Daily life and laser correction: how alcohol, sex, work and sleep can affect the operation

How does nicotine affect teeth?

Before entering the lungs, tobacco smoke passes through the mouth, therefore affecting the lips, teeth and gums.
The following factors influence the condition of the oral cavity:

1. Heat. Cigarette smoke enters the mouth of a smoker in a very hot state and affects the integrity of tooth enamel. Exposure to high temperatures may cause it to darken or crack.
2. Nicotine and tobacco tars thin out bone tissue, including the jaw. In extreme cases, bone atrophy begins, due to which it will be impossible to install implants without additional bone augmentation procedures.
3. Poor effect on the immune system. Nicotine often causes inflammation. Experienced smokers often develop osteomyelitis of the jaw. Often, an addiction leads to mucosal cancer.
4. Smoking is one of the reasons for the rejection of dental implants, which can occur at any stage of using a prosthesis.
5. When you regularly smoke tobacco products, a thick plaque forms on your teeth, which becomes a habitat for bacteria. Their vital activity disrupts the microflora of the oral cavity, weakening the entire dental system.
6. Increased salivation, which irritates the oral mucosa and enamel. Often causes dental diseases.

The effect of tobacco smoke on implants

To understand how smoking and dental implantation are combined, you need to find out what the negative effects of nicotine and tobacco tar on the oral cavity are.

Firstly, every time smokers inhale tobacco smoke through the mouth, periodontal tissues find themselves “in the line of fire”, since they are exposed to all the harmful substances at once. The smoking process itself burns the mucous membrane, thereby striking the beneficial microflora and provoking the development of inflammation.

Secondly, nicotine and tobacco tars have not only a local, but also a systemic toxic effect, as a result of which the smoker’s tissues are less well supplied with oxygen and nutrients.

If the implants themselves are made of reliable material and deeply fixed, tobacco smoke will not destroy them. However, it does not allow the body to cope with the implantation of artificial teeth into the bone and recovery after surgery.

Due to problems with regeneration, smokers are limited in their choice of surgery. For example, they cannot do one-step or one-stage dental implantation. In any, even the most virtuosic performance, surgery is stressful for the body. Violation of the integrity of the gums, insertion of foreign objects into the bone - all this requires time and effort to recover. Smoking during implantation interferes with the healing process, it does not even allow maintaining hygiene at the proper level. After all, if hot smoke regularly enters the mouth, tobacco tar forms a plaque, and the mucous membrane is constantly dry, then harmful bacteria multiply in such conditions almost unhindered.

The systemic effect of nicotine on the body also interferes with recovery. Even high-quality orthopedic products have little chance of healing with damaged bone in a short time, given its poor blood supply and weakened immunity. And heavy smokers almost always have these problems.

The installation of classical implants is also excluded due to the osseointegration zone close to the surface. If the patient does not give up the bad habit, then regular burns of the gums and the proliferation of pathogenic bacteria on the mucous membrane will soon lead to peri-implantitis. This is the name for inflammation of the bone at the site of implantation of the artificial root until it softens. Therefore, smoking during implantation often leads to rejection, and the destructive process itself is quite painful.

Another problem is that the patient may require osteoplasty before implantation. This usually happens when the bone of the upper jaw under the maxillary sinus becomes thinner—in this case, a sinus lift is performed. But in other places, it is often necessary to build up bone tissue before inserting a titanium rod into it, and in a smoking patient there is a high probability of rejection of the transplanted bone material.

Implantation and smoking

Smoking complicates the operation and increases the likelihood of complications during healing. When a person smokes, thin air is created in the mouth, which prevents the formation of a blood clot. Tissue healing is complicated, and frequent bleeding accompanies the rehabilitation period.

Note: nicotine constricts blood vessels. Because of this, stagnation and suppuration of wounds are formed.

These reasons answer the question: “Why can’t you smoke after having implants installed?” Tissues heal much more slowly than in non-smoking people, osseointegration takes longer. Sometimes smoking after dental implantation causes the sutures placed on the gums to come apart. The risk of implant rejection increases and mobility increases.

Smoking after sinus lift and implantation

Often, before implantation, the dentist prescribes an operation for a smoking patient to increase the bone of the upper jaw, which is otherwise called a sinus lift.

Smoking after bone augmentation surgery or implant installation carries a 10% risk of complications during rehabilitation. The compacted layer of plaque due to tobacco smoke becomes a favorable environment for bacteria and microbes, whose vital activity causes inflammation.

