Controlling blood loss is the immediate concern following a tooth extraction. This is achieved through the mechanical application of a properly folded gauze pad, which promotes hemostasis—the process by which a blood clot forms to seal the wound. This technique applies concentrated pressure directly to the extraction socket, stabilizing the forming blood clot and ensuring a smooth recovery.
Preparing the Materials
Before handling the gauze, wash your hands thoroughly with soap and water to prevent the introduction of bacteria to the surgical area. The most effective material is a sterile, woven gauze pad, typically 2×2 inch or 4×4 inch, which your oral surgeon provides. Avoid using household materials like cotton balls or tissue, as these can shred or fall apart, leaving small fibers in the wound site that could interfere with clotting. Aggressive rinsing should also be avoided, as it can dislodge a developing clot.
Step-by-Step Folding Technique
The goal of folding the gauze is to create a compact, dense cushion that exerts concentrated pressure, not a loose wad that only absorbs blood. Begin with two or three sterile gauze pads stacked flatly. Using multiple layers provides the necessary bulk and density for a firm bite.
Fold the stack in half once to create a rectangle, then fold the resulting rectangle in half again to form a small, thick square. Some professionals recommend slightly dampening the folded gauze with cool water and squeezing out the excess before placement; this prevents dry fibers from sticking to a newly formed blood clot upon removal. The final shape should be a firm plug ready to fit directly over the extraction site.
Effective Placement and Applying Pressure
Once the gauze is folded into a tight cushion, carefully position it directly over the empty tooth socket. The gauze must sit right on top of the wound, spanning the gap where the tooth was removed, allowing the top and bottom teeth to press down on it. Apply firm and sustained pressure by biting down, ensuring the folded gauze is compressed against the extraction site.
This mechanical pressure encourages the small blood vessels to constrict and allows the clot to stabilize. The pressure must be held continuously for 30 to 45 minutes, without checking the gauze or releasing the bite. During this time, avoid talking, chewing, or excessive swallowing, as any movement can disrupt the concentrated pressure or disturb the fragile blood clot.
Managing Bleeding After Gauze Removal
After the initial 30 to 45 minutes, gently remove the gauze to check the status of the bleeding. If the gauze is completely soaked with bright red blood or if active bleeding continues, the blood clot has not stabilized.
Apply a new, properly folded gauze cushion and repeat the process of biting down firmly for another 30 to 45 minutes until the bleeding significantly slows. When the bleeding has tapered, the gauze should appear light pink or have only a small spot of reddish-brown stain. If the gauze remains heavily saturated after two hours of continuous management, or if the bleeding seems heavy and uncontrolled, contact your oral surgeon or dentist for further guidance.