Post-extraction bleeding is a natural and expected part of the healing process following the removal of a tooth. The body initiates hemostasis to stop the flow of blood and form a protective blood clot in the empty socket. This clot acts as a natural dressing, shielding the underlying bone and nerves. While light oozing or pink-tinged saliva is normal for the first several hours, managing active flow ensures the clot remains stable. Preserving this clot is the foundation for proper tissue regeneration and recovery.
Initial Steps for Managing Bleeding
The most immediate and effective way to control post-extraction bleeding is by applying firm, consistent pressure to the surgical site. A sterile gauze pad should be folded into a thick square and placed directly over the socket. The patient must then bite down on the gauze with sustained pressure for a period of 30 to 60 minutes. This mechanical pressure compresses the small blood vessels, encouraging the formation of a stable fibrin mesh.
Maintain continuous pressure without frequently checking or changing the gauze, as repeated disturbance prevents the clot from forming completely. If bleeding persists after the initial hour, remove the old gauze and replace it with a fresh, clean pad, repeating the application of firm pressure. Keeping the head elevated above the level of the heart, such as by sitting upright, helps to lower blood pressure and reduce localized blood flow.
Alternative Methods If Bleeding Continues
If repeated applications of gauze and pressure do not fully stop the bleeding, an alternative compress can be utilized to promote coagulation. A plain black tea bag provides a method for controlling minor, persistent oozing. This method works because black tea naturally contains tannic acid, a compound known to have astringent properties.
To prepare this compress, moisten the tea bag slightly with cool water, squeeze out excess liquid, and place it directly over the socket. The patient should bite down firmly for 30 minutes, similar to the gauze technique. The tannic acid causes the blood vessels to constrict and helps to chemically stabilize the initial blood clot.
Activities to Avoid After Extraction
Preventing the dislodgement of the newly formed blood clot is a major focus of post-operative care, as its loss can lead to a painful condition known as dry socket. The primary actions to avoid are those that create negative pressure or suction within the mouth. This includes drinking through a straw, which can mechanically pull the clot from the socket, and smoking, which not only creates suction but also introduces chemicals that interfere with the healing process.
Patients should also refrain from vigorous rinsing, swishing, or spitting for at least the first 24 hours following the procedure. These forceful movements can physically break up the delicate clot. Strenuous physical activities and heavy lifting should also be postponed for several days, as they increase overall blood pressure, which may cause bleeding to restart or dislodge the clot.
Signs of Excessive Bleeding
While some blood-tinged saliva is normal, it is important to distinguish between minor oozing and active, uncontrolled bleeding. Bleeding that is considered abnormal requires immediate attention from a dental professional. A reliable indicator of problematic bleeding is when the gauze becomes completely saturated with bright red blood in less than 30 to 60 minutes.
Bleeding that continues for more than 12 hours after the extraction, despite consistent application of pressure, is also a cause for concern. The presence of large, continuous clots that resemble liver tissue, or an active flow of blood that cannot be stemmed, suggests that a larger vessel may be involved or that the clot is not forming properly. If the bleeding cannot be managed with sustained pressure and home care, contacting the dentist or oral surgeon is the appropriate next step.