Wisdom tooth extraction is a common surgical procedure where the third molars are removed, often because they are impacted or cause crowding. The procedure involves removing the tooth and manipulating surrounding gum tissue. Because the procedure disrupts blood vessels and soft tissue, some bleeding is a natural and expected part of the immediate recovery period. The body initiates coagulation to seal the wound and begin healing.
The Normal Bleeding Timeline
The most active bleeding occurs immediately following the procedure and should noticeably diminish over the next few hours. For most patients, the initial, darker red bleeding should significantly slow down or stop entirely within three to four hours after surgery. This cessation of flow results from hemostasis, where a stable blood clot forms within the empty socket, effectively sealing the wound.
After the active flow stops, light oozing is normal and can persist for up to 24 to 48 hours. This typically appears as pink-tinged saliva or subtle staining on the gauze, rather than a continuous stream of blood. Saliva mixing with a small amount of blood often makes the discharge look more dramatic than the actual blood loss. The primary sign of normal healing is that the bleeding gradually decreases in intensity over time.
The formation of a robust blood clot creates a temporary biological dressing over the extraction site. This clot is necessary to protect the underlying bone and nerve endings. As long as this clot remains secure, the wound has the foundation to begin tissue regeneration.
Practical Steps for Controlling Bleeding
The most effective way to manage post-extraction bleeding is by applying continuous, firm pressure directly to the surgical site. The oral surgeon places gauze pads over the socket immediately after the procedure. The patient must bite down on these pads with steady, gentle force for approximately 45 to 60 minutes. This mechanical pressure constricts the blood vessels and supports clot formation.
If bleeding continues after the initial gauze is removed, a fresh, clean pad should be folded into a tight cushion, placed directly over the socket, and held with firm pressure for another hour. As an alternative, some oral surgeons recommend using a damp black tea bag. The tannic acid in the tea acts as a mild vasoconstrictor, accelerating coagulation. This method requires the tea bag to be slightly moistened, wrapped in gauze, and placed over the site for 30 minutes.
Patients must avoid any action that creates negative pressure inside the mouth, as this can easily dislodge the newly formed blood clot. This includes refraining from spitting, forcefully rinsing, or drinking through a straw for at least the first 24 to 48 hours. Avoiding hot liquids, tobacco products, and strenuous physical activity is also necessary, as these increase blood flow and disrupt the healing process. Keeping the head slightly elevated during rest periods helps reduce blood pressure in the area, minimizing prolonged bleeding.
When Bleeding Signals a Problem
While some bleeding is expected, a significant hemorrhage requires professional attention. Abnormal bleeding is characterized by a heavy flow that soaks through a gauze pad in less than 30 to 45 minutes, even after an hour of firm, continuous pressure. This suggests the initial blood clot has failed to form or has been prematurely dislodged.
Bleeding that continues heavily beyond the first 24 hours should prompt a call to the oral surgeon’s office. A particularly concerning sign is bright red, pulsing blood, which may indicate that an artery or larger vessel has been affected. Patients should also monitor their pain level, as a sharp increase in discomfort accompanying persistent bleeding may signal a complication.
When contacting the dental professional, the patient should describe the color and rate of the blood flow, the last time pressure was applied, and the time the surgery was completed. This information allows the healthcare provider to determine the severity of the situation and provide instructions, which may include returning for examination or the application of specialized hemostatic agents.