The Impact of Smoking on Oral Surgery: Preoperative Quitting Recommendations for Optimal Recovery
Many oral surgeons advise their patients to quit smoking at least two weeks prior to scheduled oral surgeries. This critical advice is rooted in the understanding of how tobacco smoke affects the body's ability to heal and the potential complications that arise during and after surgery. In this article, we discuss why this recommendation is so important and what happens during surgery if you do not quit smoking.
Why Oral Surgeons Urge Patients to Quit Smoking
While the primary concern of oral surgeons is ensuring optimal surgical outcomes, the negative impact of smoking on airway health and wound healing is well-documented. In smoking cessation, the airway becomes inflamed and produces excessive mucus, which can obstruct breathing and lead to chronic obstructive airway disease (COPD). This congestion and inflammation are significant factors in the delayed healing and increased risk of infection associated with smoking.
The Risks of Smoking During Oral Surgery
Oral surgery often requires endotracheal intubation, where a breathing tube is inserted into the windpipe to assist respiration. This is an additional irritant to an already inflamed airway, potentially leading to a spasm in the airway in response to the presence of the tube. To manage this, anesthesia may need to be deepened, or bronchodilators may be administered, which can cause heart rate and blood pressure to rise.
Post-Surgical Dilemma: Upon waking from anesthesia, the anesthesiologist must make a critical decision. Either extubate (remove the breathing tube) while the patient is still under anesthesia or slowly wake the patient before extubation. Waking up with a breathing tube in place is uncomfortable for the patient, and in cases where the jaws are immobilized (e.g., after a jaw fracture repair), re-intubation may be necessary to ensure adequate oxygen supply. This scenario can lead to prolonged discomfort and potential emergencies.
The Long-Term Benefits of Quitting Smoking
Multiple studies have demonstrated that after one week of quitting smoking, the airway begins to recover from the inflammation and excess mucus production. By the end of two weeks, the patient's airway function closely resembles that of a non-smoker. This recovery significantly reduces the risks associated with airway irritation during surgery.
Alternatives to Smoking Before Surgery
While the recommendation to quit smoking is often non-negotiable, alternatives such as nicotine patches or other smoking cessation aids may be considered. These methods provide a way to manage the withdrawal symptoms associated with quitting smoking, thereby decreasing the irritation of the airway. Ultimately, the decision to quit smoking or use an alternative method remains a personal choice, but it is crucial for the health outcomes post-surgery.
Smoke-free Recovery for oral surgery is vital for wound healing and infection prevention. If you require oral surgery and are a smoker, discussing this with your oral surgeon and considering smoking cessation methods is essential. Prioritizing your health during the preoperative and postoperative phases will contribute to a more successful and comfortable recovery.