Wisdom teeth extraction is a common surgical procedure, and managing the immediate aftermath is a major part of recovery. The most immediate concern following the removal of one or more wisdom teeth is controlling post-operative bleeding. Gauze plays a direct role in this process by applying pressure to the surgical site, which is the primary mechanism for achieving hemostasis, the body’s natural process of forming a blood clot. The clot acts as a biological barrier, sealing the wound and initiating the complex process of healing.
Initial Gauze Application and Duration
The first application of gauze is typically between 30 and 60 minutes immediately following the procedure. You will be asked to bite down gently but firmly on the pad covering the extraction site. This constant pressure is necessary to compress the small blood vessels and allow the natural clotting factors in your blood to solidify.
The gauze must be positioned directly over the tooth socket, not simply between the biting surfaces of the teeth. To prepare the gauze, fold it into a small, tight square or roll it up to localize pressure to the surgical area. It is recommended to slightly moisten the gauze with water before placement, as a dry piece can adhere to the forming clot and pull it out upon removal.
After 30 to 60 minutes, when you remove the initial gauze, a small amount of dark, clotted blood is expected. Slight oozing or pink-tinged saliva is normal and indicates that hemostasis is working. If the gauze is saturated with bright red blood, or if the bleeding seems heavy, the process must be repeated with a fresh gauze pad.
Addressing Persistent Bleeding
If the initial gauze application does not sufficiently slow the bleeding, first remove the old, saturated gauze completely. Placing a new pad on top of an old clot is ineffective, as it prevents the fresh pad from applying direct pressure to the wound. Replace it with a clean, properly folded piece and bite down firmly for another 30 to 45 minutes, ensuring pressure is applied directly over the socket.
This process of replacing the gauze every 30 to 45 minutes should be repeated until the bleeding slows to a minimal ooze. If moderate bleeding continues after three to four hours of repeated gauze changes, alternative methods can be considered. For minor seepage, a slightly moistened black tea bag can be placed over the site and bitten down upon for 30 minutes. Black tea contains tannic acid, which acts as a natural vasoconstrictor and helps accelerate clot formation by causing small blood vessels to contract.
Stop using the gauze entirely once bleeding has significantly reduced, even if a faint pink color remains in your saliva. Continuous use of gauze when it is no longer required can interfere with the healing process by drawing the clot out of the socket. If the bleeding remains heavy—meaning your mouth rapidly fills with blood—contact your oral surgeon immediately for further instruction.
Protecting the Extraction Site
Once the active bleeding is controlled and the gauze is removed, the primary focus shifts to protecting the newly formed blood clot in the socket. The clot acts as a biological seal and a scaffold for bone and gum tissue to grow into during healing. Dislodging this clot exposes the underlying bone and can lead to a complication called alveolar osteitis, more commonly known as dry socket, which causes pain.
Several actions must be avoided for the first 24 to 48 hours to prevent the dislodgement of this clot. Any negative pressure created in the mouth, such as spitting, sucking on hard candy, or drinking through a straw, must be avoided. Similarly, activities that increase blood pressure in the head, like vigorous exercise or bending over, should be postponed. Smoking is detrimental because the sucking motion and the chemicals in tobacco products can break down the clot and delay healing.
Manage pain using the medication prescribed by your surgeon, taking the first dose before the local anesthetic wears off completely. Hydration is important, but you should only sip liquids and avoid any forceful rinsing for the first day.