The effect of smoking on immediate post-extraction socket filling with blood and on the incidence of painful socket.

The effect of habitual smoking on post-extraction socket filling with blood and on the incidence of painful socket, was investigated. Data were collected from 2417 adult dental out-patients in whom 3541 extractions were performed under local anaesthesia. Post-operative socket filling with blood was significantly reduced in smokers, compared with non-smokers (p less than 0.01). There was a higher incidence of painful socket in heavy smokers (20 or more cigarettes per day), compared with nonsmokers (p less than 0.05). There was a significant relationship between immediate post-extraction socket blood level and the incidence of painful socket; sockets which showed poorer filling were more likely to develop painful socket (p less than 0.02). Smoking appeared to have an adverse effect upon the healing of extraction wounds.