor oral hygiene and wisdom tooth infection.

Can a patient smoke within 24 hours of tooth extraction?

It is best not to smoke within the first 24 hours of tooth extraction as this time is crucial for the development of blood clots. Moreover, you might want to stay clear of any dental complications such as dry socket that may result from smoking after tooth extraction.

The ideal time to start smoking after a tooth extraction is one to two weeks. However, you may resume back to your smoking habit after 72 hours as well.

What are the immediate side effects of smoking after tooth extraction?

The immediate effects of smoking after a tooth extraction include –

  • Dislodgement of a blood clot
  • The dry socket identified by a bad smell, red, swollen, and tender gums. The exposed bone may also be inflamed. The patient experiences excruciating pain and discomfort.
  • Poor oral hygiene leading to infection of the extraction site
  • Delayed healing process

How long should you wait to smoke after tooth extraction?

The best time to start smoking after tooth removal is one to two weeks after the procedure. However, the minimum time that you must wait to resume smoking is 72 hours. Although this period may vary depending on the number of surgical extraction you got and the presence of any underlying health condition.

Consult with your dentist and get a check-up done before starting to smoke, especially after the tooth extraction procedure.

Is it okay to smoke with the gauze still in the mouth?

No. never smoke while the pack of gauze is in your mouth. Additionally, never smoke, especially when you are actively bleeding from the extraction site.

Smoking ay not only dislodges the blood clot but also increases the risk of burning the gauze in your mouth. It is best to avoid smoking for at least the first three days after tooth extraction.

Is it possible to smoke without getting a dry socket?

Yes, there is a possibility to smoke without getting a dry socket. However, this usually happens when you wait for the recommended time of three days, during which you must avoid smoking. The three days allow the proper formation of the blood clot, granulation tissue, and partial closure of the gums over the bone.

Some alternate ways that you can use during the healing process may include –

  • Use of a nicotine patch. However, avoid nicotine gum or chewing tobacco.
  • Whenever you feel like smoking, distract yourself with a new habit.

How does smoking dislodge the blood clot?

Usually, the toxins from cigarette smoke can cause significant inflammation of the gums. Moreover, the smoke can also irritate the gums around the extraction site and lead to pain and swelling. One of the complications that may occur due to smoking too soon after an extraction is a dry socket.

Can you treat a dry socket at home?

While home remedies may not be an ideal treatment for dry socket, they are useful for providing temporary relief. Some of the tested home remedies that can ease the pain from dry socket include –

  • Warm salt water rinses at least once a day until you feel comfortable.
  • Place cold packs for fifteen minutes against your face on the affected side. This will help to numb the nerves in that area and provide relief.
  • Dip a clean gauze in clove oil and place it in the dry socket area directly. Some patients might feel a burning sensation. However, in most cases, the burning sensation is momentary. Keep the gauze in place for at least 20 minutes.
  • Honey dressings can also help to ease the discomfort.
  • Other home remedies include the use of tea tree oil and oregano oil. Dab a gauze in these essential oils and place it on the dry socket for 20 minutes.

Take away message

Smoking is, in general, one of the most damaging oral habits one can develop in their life. It can cause a series of complex conditions such as a dry socket, hyposalivation, tooth and gum pigmentation, and cancer.

Tooth extraction is often followed by a delicate healing process where the patient must take every precaution to ensure rapid and uninterrupted healing. Usually, during this time, the patient is strictly advised to avoid smoking for at least the first three days after tooth extraction. However, it is best to avoid smoking for a week or two.

This measure will protect the blood clot in the bony socket. Moreover, it will make the healing process comfortable and pain-free for the patient. If you have a habit of smoking and are planning to get a tooth extraction, contact your dentist ad understand the importance of avoiding it post-extraction.


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