As part of an initial consultation, we make patients aware that elements of their medical history may reduce the predictability of a surgical oral surgery procedure and affect how a wound heals. The post-surgery consequences are sometimes unavoidable and must be endured by the patient, and best treated by the provider.
Patients, however, can avoid unwanted consequences in some circumstances. The most notable being the avoidance of smoking.
The smoke inhaled from cigarettes, cigars or pipes will contaminate the wound, while the nicotine contained in the tobacco will cause blood vessels delivering oxygen, wound healing cells and nutrients to the wound to become narrow and inhibit delivery.
Smokers demonstrate a slower rate of wound healing and higher chance of infection compared to non-smokers. Smokers will also tend to experience more pain than nonsmokers and have a higher chance of “dry socket” after extraction. Consequences become increasingly severe for more frequent smokers. There is also the chance of bleeding as a result of suction applied to the mouth when inhaling a cigarette.
Three specific oral surgery procedures affected by smoking are:
- Bone grafting. Bone is a slow healing tissue that matures over time and builds up in stages. Smokers have demonstrated less bone volume generation, leading to a higher risk of the wound rupturing.
- Gum grafting. Gum grafting requires a healthy blood supply and that supply is obstructed by smoking.
- Implant therapy. The long-term success of implant therapy for smokers is three to four percent lower than non-smokers.
Smokers can also experience complications when receiving office-based anesthesia for more complex oral surgery procedures or procedures of longer duration.
We understand that quitting or reducing smoking habits can be difficult. There are numerous options for people looking for help, including medical prescriptions that will gradually reduce and ultimately eliminate the urge to smoke, peer and family support, as well as other resources available through online research.
We want all of our patients to receive treatment that is successful and free of complications. Reducing or avoiding smoking is a modifiable risk factor that can really help optimize healing after oral surgery.
Dr. David W. Todd, DMD, MD, has been active in his profession. He has authored 18 articles in various publications and made numerous presentations at state, regional, and national meetings. For Dr. Todd’s full bio click here.