Smoking and guarantee for implant installation

According to the same statistics, in 95% of non-smoking people, implants function normally even 10 years after installation. For smokers, this figure barely reaches 86%. The patient’s presence of this bad habit complicates the dentist’s work, so the issue of warranty in this case can be discussed separately. As a rule, for smokers it is reduced by 5–10 years. This is also due to the fact that under the influence of tobacco tar and nicotine, the loss of bone tissue around the neck of the implant accelerates approximately twofold. In addition, smoking patients are more likely to develop peri-implantitis - inflammation of the tissues surrounding artificial roots. Given this, it is difficult to guarantee the normal functioning of implants.

When can you smoke after dental implantation?

Dentists recommend quitting smoking 2-3 weeks before surgery. It is worth quitting smoking to reduce the negative impact on the health and beauty of your teeth.

After installation of implants, you should refrain from smoking for a month, or minimize the number of cigarettes you smoke.

If you cannot quit smoking, you can use nicotine patches or e-cigarettes. E-cigarettes, smokeless and vaping devices are believed to be less harmful because they do not emit tar. However, the nicotine they produce still causes damage to the body and also complicates healing.

If you are not ready to quit smoking, your dentist will not be able to guarantee successful osseointegration. True, the risk of rejection of the structure is present regardless of smoking. Some implantologists estimate the service life of implants in smoking patients to be up to four years, while in non-smokers this period reaches ten years.

People who smoke and have implants need to pay careful attention to removing plaque from their teeth so that harmful microorganisms do not develop a habitat.

Recommendations for patients after surgery

Inpatient rehabilitation phase During the first hours after surgery,
you will wake up in the intensive care unit.
The anesthesiologist and nurse will monitor your body temperature, pulse, blood pressure and other indicators. During surgery, you may have a catheter inserted into your bladder to monitor the amount of urine you produce. You will also have a chest tube connected to a drainage device. During the first hours/days after surgery, your voice may be slightly different from normal, this is normal. You may remain in the recovery room for one or several days, depending on your condition after surgery. Then you will be transferred to the ward in the surgical department where you were originally located. Frequently Asked Questions Will I experience pain after surgery?
You will experience pain after surgery, this is normal.
Your doctor and nurse will ask you frequently about your pain and give you pain medications as needed. If the pain does not go away, tell your doctor or nurse. Pain relief is essential so that you can clear your throat, breathe deeply, and get out of bed and walk. Remember that taking painkillers can lead to constipation (retention of stool for more than 2-3 days). If constipation occurs, consult your doctor. Upon discharge, your doctor will give you recommendations on taking pain medications. What is pleural drainage and why do I need it?
A chest tube is a flexible tube that drains blood, fluid, and air that accumulates in the chest cavity after surgery. This tube is placed between the ribs in the space between the chest and lungs (see Figure 1).

Picture 1

Chest drainage and pleural banking.

The timing of drainage of the pleural cavity is individual for each patient.
Removal of pleural drainage is carried out by the attending physician if 2 conditions are met: 1) the amount of fluid released does not exceed 200 ml/day 2) there is no air flow through the drainage . Why is it important to walk after surgery?
Walking helps prevent blood clots from forming in the legs.
It also reduces the risk of other complications, such as pneumonia. During your postoperative hospital stay, try to set yourself a goal of walking 1.5-2 km daily. Will I be able to eat after surgery?
You will gradually return to your normal diet when you are ready.
Your healthcare provider will provide you with more information. Can I shower?
You can shower 48 hours after your chest tube is removed.
A warm shower is relaxing and helps reduce muscle pain. Try to avoid contact of the wound with water until it is completely healed. If you do get the bandage wet, contact your doctor to change the bandage. When can visitors come to me?
Visitors can visit you as soon as you are transferred from the intensive care unit to the surgical unit.
You can find out the hours during which visits are allowed from your attending physician at the department. When will I be discharged from the hospital?
The length of your hospital stay depends on many factors, such as the type of surgery you had and how well your recovery was. You will remain in the hospital until your doctor thinks you are ready to go home. Your doctor will tell you what day and time you can expect to be discharged. Your doctor will tell you if you need to stay in the hospital longer than planned. The following are examples of reasons why you may need to stay in the hospital for a longer time:

• prolonged release of air through pleural drainage;
• problems with healing of postoperative wounds;
• breathing problems;
• increase in temperature in the postoperative period (38.0 °C) and higher.

