Managing the surgical site after wisdom tooth extraction requires careful attention, and the proper use of gauze is essential. A sterile gauze pad placed directly over the wound is necessary to achieve hemostasis, the process of stopping blood flow. Applying controlled pressure helps stabilize the forming blood clot, a protective barrier fundamental for proper healing. This initial clot allows for the soft tissue and bone regeneration that must occur in the empty socket. Without this pressure, bleeding can continue, and the healing process will be significantly delayed.
Preparing the Gauze Pad
Before handling the gauze, thoroughly wash your hands to maintain a clean environment for the surgical site. A standard piece of sterile gauze must be transformed into a dense, compact pad that can apply focused pressure. The goal is to create a cushion that will not unravel or simply absorb blood without actually pushing down on the wound.
To prepare the gauze, begin by taking two to three pieces of the provided material and stacking them on top of one another. Take this stack and fold it in half, then fold it in half again, creating a thick, narrow rectangle. A common alternative method is to place the material corner-to-corner and roll it up tightly, like a small scroll, to form a cylindrical shape. Both methods aim to maximize the density of the material, which translates directly into effective pressure.
The final prepared pad must be firm and dense enough to resist being flattened completely when bitten down upon. If the pad is too loose or thin, it will not exert the necessary force to compress the small blood vessels in the extraction socket. Some doctors recommend lightly moistening the prepared gauze with water before placement; this prevents the dry material from adhering to the delicate blood clot, which could cause the clot to dislodge when the gauze is later removed.
Correct Placement and Bite Pressure
The effectiveness of the gauze depends on its location and the pressure applied to it. The prepared pad must be positioned directly over the extraction site—the socket where the tooth was removed—not simply placed loosely in the cheek or between the chewing surfaces of the adjacent teeth. Proper placement ensures that the pressure is localized to the area where the bleeding is originating.
Once the gauze is in place, you must bite down with firm, steady pressure that holds the pad securely against the socket. This biting force promotes the formation of a stable clot within the socket. The pressure should be substantial enough to feel a definite compression but not so hard that it causes pain.
If you are only biting on the gauze with your front teeth, or if the pad is positioned too far forward, the pressure will be misdirected and ineffective. Improper placement allows the blood to pool around the wound instead of clotting, and it may lead to swallowing excess blood. If you notice your teeth clenching down completely, the gauze is likely too thin or misplaced and needs to be adjusted or replaced with a denser pad.
When to Change or Remove the Gauze
The initial gauze placed by the surgeon or dental assistant should remain undisturbed for the first 30 to 45 minutes following the procedure. This duration provides time for the initial blood clot to begin forming under continuous pressure. After this initial period, the gauze should be gently removed and assessed for the degree of saturation.
If the gauze is completely soaked with active bleeding, a fresh pad must be immediately placed back over the site. Repeat this process, changing the gauze every 30 to 45 minutes, until the discharge on the removed pad is a light pink or a faint red ooze. Changing the gauze too frequently, however, can be counterproductive as it may disrupt the fragile clot formation.
The gauze is no longer necessary once the pad remains mostly clean or only lightly stained. Expecting a completely dry pad is unrealistic, as some oozing can persist for up to 24 hours. If heavy bleeding continues after several hours of consistent gauze changes and firm pressure, contact your oral surgeon for further guidance.