What are the dangers of smoking shortly after a surgical tooth extraction?!

What are the dangers of smoking shortly after a surgical tooth extraction?

Also, if you simply MUST have a cigarette, what steps could you take to reduce any risks?

The sucking action you make when smoking causes
"dry socket". They occur when the blood clot is lost from an extraction site prematurely. Basically, the blood clot in the socket serves the same two functions as a "scab" on a skin surface cut. First, it assists in the cessation of bleeding and second, it protects underlying structures during the healing process. Like the child who "picks at a scab" the area heals in time but is painful for far longer than if the "scab" had been left alone.

When the blood clot is lost before the underlying structres have had time to heal, bone is exposed to the oral environment along with fine nerve endings. This is an exquisitely painful but otherwise relatively harmless situation. There are packing materials which the oral surgeon can place to help ease the discomfort both by physically blocking the wound and by the action of the chemicals in the pack on local nerve endings. Generally, patients return to have the pack changed every day or two and most patients do not require more than 2 or three dressing changes. Some patients require no dressing while others may require 4 or 5 changes of packing. Tincture of time and good oral hygiene usually resolve the situation.

There are some activities which may increase the propensity for dry socket formation...smoking, drinking carbonated beverages in the first 24 hours after surgery, spitting or drinking through a straw in that same time period...but often "dry sockets" occur for no particular reason at all.