Recovery after returning home Will I feel pain when I return home?
The duration of the presence of pain and discomfort in the area of ​​surgical access is different for each person and depends on a large number of factors.
Thus, pain after open operations will be stronger and longer lasting than after video-assisted thoracoscopic and robotic operations. For some people, pain in the area of ​​the surgical wound or a feeling of tightness or aching muscles may continue for 6 months or longer. This doesn't mean there's anything wrong with you. Follow the guidelines below. Take pain medications as directed by your doctor and as needed. Call your doctor if the prescribed medicine does not relieve your pain. Do not drive or drink alcohol if you are taking prescription pain medication. As your surgical wounds heal, the pain will become less painful and you will need less pain medication. To relieve pain and discomfort, mild painkillers and non-steroidal anti-inflammatory drugs are suitable: ketanov, ibuprofen (Nurofen-express), Nise (imisulide), xefocam (lornaxicam), diclofenac, as well as other drugs in this group. Pain medications should help you as you return to your normal routine. Take enough medication so that you can exercise comfortably. Remember that it is normal for a slight increase in pain as your activity level increases. Keep track of when you take pain medications. Pain medications are most effective 30 to 45 minutes after you take them. It is better to take the medicine at the first appearance of pain and not wait for it to intensify. How should I care for surgical wounds?
After surgery, you will have several incisions. The location of the incisions will depend on the type of surgery performed. They will be performed at the site of the operation and at the site of the chest tube. You may experience some numbness below and above the incision, as well as along the intercostal space where the incision was made. You may also experience tingling and tenderness in the area around your incisions as they heal. By the time you leave the hospital, your surgical wounds will begin to heal.

Change the wound dressing daily and clean the wound with skin antiseptic/diamond green/betadine (check with your healthcare provider for instructions on how to care for surgical wounds).

Upon discharge, your attending physician will give recommendations on when to remove sutures from post-operative wounds. To do this, you will need to contact a surgeon at the clinic at your place of residence.

If, after discharge from the hospital, discharge appears in your postoperative wounds, contact your doctor.
What should I eat at home?
Eating a balanced, high-protein diet will help you recover faster after surgery.
Your diet should include a source of healthy protein at every meal, as well as fruits, vegetables and whole grains. How can I prevent constipation?
After surgery, your bowel movements will change.
There may be problems with bowel movements (stool excretion). If you can, drink 8 glasses (250-300 ml each, 2 liters total) of fluid daily. Drink water, juices, soups, milkshakes and other caffeine-free drinks. Caffeinated drinks, such as coffee and soda, remove fluid from the body. Both prescription and over-the-counter medications are used to treat constipation. If constipation occurs, start with 1 of the following over-the-counter medications: Docusate sodium (Norgalax) 100 mg. Take 3 capsules once daily. This remedy softens the stool and causes only minor side effects. Senna 2 tablets before bed. It is a stimulant laxative that may cause cramping. How can I speed up the recovery process?
Exercise for at least 30 minutes a day. This will make you stronger, improve your well-being and promote recovery. Incorporate a daily walk into your daily schedule. Just walking down the street or walking on a gym will do. If the weather is not very suitable for walking, you can spend time in the shopping center. Climbing stairs is also suitable as a workout. When you return home, continue to do deep breathing exercises and exercises that stimulate coughing. Drink fluids so that the mucus is not thick and can be easily coughed up. Ask your doctor how much fluid you should drink daily. For most people, this will be at least 8-10 glasses (250-300 ml) of water or other liquids (such as juices) per day. During the winter months, run a humidifier in your bedroom. Follow the instructions for cleaning this device. Change the water in it frequently. Avoid contact with people who have a sore throat or cold or flu symptoms. All this can cause an infection to develop.

Do not drink alcohol, especially if you are taking pain medication.

Do not smoke.
Smoking cigarettes will always be harmful to your health. It is especially dangerous during the recovery period after surgery. Smoking causes blood vessels to narrow. This reduces the amount of oxygen supplied to wounds during their healing process, which significantly slows down the regeneration process. Remember, if you are not able to quit smoking on your own, you can contact the “Smoking Quit Assistance Center” located on the territory of the St. Petersburg NIIF by contacting them on the hotline (+7). Can I return to normal activities?
It is very important that you return to your normal activities after surgery. Distribute their implementation throughout the day. Walking and climbing stairs are excellent exercise. Gradually increase the distance you walk. Climb the stairs slowly, resting and stopping as needed. Do light housework. To the best of your ability, try to dust, wash dishes, cook simple meals, and do other tasks. When going about your business, use the arm and shoulder on which the operation was performed. For example, wash yourself, comb your hair, take things out of the closet shelf with this hand. This will help restore full function of the arm and shoulder.

You can return to your normal sex life as soon as the post-operative wounds have healed, without experiencing any pain or weakness.

