October 26, 2020
Oral surgery for tooth extraction is something many people will experience at some point in their lifetime, and a smooth operation and recovery is critical. Dentists are more concerned about a patient’s safety than anything else. They need to be aware of any lifestyle habits that could make surgery and recovery more difficult, like using tobacco, traditional cigarettes, e-cigarettes, and vape pens. It is also important to understand the risks of nicotine and how to prepare for dental surgery as a smoker.
Nicotine and dental health
Most people believe smokeless tobacco in e-cigarettes and vape pens is a safer alternative to traditional cigarettes. But smoking is never good. Nicotine, the addictive substance found in vape pens and e-cigarettes, reduces the amount of oxygen received by vital organs and tissue, breaks down tissue in the mouth, causes inflammation, and makes healing more difficult. It also increases the risks of anesthesia and could lead to other complications during oral surgery. Patients should avoid smoking and vaping and could use dental surgery as a reason to begin a smoking cessation program.
However, if the patient is not interested in quitting they should try to avoid, or reduce, tobacco and nicotine intake for at least 72 hours before tooth extraction. They should also understand that smoking too soon after surgery can prolong recovery and increase their risk of developing alveolar osteitis (dry socket).
What is a dry socket?
One major concern following a tooth extraction is dry socket. It is the condition that develops when a blood clot dissolves, dislodges, or does not form properly at the extraction site. The blood clot protects the nerve tissue and the bone at the extraction site so the gums can heal. Without it, recovery is prolonged and even more painful.
One study found that dry socket occurs in 12 percent of patients who smoked after extraction, and only 4 percent of patients who don’t smoke. This is because the combination of heat, chemicals, and suction from smoking dramatically impacts the formation and stabilization of the blood clot.
Signs of dry socket include intense pain a couple of days after surgery, a visibly empty socket or partially missing blood clot, bad breath or foul odor in the mouth, and visible bone in the socket. The only treatment for dry socket is returning to the dentist to irrigate the site, sterilize it, and apply medicated bandages.
Home care after an extraction
It is important to follow proper oral care after surgery. It will improve recovery and reduce the risk of infection. A few tips for aftercare include:
• Keeping your mouth clean using a saltwater rise (avoid mouthwash with alcohol)
• Treating swelling by holding an ice pack to your cheek
• Softly brushing teeth twice a day
• Drinking plenty of fluid
• Avoiding food and beverages that threaten the blood clot
• Resting from strenuous work
Tips for preventing dry socket
There are a few things patients can and should do to help prevent dry socket:
• Checking on medication interactions
• Avoiding straws
• Avoiding tobacco and smoking
• Avoiding gum and chewing tobacco
• Sticking to soft foods
When can a patient vape after extraction?
It is important to talk to the dentist about recovery times for each unique situation. After extraction, the body needs to heal for as long as possible before returning to normal routines and habits. The longer a patient is able to refrain from smoking and vaping, the quicker they will recover.
That said, generally, patients should wait three to four days or a minimum of 72 hours after an extraction to smoke or vape. The time could be longer for multiple extractions. During this time they might switch to a nicotine patch. After that, when a patient resumes smoking, they should be cautious. They should keep gauze in place over the site while smoking and should inhale very gently to avoid dislodging the clot.