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Dental bone graft and smoking: Smoking after dental bone graft

Dental bone graft and smoking: Smoking after dental bone graft

In our previous article, we have discussed the potential complications of bone grafting. We warned that smoking is strictly forbidden to those suffering from a bone deficiency. We are now going to tell you why.

In this article, we are discussing the following topics:

dental bone graft and smoking

Bone grafting in brief

Bone deficiencies of the jaw used to be considered serious challenges in medical science. With the application of a revolutionary method of bone grafting, however, bones missing from the jaw can be replaced and reconstructed today. Following bone grafting, the new living bones may start to develop. Thanks to this method, we are now able to provide a solid base in the oral cavity for inserting dental implants.
Bone deficiencies in the jaw may be a result of wearing a prosthesis for a long period of time, as well as advanced periodontitis or the loss of teeth as a result of a trauma. Smoking may also be a serious risk in the development of the disease.

General harmful effects of smoking

It is a standard protocol before any surgery that the doctor assesses the general condition of the patient. Bone grafting surgeries are no exception, as the general condition of the patient has a direct impact on the success of the intervention.
Cigarette smoke contains several harmful substances: tar, carbon monoxide, nicotine, polycyclic hydrocarbons, hydrocyanic acid, arsenic, etc.
Smokers are usually less healthy than their non-smoking counterparts. The process and success of bone grafting surgery depends on the following risks caused by smoking:

  • vascular contraction, the risk of a heart attack, coronary artery diseases,
  • cancerous diseases and cancer lesions,
  • diabetes,
  • arthritis,
  • psychiatric disorders (anxiety, eating disorder…),
  • fecundity disorder,
  • problems related to the protection mechanism of the immune system, etc.

Generally speaking, smoking has harmful effects on most of the organs, and may be a risk factor when it comes to several diseases. The doctor is obliged to pay particular attention to the general well-being of smokers during bone grafting. Before the procedure, they must ask for and assess thoroughly the general health condition of the patient, with regard to the risk factors listed above.

Dental-related risks caused by smoking

In general, smoking has a negative effect on the success of most therapeutic procedures carried out in the oral cavity.
As a result of smoking, the following diseases might affect the oral cavity more frequently:

dental bone graft

  • prolonged wound healing,
  • the risk of infection,
  • gingivitis,
  • plaque build-up,
  • periodontitis,
  • cancer lesions,
  • caries on the tooth and on the root,
  • tooth discolouration, etc.

The above mentioned diseases might result in prolonged wound-healing after bone grafting, and in more serious cases, the procedure itself may be jeopardised.

Dental bone graft and smoking.Harmful effects of smoking during bone grafting

Unfortunately, the issues listed here might all have an influence on the bone grafting procedure, its success and on the effectiveness of the general healing process.
Smoking may affect both the period preceding and following the bone grafting surgery.

Harmful effects of smoking before bone grafting

We distinguish between three main methods of bone grafting: bone grafting using the patient’s own bone, a donor’s bone or a synthetic substance. In our previous article, we have already warned that the doctor always makes a decision on the applicable method based on their consultation with the patient and the patient’s general condition. Each method has its advantages and disadvantages, but smoking may limit the opportunities – it may directly affect which method of bone grafting the doctor can apply.

Harmful effects of smoking after bone grafting

Potential risks of bone grafting include inflammation and haemorrhage.
Smoking generally limits the blood supply of the surgical site. This condition might have serious consequences. The toxins and nicotine that tobacco contains tighten the blood vessels, and as a result, a significantly smaller amount of waste and harmful substances may leave from the surgical site during circulation. Furthermore, tightened vessels will be able to transport less oxygen and nutrition. These processes may all affect the adequate healing of the wound following the bone grafting surgery.
Due to the issues listed above, your doctor will likely draw your attention to the fact that you should not smoke during the period following surgery.

Smoking after dental bone graft.What should smokers do?

If the patient cannot resist smoking during bone grafting, they must pay attention to the following:

Doctor’s instructions

Both during the period preceding and following your surgery, the doctor should be aware of your intention to smoke.
By all means, you must let your doctor know during the consultation preceding bone grafting. As we have noted before, smoking has a significant role in the doctor’s choice of the bone grafting method to be applied.


After you have informed your doctor, they will provide you with thorough advice on what needs to be done in terms of oral hygiene during bone grafting. These instructions may be different or stricter based on the given surgical phase (the period preceding and directly following bone grafting, as well as the later healing period). Thus, it is very important for the patient to discuss all the necessary information with their doctor before the bone grafting surgery in a thorough and honest way.
It is a general fact that more attention must be paid to oral hygiene in the case of smokers; potential actions include rinsing our mouth after smoking, tooth brushing, the application of an oral irrigator, or if necessary, teeth cleaning performed by a dentist. Please consult your doctor for further details.

Vaporisers and e-cigarettes

It is a common misconception that with the use of the fairly new vaporisers and E-cigarettes we can eliminate the risks caused by smoking. Unfortunately, this is not true.
Using these devices may cause the following symptoms:


We all know that during the use of vaporisers and electric cigarettes, hot and concentrated smoke is produced, which may burn the surface of the tissues in our mouth.


Vaporisers and E-cigarettes cause dryness in our mouth and throat. Dryness enhances the risk of dental caries, among other problems. Dryness of the mouth can cause adverse conditions before surgery and affects the healing of the wound after the intervention.

Chemical substances

These devices also contain the harmful chemical substances of standard cigarettes, even though in smaller amounts.
The issues mentioned above suggest that vaporisers and E-cigarettes cannot be considered ideal alternatives for smokers about to undergo bone graft surgery. In the case of heavy addiction, however, it might be recommended to switch to these devices, as they may reduce the damage caused by standard cigarettes.

As shown in this article, it is definitely advisable to convince the patient to quit smoking before bone grafting, or at least stop smoking for a certain period of time. Obviously, the success rate of bone grafting surgeries carried out on smoking patients is high. Such cases demonstrate well the importance of cooperation and honest discussion between the patient and the doctor.

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