Smoking after Tooth Extraction: Is it Really that Harmful?

Medically Reviewed By
Jonathan G. Campbell, DDS, FAGD
One of the top rated Dentist in Salt Lake City, UT

Permanent teeth should last a lifetime- but this isn’t always the case. Teeth may become damaged for a variety of reasons. Most dentists will try to salvage the natural tooth with dental fillings or crowns.

Tooth extraction

Smoking is dangerous for your oral and overall health, especially following tooth extraction. If you must smoke, experts recommend that you wait at least 72 hours following the procedure. This will allow the site time to develop the clot and begin healing.

Sometimes, extraction becomes necessary. Tooth extraction is the process of removing a tooth from the socket. There are several reasons why a dentist may recommend extraction, including:

What happens after tooth extraction?

  1. Before removing the tooth, the dentist will administer local anesthesia to numb the area so that you do not feel pain. Patients who have dental phobia may be provided with general anesthesia, which will allow them to sleep during the procedure.
  2. If the tooth is already loose, the dentist will rock it back and forth to remove it. On the other hand, if it is impacted, some of the gum tissue and bone will be cut away and then the tooth will be removed. If a tooth is especially difficult to remove, it may be removed in pieces.  
  3. Once the tooth is removed, you will be given a gauze pad and instructed to bite down to stop the bleeding. A blood clot will form in the socket. If you are not careful, the blood clot could fall out, which exposes the jawbone and results in a painful condition known as dry socket.

Recovery from a tooth extraction typically takes a few days. During this time, you’ll want to avoid smoking, as it may inhibit healing and increase your risk of complications. You should also:

  • Take pain medications and antibiotics as directed
  • Bite down on the gauze pad to reduce bleeding and encourage the formation of a blood clot. Leave the gauze pad in for 3 to 4 hours, changing out as needed.
  • Use an ice pack in 10-minute increments to reduce swelling
  • Rest for at least 24 hours and limit activity for at least 2 days
  • Do not rinse or spit forcefully for 24 hours to avoid causing the clot to dislodge
  • Avoid drinking from a straw for 24 hours
  • After 24 hours, rinse with a saltwater solution
  • Stick to soft foods, gradually returning to your normal diet as the site heals and you are comfortable
  • Avoid lying flat
  • Brush and floss teeth as usual, avoiding the extraction site

Dangers of Smoking after Tooth Extraction

According to the American Dental Association, smoking after tooth extraction can cause a variety of complications, including:

Delayed healing

Smoking disrupts blood flow to the alveolar nerve, which can cause increased pain in the extraction site. There is also some indication that the chemicals in cigarettes can slow tissue growth, which means the site takes longer to heal.

Dry socket

After a tooth is extracted, a blood clot will form in the space, which protects the jawbone from being exposed and allows the gum to heal. The suction from smoking can cause the clot to dislodge, which exposes the jawbone and nerve endings. This is known as dry socket and is a very painful condition, typically lasting approximately 7 days- but may result in other problems such as infection. Research shows that 45% of individuals who have dry socket must visit the dentist several times to treat the condition.

Gum disease

Smoking increases your risk of developing gum disease, especially following tooth extraction. Gum disease can destroy the jawbone supporting your teeth and increase your risk of needing additional teeth extracted.


If left untreated, dry socket can lead to infection, which can spread to your jawbone. An infection in the bone is known as osteomyelitis. This will cause your immune system to attack, causing an abscess to form inside the bone. An abscess will prevent blood flow to the bone, which will cause the bone to die.

Alternative Methods for Managing Pain after Tooth Extraction

There are several ways that you can manage pain following tooth extraction that do not involve smoking or tobacco use. These include:

  • OTC or prescription pain relievers
  • Ice packs
  • Rest
  • Warm compress
  • Eat soft, cool foods
  • Rinse with a saltwater solution 24 hours after extraction


Legacy Dental blog is proudly run by our Salt Lake City dentists team; We share knowledge about general dental care and practices. Apart from running this blog, we offer various dental services such as general dentistry, emergency dentistry, and dental implants for the community in Salt Lake City, Utah

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