Your body will tell you when you are overtired.
As you increase the intensity of your exercise, monitor your body’s reaction. You may notice that you have more energy in the morning or afternoon. Schedule your activities for the time of day when you feel more energetic. Is it normal to feel tired after surgery?
Typically, a person has less strength than usual after surgery.
Recovery time is different for everyone. Increase your activity every day to the best of your ability. Always maintain a balance between periods of activity and periods of rest. Rest is an important factor in your recovery. It may take some time for you to return to your normal sleep pattern. Try not to sleep during the day. Showering before bed and taking prescribed pain medications will also help. When will I be able to drive?
You will be able to drive again after: the range of motion of the arm and shoulder on which the operation was performed is restored to full extent;
you will not take narcotic pain medications (which make you drowsy) for 24 hours. Can I travel by plane?
Do not fly by plane until your doctor allows it; in the first months after surgery, try to use other means of transport or completely avoid long-distance travel.
When can I return to work?
The time frame for returning to work depends on what type of job you have, what type of surgery you had, and how quickly your body recovers.
If you need a certificate to return to work, contact your doctor. When can I lift weights?
Check with your doctor before lifting weights.
It is generally not recommended to lift anything heavier than a normal grocery bag (5kg) for at least 1 month after surgery. Ask your doctor how long you should avoid lifting heavy objects. This depends on the type of surgery you had. Which doctors should I see after surgery?
Upon discharge from the hospital, your attending physician will give you a discharge summary with further recommendations.
If it is necessary to consult any specialists, this will be indicated in the epicrisis. What questions should you contact your doctor about?
Sometimes in the postoperative period the patient may be bothered by the following conditions:

• shortness of breath appeared or worsened;
• swelling of the chest, neck, or face;
• the voice changed dramatically;
• temperature increased (38.0 °C) or higher;
• the pain has sharply increased and does not go away after taking painkillers;
• redness or swelling appears around the postoperative wound;
• there is discharge from the postoperative wound that has an unpleasant odor, thick consistency or yellow color (similar to pus);
• no bowel movements for 3 days or longer;
• new symptoms or physical changes appear;

And if you have any questions or concerns regarding your health, please contact your healthcare provider.

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How does an implant take root in a smoker?

The following factors influence the osseointegration of a smoking patient:

1. Burns to the mucous membrane due to regular exposure to hot smoke. This provokes hyperkeratosis, which slows down reparative processes. The gums heal worse, and there is a risk of peri-implantitis.
2. The functioning of the salivary glands is disrupted, which leads to chronic drying of the mucous membrane. This affects not only the gums, but also the balance of the oral microflora - the number of harmful microorganisms increases, which ultimately provoke peri-implantitis or inflammation of the gums around the implant. This may lead to failure of the structure.
3. Nicotine constricts blood vessels, causing spasms. The speed of blood flow slows down, oxygen reaches the tissues less well, and the injured area receives fewer vitamins and building elements. The implant fuses with the bone less well.
4. The immune system weakens - the dental system is exposed to the negative influence of bacteria. As a result, inflammation occurs at the implant site.

Possibility of implantation in a smoking patient

Smokers have a chance of successful implantation under the following conditions:

• Choosing the appropriate type of implants. To avoid the development of inflammation in the area of ​​osseointegration, it is necessary that this area is as deep as possible. The deepest fixation in the jaw is provided by basal implants, which are implanted not into the upper part, but into the lower layer of the jawbone. This type of implant is also most suitable for thinning bone tissue.
• Strict smoking cessation for a certain period of time before and after surgery. Moreover, from any type of smoking, including electronic cigarettes.
• Compliance with all doctor's prescriptions. The patient will have to not only carefully monitor oral hygiene, but also follow other recommendations. That is, take prescribed antibiotics in the prescribed course, antihistamines, specific vitamins to support immunity, etc.

Is it possible to smoke after the implant has taken root?

The dentist cannot prohibit the patient from smoking; he can talk about the consequences, as well as give advice on how to quit the bad habit. Many people resume smoking when the implant takes root, that is, after 1-2 months. Tobacco smoke destroys bone, which provokes implant rejection. Bone separation also occurs in non-smokers, but smoking only increases the risk. Gradually, the gums may recede down to the body of the rod.

Nicotine poses a risk of peri-implantitis even after the implant has taken root. The gums change color and may turn red or, on the contrary, turn pale or blue. In critical cases, an abscess may form. To prevent possible complications, you need to take good care of your oral hygiene and visit your dentist regularly.

Is it possible to smoke before implantation?

Before dental implantation, you should not smoke for a month to give the mucous membrane the opportunity to recover from burns and dryness and improve blood circulation. At this time, it is recommended to lead a healthy lifestyle, that is, it is advisable not to drink alcohol, eat right and take vitamins to strengthen the immune system. In addition, you need to carefully monitor your oral hygiene.

A month is the minimum period of abstinence from smoking before surgery. Ideally, the longer the better.