Dry sockets and smoking

I know smoking is bad but I had all 4 Wisdom teeth removed 2 days ago and the healing process has been smooth. Very little pain and no bleeding after 5 hours of the teeth being removed. How long should you wait to smoke again to prevent dry sockets because I have had friends who smoke the same day and did not get them and friends who waited 3 days after and got them.
– Jason from Wisconsin

Jason,
Dry socket is an infection of the socket and isn’t related to how soon after surgery you smoke. Smokers tend to get more dry sockets than non-smokers, but it isn’t caused by the physical act of smoking, as many dental assistants, and even some dentists, believe.

Dry socket occurs after about 15% of the extractions of lower wisdom teeth, and it is characterized by a dramatic increase of pain about two or three days after the surgery. When the socket is examined, it doesn’t have a blood clot. Seeing that, dentists many years ago thought that the blood clot must be missing because the patient “sucked it out,” and that this was the cause of the problem. From this erroneous idea come all the instructions to not suck through a straw or smoke, because smoking requires sucking. But scientific studies do not confirm this. The loss of the blood clot is an effect of the infection, not a cause.

The incidence of dry socket increases with increasing trauma to the socket that occurs during the surgery. An oral surgeon, with careful and gentle surgical technique and placing an antibiotic dressing of clindamycin in the socket right after removing the tooth, can nearly completely eliminate dry socket as a surgical complication. I know, because I did that and went for over ten years and hundreds of wisdom teeth extractions without a single incidence of dry socket.

I don’t smoke, and I would love to be able to tell you not to smoke. You’d be much better off to kick that self-destructive habit. But the truth is that you will not cause dry socket by smoking too soon after your surgery.

Dr. Hall