Post-extraction bleeding is common after a tooth removal. While some oozing is a normal part of the healing process, continuous or heavy bleeding suggests the blood clot may be compromised. Understanding the difference between normal spotting and excessive bleeding is crucial for effective management. This article provides actionable steps for home care and defines when professional medical attention is necessary.
Immediate Steps to Control Bleeding
Applying direct pressure to the extraction site is the most effective immediate action for controlling bleeding. Fold a piece of sterile gauze into a thick pad, place it directly over the socket, and bite down firmly for 30 to 60 minutes without checking it. This sustained pressure helps compress the blood vessels and stabilize the forming blood clot. If the gauze becomes fully soaked, gently remove it and replace it with a fresh pad, ensuring pressure is applied directly to the wound.
If bleeding continues after two or three gauze changes, use a black tea bag as an alternative measure. Black tea contains tannic acid, a natural astringent that promotes vasoconstriction and accelerates blood coagulation. To use it, moisten the tea bag with lukewarm water, squeeze out the excess liquid, and bite down on it for 20 to 30 minutes.
Keeping your head elevated helps decrease blood pressure and aids in staunching the flow. Sit upright or remain propped up while resting, rather than lying flat. Applying a cold compress or ice pack wrapped in a cloth to the outside of the cheek can help constrict external blood vessels and minimize swelling. Apply the cold pack for 20 minutes on and 20 minutes off during the first 24 hours.
Activities That Increase Bleeding Risk
Certain actions can easily dislodge the protective blood clot, leading to renewed or prolonged bleeding. Avoid any activity that creates negative pressure or suction in the mouth, as this physically pulls the clot out of the socket. This includes using a straw, smoking or vaping, and forcefully spitting or rinsing the mouth.
Vigorous rinsing, even with water, should be avoided for at least the first 24 hours, as the physical force can disrupt the fragile healing site. If you need to clear your mouth, allow any liquid to passively drain out over the sink rather than spitting. Physical exertion, such as heavy lifting or intense exercise, increases overall blood pressure and can restart bleeding, so restrict strenuous activity for the first few days.
The food and drink you consume also play a role in clot stability. Avoid hot liquids and hot foods for the first 24 to 48 hours, as heat can dilate blood vessels and interfere with clot formation. Inform your dentist if you regularly take blood-thinning medications, such as aspirin or certain non-steroidal anti-inflammatory drugs, as these impede the body’s natural clotting ability.
When to Contact Your Dentist or Seek Urgent Care
While light oozing or pink-tinged saliva is normal for up to 24 hours, excessive bleeding requires professional attention. A warning sign is active, bright red bleeding that continues without slowing down despite one to two hours of continuous, firm pressure with gauze or a tea bag. Excessive bleeding is often defined as the gauze becoming completely saturated with blood within 15 to 20 minutes of application.
If bleeding persists for more than four to six hours after trying home remedies, contact your dental provider. Continuous flowing blood, rather than a manageable ooze mixed with saliva, suggests the clot is not forming or is being repeatedly dislodged. Persistent bleeding that lasts beyond 24 hours is considered abnormal and warrants immediate assessment.
Beyond the bleeding, be alert for signs of systemic complications or infection. Contact your dentist immediately if you experience severe, escalating pain not managed by prescribed medication, or if you develop a fever or chills. Excessive swelling that worsens significantly after the first 48 hours, or difficulty breathing or swallowing, requires seeking immediate care at an urgent care facility or emergency room.